title: Neutralizing antibody response and SARS severity.
abstract: Using the Taiwan nationwide laboratory-confirmed severe acute respiratory syndrome (SARS) database, we analyzed neutralizing antibody in relation to clinical outcomes. With a linear mixed model, neutralizing antibody titer was shown to peak between week 5 and week 8 after onset and to decline thereafter, with a half-life of 6.4 weeks. Patients with a longer illness showed a lower neutralizing antibody response than patients with a shorter illness duration (p = 0.008). When early responders were compared with most patients, who seroconverted on and after week 3 of illness, the small proportion (17.4%) of early responders (antibody detectable within 2 weeks) had a higher death rate (29.6% vs. 7.8%) (Fisher exact test, p = 0.004), had a shorter survival time of <2 weeks (Fisher exact test, p = 0.013), and were more likely to be > 60 years of age (Fisher exact test, p = 0.01). Our findings have implications for understanding the pathogenesis of SARS and for SARS vaccine research and development.
authors.affiliation: Academia Sinica, Taipei, Taiwan.
authors.forename: Mei-Shang
authors.initials: MS
authors.lastname: Ho
authors.forename: Wei-Ju
authors.initials: WJ
authors.lastname: Chen
authors.forename: Hour-Young
authors.initials: HY
authors.lastname: Chen
authors.forename: Szu-Fong
authors.initials: SF
authors.lastname: Lin
authors.forename: Min-Chin
authors.initials: MC
authors.lastname: Wang
authors.forename: Jiali
authors.initials: J
authors.lastname: Di
authors.forename: Yen-Ta
authors.initials: YT
authors.lastname: Lu
authors.forename: Ching-Lung
authors.initials: CL
authors.lastname: Liu
authors.forename: Shan-Chwen
authors.initials: SC
authors.lastname: Chang
authors.forename: Chung-Liang
authors.initials: CL
authors.lastname: Chao
authors.forename: Chwan-Chuen
authors.initials: CC
authors.lastname: King
authors.forename: Jeng-Min
authors.initials: JM
authors.lastname: Chiou
authors.forename: Ih-Jen
authors.initials: IJ
authors.lastname: Su
authors.forename: Jyh-Yuan
authors.initials: JY
authors.lastname: Yang
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009500:Neutralization Tests; D045473:Severe acute respiratory syndrome-related coronavirus / Q000276:immunology*; D045169:Severe Acute Respiratory Syndrome / Q000276:immunology / Q000401:mortality / Q000503:physiopathology* / Q000821:virology; D012720:Severity of Illness Index
chemical_list: D000914:Antibodies, Viral