• J. Intern. Med. · Feb 2022

    Low anti-SARS-CoV-2 S antibody levels predict increased mortality and dissemination of viral components in the blood of critical COVID-19 patients.

    • María Martin-Vicente, Raquel Almansa, Isidoro Martínez, Ana P Tedim, Elena Bustamante, Luis Tamayo, César Aldecoa, José Manuel Gómez, Gloria Renedo, Jose Ángel Berezo, Jamil Antonio Cedeño, Nuria Mamolar, Pablo García Olivares, Rubén Herrán-Monge, Ramón Cicuendez, Pedro Enríquez, Alicia Ortega, Noelia Jorge, Cristina Doncel, Amanda de la Fuente, Juan Bustamante-Munguira, María José Muñoz-Gómez, Milagros González-Rivera, Carolina Puertas, Vicente Más, Mónica Vázquez, Felipe Pérez-García, Jesús Rico-Feijoo, Silvia Martín, Anna Motos, Laia Fernandez-Barat, Jose María Eiros, Marta Dominguez-Gil, Ricard Ferrer, Ferrán Barbé, Wysali Trapiello, David J Kelvin, Jesús F Bermejo-Martin, Salvador Resino, and Antoni Torres.
    • Unidad de Infección Viral e Inmunidad, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Spain.
    • J. Intern. Med. 2022 Feb 1; 291 (2): 232-240.

    BackgroundAnti-SARS-CoV-2 S antibodies prevent viral replication. Critically ill COVID-19 patients show viral material in plasma, associated with a dysregulated host response. If these antibodies influence survival and viral dissemination in ICU-COVID patients is unknown.Patients/MethodsWe studied the impact of anti-SARS-CoV-2 S antibodies levels on survival, viral RNA-load in plasma, and N-antigenaemia in 92 COVID-19 patients over ICU admission.ResultsFrequency of N-antigenaemia was >2.5-fold higher in absence of antibodies. Antibodies correlated inversely with viral RNA-load in plasma, representing a protective factor against mortality (adjusted HR [CI 95%], p): (S IgM [AUC ≥ 60]: 0.44 [0.22; 0.88], 0.020); (S IgG [AUC ≥ 237]: 0.31 [0.16; 0.61], <0.001). Viral RNA-load in plasma and N-antigenaemia predicted increased mortality: (N1-viral load [≥2.156 copies/ml]: 2.25 [1.16; 4.36], 0.016); (N-antigenaemia: 2.45 [1.27; 4.69], 0.007).ConclusionsLow anti-SARS-CoV-2 S antibody levels predict mortality in critical COVID-19. Our findings support that these antibodies contribute to prevent systemic dissemination of SARS-CoV-2.© 2021 The Association for the Publication of the Journal of Internal Medicine.

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