2019年冠状病毒病(COVID-19),由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起,引起了全球大流行。早期和准确的诊断和隔离仍然是最有效的缓解策略。尽管逆转录酶聚合酶链反应(RT-qPCR)是COVID-19诊断的金标准,最近的研究表明,在大量具有COVID-19临床特征的病例中,核酸检测不到。SARS-CoV-2的血清学测定在COVID-19的诊断,了解病毒流行病学和筛选用于治疗和预防目的的恢复期血清中起作用,为了更好地了解对病毒的免疫反应,并评估特异性抗体反应的程度和持续时间。在这篇文章中,我们找到了PubMed,Embase,2022年12月1日前发表的文章和评论的中国国家知识基础设施(CNKI)和WEBSCI数据库。使用\"IgM,IgG,IgA,中和抗体,特异性抗体,COVID-19,动态特征\“作为关键词,并在此基础上进行了全面审查。根据作者的标准,只包括被认为相关的文章,涵盖原创文章,案例系列,实验研究,reviews,和病例报告。关于绩效评估的文章,意见片,技术问题被排除在外。从COVID-19症状开始,免疫球蛋白A(IgA)的中位血清转换时间为11天,IgA抗体滴度峰值的中位时间为23(16~30天).在免疫球蛋白G(IgG)之前检测免疫球蛋白M(IgM),在症状发作后2-5周达到峰值,在免疫能力强的患者中至少可检测到8周。中和抗体最早在疾病发作后6-7天内检测到,水平一直上升到14-22天,然后变平,然后下降,但临床轻度疾病的滴度较低。不同临床类型的患者对SARS-CoV-2的抗体反应不同,重症COVID-19患者>非重症COVID-19患者>无症状感染者,但在疾病的早期阶段没有区别。通常,IgM和IgA抗体比IgG抗体更早检测。IgA抗体在局部黏膜免疫中起重要作用。IgM抗体的检测往往表明最近暴露于SARS-CoV-2,而COVID-19IgG抗体的检测表明病毒暴露于一段时间前。在恢复期血浆中检测有效的中和抗体在开发治疗剂和疫苗的背景下是重要的。随着SARS-CoV-2免疫逃逸变种的出现,体液免疫受到挑战,对特异性抗体的详细了解对于指导疫苗设计策略和抗体介导的治疗至关重要。
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a global pandemic. Early and accurate diagnosis and quarantine remain the most effective mitigation strategy. Although reverse transcriptase polymerase chain reaction (RT-qPCR) is the gold standard for COVID-19 diagnosis, recent studies suggest that nucleic acids were undetectable in a significant number of cases with clinical features of COVID-19.Serological assays for SARS-CoV-2 play a role in diagnosis of COVID-19, in understanding viral epidemiology and screening convalescent sera for therapeutic and prophylactic purposes, to better understand the immune response to the virus, and to assess the degree and duration of the response of specific antibodies. In this article, we retrieved PubMed, Embase, China National Knowledge Infrastructure (CNKI) and WEB OF SCI databases for articles and reviews published before December 1, 2022. Using \"IgM, IgG,
IgA, neutralizing antibody, specific antibody,COVID-19, dynamic characteristics\" as keywords, and comprehensively reviewed on their basis.According to the authors\' criteria, only articles deemed relevant were included, covering original articles, case series, experimental studies, reviews, and case reports. Articles on performance evaluation, opinion pieces, and technical issues were excluded. From the onset of COVID-19 symptoms, the median time of seroconversion was 11 days for immunoglobulin A (
IgA), the median time of peak antibody titer was 23 (16-30 days) for IgA.Immunoglobulin M (IgM) is detected prior to immunoglobulin G (IgG), peaking 2-5 weeks post symptom onset and detectable for a minimum of 8 weeks in the immunocompetent.Neutralizing antibodies were earliest detectable within 6-7 days following disease onset, with levels increasing until days 14-22 before levelling and then decreasing, but titres were lower in clinically mild disease. Different clinical types of patients showed different antibody responses to SARS-CoV-2, with severe COVID-19 patients > non-severe COVID-19 patients > asymptomatic infected persons, but no difference in the early stage of the disease. Usually, IgM and
IgA antibodies are detectable earlier than IgG antibodies.IgA antibodys plays an important role in local mucosal immunity.Detection of IgM antibodies tends to indicate recent exposure to SARS-CoV-2, whereas the detection of COVID-19 IgG antibodies indicates virus exposure some time ago. The detection of potent neutralizing antibodies in convalescent plasma is important in the context of development of therapeutics and vaccines.With the emergence of immune escape variants of SARS-CoV-2, humoral immunity is being challenged, and a detailed understanding of Specific antibodies is critical to guide vaccine design strategies and antibody-mediated therapies.