新型冠状病毒感染者咽拭子病毒载量与抗体水平的动态分析-东南大学学报医学版

新型冠状病毒感染者咽拭子病毒载量与抗体水平的动态分析

单位：1. 南京大学医学院附属鼓楼医院检验科, 江苏南京 210008;
2. 南京中医药大学附属南京医院/南京市第二医院检验科, 江苏南京 210003

分类号：R511

出版年·卷·期（页码）：2021·40·第五期（645-652）

摘要：

目的：分析新型冠状病毒肺炎（COVID-19）患者的咽拭子病毒载量与其血清特异性抗体水平的相关性。方法：选取2020年1月至3月在南京市第二医院汤山分院收治的19例COVID-19患者，包括7例重症感染者和12例轻症感染者。通过实时荧光逆转录聚合酶链反应动态监测其咽拭子SARS-CoV-2核酸病毒载量。利用新型冠状病毒的4种蛋白（S1、ECD、RBD和NP）作为包被抗原，ELISA方法检测患者体内针对NP、S1、RBD、ECD蛋白的特异性IgM和IgG抗体水平，并分析病毒载量与抗体之间的动态变化模式。结果：通过ELISA实验发现，72.2%~93.1%的COVID-19血清标本为阳性；且在COVID-19发病进程中，所有患者体内均产生了针对新冠病毒抗原的特异抗体。COVID-19重症患者和轻症患者的病毒载量及抗体的动态变化模式呈多样化。结论：COVID-19重症患者的病毒载量较轻症患者显著增高；利用新冠病毒不同抗原蛋白能有效检出新冠病毒特异性抗体，其抗体水平在COVID-19患者中差异较大。

Objective: To analyze the correlation between the viral load of throat swabs from patients with novel coronavirus pneumonia (COVID-19) and antibody responses targeting at SARS-CoV-2. Methods: A total of 19 COVID-19 patients from the Tangshan Branch of Nanjing Second Hospital during the period of January to March 2020 were enrolled in this study, including 7 severe patients and 12 non-severe patients. Real-time fluorescent reverse transcription polymerase chain reaction (RT-PCR) was used to monitor SARS-CoV-2 viral load. An in-house ELISA assay was developed to measure the magnitude of viral specific IgM and IgG antibodies, targeting the four recombinant proteins S1, NP, ECD, RBD and from SARS-CoV-2 as coating antigens. Further, dynamic patterns of viral load and antibody levels were analyzed. Results: We found that 72.2%-93.1% of samples collected from different time points from COVID-19 patients were positive with our in-house ELISA assay, suggesting our assay is reliable. All patients included in this study generated virus specific antibodies against the four recombinant proteins. The dynamic change patterns of viral load and antibodies in severe and non-severe COVID-10 patients were diversified. Conclusion: The viral load of severe COVID-19 patients has increased significantly compared with that of mild patients; the use of different antigen proteins of the new coronavirus can effectively detect new coronavirus-specific antibodies varies greatly among COVID-19 patients.

参考文献：

[1] 国家卫生健康委办公厅,国家中医药管理局办公室.关于印发新型冠状病毒肺炎诊疗方案(试行第八版修订版)的通知(国卫办医函(2021)191号)[EB/OL].(2021-04-14).http://www.nhc.gov.cn/yzygj/s7653p/202104/7de0b3837c8b4606a0594aeb0105232b.shtml
[2] 国家卫生健康委办公厅,国家中医药管理局办公室.关于印发新型冠状病毒肺炎诊疗方案(试行第八版修订版)(国卫办医函(2021)191号)[EB/OL].(2021-04-14).http://www.nhc.gov.cn/yzygj/s7653p/202104/7de0b3837c8b4606a0594aeb0105232b/files/f192ac6e5567469db4f0a8691ca18907.pdf
[3] CHAN J F,TO K K,TSE H,et al.Interspecies transmision and emergence of novel viruses:lesons from bats and birds[J].Trends Microbiol,2013,21(10):544-555.
[4] CUI J,LI F,SHI Z L.Origin and evolution of pathogenic coronaviruses[J].Nat Rev Microbiol,2019,17(3):181-192.
[5] 邹明园,吴国球.抗原交叉反应对新型冠状病毒血清特异性抗体检测的影响[J].临床检验杂志,2020,38(3):161-163.
[6] 宁明哲,陶月,陈雨欣,等.新型冠状病毒血清特异性抗体检测的假性问题分析和对策探讨[J].现代检验医学杂志,2020,35(6):129-131.
[7] 陈咏竹,邱峰.刺突蛋白与新型冠状病毒的检测和治疗[J].生物医学工程学杂志,2020,37(2):246-250.
[8] ZHOU P,YANG X,WANG X,et al.Discovery of a novel coronavirus associated with the recent pneumonia outbreak in humans and its potential bat origin[J/OL].BioRxiv,2020,https://doi.org/10.1101/2020.01.22.914952.
[9] 唐骢宸,王丽春.冠状病毒的研究进展[J].中国呼吸与危重监护杂志,2020,19(4):330-336.
[10] 张瑞,吴国球.SARS-CoV-2的生物学性状和病毒检测方法以及COV1D-19的治疗现状[J].东南大学学报(医学版),2020,39(4):550-556.
[11] 王宾,钟一维.新冠疫苗的安全性和有效性的展望[J].中国科学基金,2020,34(5):581-587.

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