Wide Range of Antibody Responses After 'Mild' COVID-19: JAMA
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Patients hospitalized with mild COVID-19 in China exhibited a wide range of SARS-CoV-2-specific neutralizing antibodies, with a minority of patients with levels below the detectable limit of the assay, researchers found.

Out of 175 patients, 30% developed SARS-CoV-2-specific neutralizing antibody titers of less than 500, and 10 patients with neutralizing antibody titers under the detectable limit, reported researchers.

These titers tended to be higher in men versus women, and in older and middle-age patients versus younger patients, and those with indicators of stronger immune response, the authors wrote in JAMA Internal Medicine.

Researchers examined data from patients in Shanghai who were diagnosed with laboratory-confirmed COVID-19. They were isolated and hospitalized, but were classified as having "mild symptoms" (defined as fever, respiratory symptoms, and radiologic evidence of pneumonia). Severe and critical patients were excluded from the study, as they received antibody treatment.

Patients were discharged after being afebrile for 3 days, with improved respiratory symptoms, imaging that showed lessening of inflammation, and two sequential negative nucleic acid tests in nasopharyngeal samples. Plasma was collected at 2 weeks post-discharge and neutralizing antibody titers were measured against measurements obtained at discharge.

SARS-CoV-2-specific neutralizing antibody titers ranged from below the limit of detection to over 21,000 at the time of discharge, the authors said. The greatest proportion of patients (39%) had medium-high levels of neutralizing antibody titers, while 17% had medium-low levels, and 14% had high levels. Only two patients had neutralizing antibody titers with ID50 levels over 15,000.

Ultimately, the authors concluded that due to the wide range of antibody titers from patients with mild COVID-19 infection, the clinical implications for vaccine development and future preventative measures are still "unknown."

Source: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2769741
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