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Clinical and immunological assessment of asymptomatic SARS-CoV-2 infections.
Nature Medicine ( IF 58.7 ) Pub Date : 2020-06-18 , DOI: 10.1038/s41591-020-0965-6
Quan-Xin Long 1 , Xiao-Jun Tang 2 , Qiu-Lin Shi 2 , Qin Li 3 , Hai-Jun Deng 1 , Jun Yuan 1 , Jie-Li Hu 1 , Wei Xu 2 , Yong Zhang 2 , Fa-Jin Lv 4 , Kun Su 3 , Fan Zhang 5 , Jiang Gong 5 , Bo Wu 6 , Xia-Mao Liu 7 , Jin-Jing Li 7 , Jing-Fu Qiu 2 , Juan Chen 1 , Ai-Long Huang 1
Affiliation  

The clinical features and immune responses of asymptomatic individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have not been well described. We studied 37 asymptomatic individuals in the Wanzhou District who were diagnosed with RT–PCR-confirmed SARS-CoV-2 infections but without any relevant clinical symptoms in the preceding 14 d and during hospitalization. Asymptomatic individuals were admitted to the government-designated Wanzhou People’s Hospital for centralized isolation in accordance with policy1. The median duration of viral shedding in the asymptomatic group was 19 d (interquartile range (IQR), 15–26 d). The asymptomatic group had a significantly longer duration of viral shedding than the symptomatic group (log-rank P = 0.028). The virus-specific IgG levels in the asymptomatic group (median S/CO, 3.4; IQR, 1.6–10.7) were significantly lower (P = 0.005) relative to the symptomatic group (median S/CO, 20.5; IQR, 5.8–38.2) in the acute phase. Of asymptomatic individuals, 93.3% (28/30) and 81.1% (30/37) had reduction in IgG and neutralizing antibody levels, respectively, during the early convalescent phase, as compared to 96.8% (30/31) and 62.2% (23/37) of symptomatic patients. Forty percent of asymptomatic individuals became seronegative and 12.9% of the symptomatic group became negative for IgG in the early convalescent phase. In addition, asymptomatic individuals exhibited lower levels of 18 pro- and anti-inflammatory cytokines. These data suggest that asymptomatic individuals had a weaker immune response to SARS-CoV-2 infection. The reduction in IgG and neutralizing antibody levels in the early convalescent phase might have implications for immunity strategy and serological surveys.



中文翻译:

无症状SARS-CoV-2感染的临床和免疫学评估。

尚未充分描述感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的无症状个体的临床特征和免疫应答。我们对万州地区的37名无症状患者进行了研究,这些患者在前14天和住院期间被诊断为RT-PCR确诊的SARS-CoV-2感染,但没有任何相关的临床症状。根据政策1,无症状者被送往政府指定的万州人民医院进行集中隔离。无症状组中病毒脱落的中位时间为19 d(四分位间距(IQR),15-26 d)。无症状组的病毒脱落持续时间明显长于有症状组(对数秩P = 0.028)。无症状组的病毒特异性IgG水平(中位数S / CO为3.4; IQR为1.6-10.7)显着降低(P 相对于急性期的症状组(中位数S / CO,20.5; IQR,5.8-38.2)= 0.005。在无症状个体中,恢复期初期,IgG和中和抗体水平分别降低了93.3%(28/30)和81.1%(30/37),而96.8%(30/31)和62.2%( 23/37)有症状的患者。在早期恢复期,有40%的无症状个体呈血清阴性,而有症状组的12.9%呈阴性。此外,无症状的个体表现出较低水平的18种促炎和抗炎细胞因子。这些数据表明,无症状个体对SARS-CoV-2感染的免疫反应较弱。恢复期早期IgG和中和抗体水平的降低可能对免疫策略和血清学检查有影响。

更新日期:2020-06-18
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