Abstract
The development and persistence of SARS-CoV-2-specific immune response in immunocompetent (IC) and immunocompromised patients is crucial for long-term protection. Immune response to SARS-CoV-2 infection was analysed in 57 IC and 15 solid organ transplanted (TX) patients. Antibody responses were determined by ELISA and neutralization assay. T-cell response was determined by stimulation with peptide pools of the Spike, Envelope, Membrane, and Nucleocapsid proteins with a 20-h Activation Induced Marker (AIM) and 7-day lymphoproliferative assays. Antibody response was detected at similar levels in IC and TX patients. Anti-Spike IgG, IgA and neutralizing antibodies persisted for at least one year, while anti-Nucleocapsid IgG declined earlier. Patients with pneumonia developed higher antibody levels than patients with mild symptoms. Similarly, both rapid and proliferative T-cell responses were detected within the first two months after infection at comparable levels in IC and TX patients, and were higher in patients with pneumonia. T-cell response persisted for at least one year in both IC and TX patients. Spike, Membrane, and Nucleocapsid proteins elicited the major CD4+ and CD8+ T-cell responses, whereas the T-cell response to Envelope protein was negligible. After SARS-CoV-2 infection, antibody and T-cell responses develop rapidly and persist over time in both immunocompetent and transplanted patients.
Highlights
A novel coronavirus named SARS-CoV-2 has been identified as the causative agent of a global outbreak of a respiratory tract disease, referred to as COVID-19 [1,2].COVID-19 is characterised by fever, cough, dyspnoea, and myalgia
One of the six TX patients with mild symptoms died from sudden death five months after the resolution of SARS-CoV-2 infection, with no apparent direct link with COVID-19
SARS-CoV-2 specific antibody response in post COVID-19 IC and TX patients was compared at two sequential time points during convalescent periods, in both pneumonia and mild symptoms patients
Summary
A novel coronavirus named SARS-CoV-2 has been identified as the causative agent of a global outbreak of a respiratory tract disease, referred to as COVID-19 [1,2].COVID-19 is characterised by fever, cough, dyspnoea, and myalgia. Several studies reported that IgG antibodies persist longer in immunocompetent patients with severe SARS-CoV-2 infection compared to milder cases [4,5]. The IgG and IgA titres were higher in patients with severe symptoms [5,6,7]. A study reported no difference between mild and severe immunocompetent patients [8]. Higher titres of neutralizing antibodies (Nt Ab) were detected in the most clinically severe cases [9,10,11,12,13,14], while no neutralizing activity was detected in plasma from the majority of asymptomatic cases [12]
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