Neutralizing antibody response and SARS severity.
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.
Ho
Mei-Shang
MS
Academia Sinica, Taipei, Taiwan.
Chen
Wei-Ju
WJ
Chen
Hour-Young
HY
Lin
Szu-Fong
SF
Wang
Min-Chin
MC
Di
Jiali
J
Lu
Yen-Ta
YT
Liu
Ching-Lung
CL
Chang
Shan-Chwen
SC
Chao
Chung-Liang
CL
King
Chwan-Chuen
CC
Chiou
Jeng-Min
JM
Su
Ih-Jen
IJ
Yang
Jyh-Yuan
JY
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
D000914:Antibodies, Viral