目的动态监测COVID-19确诊患者SARS-CoV-2感染后体内特异性IgM和IgG抗体的变化特点,并分析其临床意义。
方法收集2020年1月8日至2月21日在河南省疾病预防控制中心核酸检测阳性的56例COVID-19确诊患者不同病程的168份血清样本,已排除COVID-19的25例健康人群的血清样本作为对照组,采用化学发光法检测SARS-CoV-2 IgM和IgG抗体。
结果IgM抗体在发病后1~3周急剧上升,在发病后第3周达到峰值(21.78 AU/ml);IgG抗体在发病后3~6周上升幅度最大,在发病后第9周达到峰值(81.58 AU/ml); IgM和IgG抗体水平与患者年龄和病程密切相关( P<0.05)。其中30~60岁组抗体水平最高,急性期、既往感染IgM抗体阳性率与抗体水平低于恢复期,急性期IgG抗体阳性率与抗体水平均低于恢复期和既往感染;在整个病程中,IgM和IgG抗体水平总体呈现急性期逐渐升高、恢复期达到高峰、既往感染下降并维持在一定水平的趋势。
结论血清SARS-CoV-2 IgM和IgG抗体检测可作为COVID-19的辅助诊断指标,对其连续观测有助于流行病学调查、血清学诊断及病程监测。
ObjectiveTo monitor the changes in specific IgM and IgG antibodies in patients diagnosed with COVID-19 after SARS-CoV-2 infection, and analyze their clinical significance.
MethodsA total of 168 serum samples were collected from 56 COVID-19 patients with different disease courses who were positive for nucleic acid test at Henan Center for Disease Control and Prevention on January 8, 2020 and February 21, 2020. Serum samples from 25 healthy people excluded from COVID-19 were used as control group. IgM and IgG antibodies against SARS-CoV-2 were detected by chemiluminescence method.
ResultsIgM antibody increased sharply in 1-3 weeks after onset, and reached the peak value (21.78 AU/ml) in the 3rd week after onset. IgG antibody increased the most in 3-6 weeks after onset, and reached the peak value (81.58 AU/ml) in the 9th week after onset. The levels of IgM and IgG antibodies were closely correlated with age and disease course ( P<0.05). The antibody level of 30-60 years old group was the highest, the IgM antibody positive rate and antibody level of acute stage and previous infection were lower than that of recovery stage, and the IgG antibody positive rate and antibody level of acute stage were lower than that of recovery stage and previous infection. During the whole course of the disease, the levels of IgM and IgG antibodies increased gradually in the acute stage, reached the peak in the recovery stage, and decreased and maintained at a certain level in the past infection.
ConclusionsSerum SARS-CoV-2 IgM and IgG antibody detection can be used as auxiliary diagnostic indicators for COVID-19, and its continuous observation is helpful for epidemiological investigation, serological diagnosis and disease course monitoring.
宋云,毋碧聪,卢世栋,等. 新型冠状病毒肺炎患者血清IgM和IgG抗体动态变化分析[J]. 中华微生物学和免疫学杂志,2021,41(06):417-422.
DOI:10.3760/cma.j.cn112309-20210319-00090版权归中华医学会所有。
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病程 | 标本采集距发病天数 | 标本数量( n) | IgM抗体 | IgG抗体 | |||
---|---|---|---|---|---|---|---|
阳性率(%) | 抗体水平(AU/ml) | 阳性率(%) | 抗体水平(AU/ml) | ||||
急性期 | 第1周(1~7 d) | 34 | 47.06 | 0.75 | 88.24 | 2.16 | |
第2周(8~14 d) | 16 | 68.75 | 7.68 | 81.25 | 6.72 | ||
第3周(15~21 d) | 6 | 83.33 | 21.78 | 83.33 | 9.62 | ||
恢复期 | 第5周(28~35 d) | 8 | 87.50 | 5.60 | 100.00 | 51.44 | |
第6周(36~42 d) | 4 | 100.00 | 15.82 | 100.00 | 70.60 | ||
第7周(43~49 d) | 18 | 94.44 | 10.33 | 100.00 | 59.75 | ||
第8周(50~56 d) | 20 | 95.00 | 6.68 | 100.00 | 45.53 | ||
第9周(57~63 d) | 6 | 100.00 | 14.07 | 100.00 | 81.58 | ||
既往感染 | 第26周(175~182 d) | 4 | 50.00 | 1.54 | 100.00 | 5.17 | |
第27周(183~189 d) | 8 | 75.00 | 2.03 | 87.50 | 22.76 | ||
第28周(190~196 d) | 20 | 65.00 | 2.20 | 100.00 | 18.67 | ||
第29周(197~203 d) | 20 | 75.00 | 1.48 | 100.00 | 15.17 | ||
第30周(204~210 d) | 4 | 75.00 | 3.22 | 100.00 | 23.77 | ||
总计 | |||||||
急性期 | 第1~3周(1~21 d) | 56 | 57.14 | 2.01 | 85.71 | 2.48 | |
恢复期 | 第5~9周(28~63 d) | 56 | 94.64 | 7.40 | 100.00 | 59.16 | |
既往感染 | 第26~30周(175~210 d) | 56 | 69.64 | 1.66 | 98.21 | 16.99 |

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