Abstract
We investigated the kinetics of the Middle East respiratory syndrome coronavirus (MERS-CoV) neutralizing and spike protein antibody titers over the course of 1 year in 11 patients who were confirmed by reverse transcription PCR to have been infected during the outbreak in South Korea in 2015. Robust antibody responses were detected in all survivors who had severe disease; responses remained detectable, albeit with some waning, for <1 year. The duration of viral RNA detection (but not viral load) in sputum significantly correlated with the antibody response magnitude. The MERS S1 ELISA antibody titers correlated well with the neutralizing antibody response. Antibody titers in 4 of 6 patients who had mild illness were undetectable even though most had evidence of pneumonia. This finding implies that MERS-CoV seroepidemiologic studies markedly underestimate the extent of mild and asymptomatic infection. Obtaining convalescent-phase plasma with high antibody titers to treat MERS will be challenging.
Highlights
We investigated the kinetics of the Middle East respiratory syndrome coronavirus (MERS-CoV) neutralizing and spike protein antibody titers over the course of 1 year in 11 patients who were confirmed by reverse transcription PCR to have been infected during the outbreak in South Korea in 2015
Because of the small number of patients given this treatment, evaluating its quality with a statistical analysis was not possible. With this cohort of patients, we had previously reported that the severity of illness was associated with higher neutralizing antibody responses and ELISA optical density (OD) in the acute phase of illness [7]
The analysis of antibody titers at ≈1 year after illness shows that these higher antibody titers continue to persist for at least 1 year
Summary
We investigated the kinetics of the Middle East respiratory syndrome coronavirus (MERS-CoV) neutralizing and spike protein antibody titers over the course of 1 year in 11 patients who were confirmed by reverse transcription PCR to have been infected during the outbreak in South Korea in 2015. Antibody titers in 4 of 6 patients who had mild illness were undetectable even though most had evidence of pneumonia This finding implies that MERS-CoV seroepidemiologic studies markedly underestimate the extent of mild and asymptomatic infection. The kinetics of the serologic responses during the acute phase have already been reported, and they showed that robust but delayed antibody responses could be detected in patients who were more severely ill [7]. Another study reported a significant linear correlation between the log viral loads and the serologic response in the acute phase of illness [8]. We report the results of a 1-year follow-up on the antibody responses in 11 of these patients
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