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Factors of severity in patients with COVID-19: Cytokine/Chemokine concentrations, viral load, and antibody responsesopen access

Authors
Kwon, Ji-SooKim, Ji YeunKim, Min-ChulPark, Se YoonKim, Baek-NamBae, SeongmanCha, Hye HeeJung, JiwonKim, Min-JaeLee, Myung JinChoi, Seong-HoChung, Jin-WonShin, Eui-CheolKim, Sung-Han
Issue Date
Dec-2020
Publisher
American Society of Tropical Medicine and Hygiene
Citation
American Journal of Tropical Medicine and Hygiene, v.103, no.6, pp 2412 - 2418
Pages
7
Journal Title
American Journal of Tropical Medicine and Hygiene
Volume
103
Number
6
Start Page
2412
End Page
2418
URI
https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/52507
DOI
10.4269/ajtmh.20-1110
ISSN
0002-9637
1476-1645
Abstract
The severity of COVID-19 ranges from mild to critical diseases. However, limited data have been published on the detailed kinetics of viral load and host immune response throughout the disease course depending on disease severity. In this study, we comprehensively analyzed viral load, antibody responses to SARS-CoV-2, and cytokines/ chemokines during the disease course, and identified the factors related to severity. Nasopharyngeal (NP) and plasma specimens were obtained from 31 patients with COVID-19 during hospitalization. Viral RNA in NP specimens was quantified by reverse transcription-PCR. Anti-SARS-CoV-2 antibodies and cytokines/chemokines in plasma specimens were analyzed by ELISA and cytometric bead array. The viral load in patients with COVID-19 peaked at the early stage of the disease and continuously decreased. Severe and critical cases showed higher viral load and prolonged viral shedding than asymptomatic and mild cases. Whereas plasma IgG was gradually increased and maintained during hospitalization, plasma IgM peaked at 3 weeks after symptom onset and dissipated. The antibody response in severe and critical cases was slightly delayed but stronger than those in others. High levels of interferon (IFN)-α, IFN-γ-induced protein-10, monokine induced by IFN-γ, and interleukin-6 at 5-10 days from symptom onset were associated with the severity of COVID-19. Our data indicate that high viral load in the respiratory tract and excessive production of cytokines and chemokines between 1 and 2 weeks from the symptom onset were significantly associated with the severity of COVID-19. © 2020 American Society of Tropical Medicine and Hygiene. All rights reserved.
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의과대학 (의학부(임상-광명))
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