anti-SARS-CoV-2 antibodies

抗 SARS - CoV - 2 抗体
  • 文章类型: Journal Article
    背景:疫苗接种是预防传染病的最有效的医学干预措施之一。推出针对冠状病毒急性呼吸道综合症2(SARS-CoV-2)的疫苗旨在预防2019年冠状病毒疾病(COVID-19)导致的严重疾病和死亡。实体器官移植受者(SOTR)感染SARS-CoV-2和与COVID-19相关的严重影响的风险很高,主要是由于使用免疫抑制疗法,这进一步导致对COVID-19疫苗接种的反应欠佳。
    目的:我们旨在比较肾胰腺移植受者对BNT162b2的接种后反应,特别是在有免疫能力的个体中,两年多的同步监测。
    方法:为了确定体液反应,测量IgG和IgA抗S1抗体的水平.为了评估对SARS-CoV-2的细胞应答,测定释放的IFN-γ-S1。
    结论:初次接种疫苗后,与有免疫能力的受试者相比,SOTR显示两种抗体类型的血清转化较低。在基线疫苗接种后,仅额外剂量产生对照组达到的水平的抗体。在监测期间,与免疫功能正常的个体相比,SOTR没有获得积极的细胞反应,所以为了获得更长的保护,包括免疫记忆,应考虑采用加强剂量的疫苗。
    BACKGROUND: Vaccination is one of the most effective medical interventions to prevent infectious diseases. The introduction of vaccines against coronavirus acute respiratory syndrome 2 (SARS-CoV-2) was aimed at preventing severe illness and death due to coronavirus disease 2019 (COVID-19). Solid organ transplant recipients (SOTRs) are at high risk of infection with SARS-CoV-2 and serious effects associated with COVID-19, mainly due to the use of immunosuppressive therapies, which further cause suboptimal response to COVID-19 vaccination.
    OBJECTIVE: We aimed to compare post-vaccination response to BNT162b2 in kidney-pancreas transplant recipient, specifically in immunocompetent individuals, over two years of simultaneous monitoring.
    METHODS: To determine the humoral response, the levels of the IgG and IgA anti-S1 antibodies were measured. To assess the cellular response to SARS-CoV-2, the released IFN-γ-S1 was determinate.
    CONCLUSIONS: After primary vaccination, compared to immunocompetent subjects, SOTR showed lower seroconversion for both antibody classes. Only the additional dose produced antibodies at the level reached by the control group after the baseline vaccination. During the monitored period, SOTR did not achieve a positive cellular response in contrast to immunocompetent individuals, so in order to obtain longer protection, including immune memory, the adoption of booster doses of the vaccine should be considered.
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  • 文章类型: Journal Article
    背景:导致COVID-19严重病程的免疫学背景和预防SARS-CoV-2感染的免疫因子尚不清楚。这项研究的目的是调查高度暴露于SARS-CoV-2感染的人的免疫系统状况。
    方法:在2020年11月至2021年10月期间,观察和传染病单位雇用的71名人员符合研究条件。有症状的COVID-19被诊断为35人。在8人中还发现了抗SARS-CoV-2抗体。通过流式细胞术分析外周血单个核细胞亚群,通过ELISA测定细胞因子和抗SARS-CoV-2抗体的浓度。
    结果:细胞毒性T淋巴细胞(CTL)的百分比,有症状的COVID-19患者具有不变T细胞受体的CD28+和T辅助(Th)细胞明显高于没有出现COVID-19症状的患者。相反,有症状的COVID-19人的百分比显着降低:a)激活后期的CTL(CD8/CD95),b)NK细胞,c)调节性Th细胞(CD4+/CTLA-4+),和d)Th17样细胞(CD4+/CD161+)与无症状COVID-19人相比。此外,具有抗SARS-CoV-2抗体的人的淋巴细胞计数和IL-6浓度显著高于没有这些抗体的人.
    结论:许多淋巴细胞群被SARS-CoV-2感染永久改变。两种群体的高百分比:NK细胞-作为非特异性反应的一部分,和T辅助细胞作为调节免疫反应的细胞,可以预防急性COVID-19症状的发展。了解COVID-19的免疫背景可能会通过识别有严重感染过程风险的人来改善对这种疾病的预防。
    背景:这是一项回顾性观察性研究,没有试验登记号。
    BACKGROUND: The immunological background responsible for the severe course of COVID-19 and the immune factors that protect against SARS-CoV-2 infection are still unclear. The aim of this study was to investigate immune system status in persons with high exposure to SARS-CoV-2 infection.
    METHODS: Seventy-one persons employed in the observation and infectious diseases unit were qualified for the study between November 2020 and October 2021. Symptomatic COVID-19 was diagnosed in 35 persons. Anti-SARS-CoV-2 antibodies were also found in 8 persons. Peripheral blood mononuclear cells subpopulations were analyzed by flow cytometry, and the concentrations of cytokines and anti-SARS-CoV-2 antibodies were determined by ELISA.
    RESULTS: The percentages of cytotoxic T lymphocytes (CTLs), CD28+ and T helper (Th) cells with invariant T-cell receptors were significantly higher in persons with symptomatic COVID-19 than in those who did not develop COVID-19\' symptoms. Conversely, symptomatic COVID-19 persons had significantly lower percentages of: a) CTLs in the late stage of activation (CD8+/CD95+), b) NK cells, c) regulatory-like Th cells (CD4+/CTLA-4+), and d) Th17-like cells (CD4+/CD161+) compared to asymptomatic COVID-19\' persons. Additionally, persons with anti-SARS-CoV-2 antibodies had a significantly higher lymphocyte count and IL-6 concentration than persons without these antibodies.
    CONCLUSIONS: Numerous lymphocyte populations are permanently altered by SARS-CoV-2 infection. High percentages of both populations: NK cells-as a part of the non-specific response, and T helper cells\' as those regulating the immune response, could protect against the acute COVID-19 symptoms development. Understanding the immune background of COVID-19 may improve the prevention of this disease by identifying people at risk of a severe course of infection.
    BACKGROUND: This is a retrospective observational study without a trial registration number.
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  • 文章类型: Journal Article
    在大流行开始时,建议将含有抗SARS-CoV-2抗体的COVID-19恢复期血浆(CCP)作为治疗来源。在过去的3年里,许多试验证明CCP治疗的有效性有限.这导致我们假设中共可能包含其他元素,以及所需的中和抗体,这可能会阻止它产生治疗效果,其中细胞因子,趋化因子,生长因子,凝血因子,和自身抗体。
    总共,在190名献血者的血浆中分析了39种细胞因子,进一步的研究集中在CCP中23种不同的细胞因子(sCD40L,eotaxin,FGF-2,FLT-3L,ractalkine,GRO-α,IFNα2,IL-1β,IL-1RA,IL-5、IL-6、IL-8、IL-12、IL-13、IL-15、IL-17E、IP-10,MCP-1,MIP-1b,PDGF-AA,TGFα,TNFα,和TRAIL)。在CCP中检测到抗SARS-CoV-2抗体和中和抗体。
    我们发现在首次出现COVID-19症状后最多180天内服用的CCP与对照组之间没有显着差异。我们还比较了低中和抗体(<160)组和高中和抗体(≥160)组之间的细胞因子水平,发现两组之间没有差异。我们的研究还显示与抗SARS-CoV-2IgGAb的水平或中和抗体的水平没有相关性。根据COVID-19症状开始后的一段时间,细胞因子水平也没有显著变化。
    没有发现可能导致预防CCP产生治疗作用的元素。
    UNASSIGNED: At the beginning of the pandemic, COVID-19 convalescent plasma (CCP) containing anti-SARS-CoV-2 antibodies was suggested as a source of therapy. In the last 3 years, many trials have demonstrated the limited usefulness of CCP therapy. This led us to the hypothesis that CCP could contain other elements, along with the desired neutralizing antibodies, which could potentially prevent it from having a therapeutic effect, among them cytokines, chemokines, growth factors, clotting factors, and autoantibodies.
    UNASSIGNED: In total, 39 cytokines were analyzed in the plasma of 190 blood donors, and further research focused on the levels of 23 different cytokines in CCP (sCD40L, eotaxin, FGF-2, FLT-3L, ractalkine, GRO-α, IFNα2, IL-1β, IL-1RA, IL-5, IL-6, IL-8, IL-12, IL-13, IL-15, IL-17E, IP-10, MCP-1, MIP-1b, PDGF-AA, TGFα, TNFα, and TRAIL). Anti-SARS-CoV-2 antibodies and neutralizing antibodies were detected in CCP.
    UNASSIGNED: We found no significant differences between CCP taken within a maximum of 180 days from the onset of the first COVID-19 symptoms and the controls. We also made a comparison of the cytokine levels between the low neutralizing antibodies (<160) group and the high neutralizing antibodies (≥160) group and found there were no differences between the groups. Our research also showed no correlation either to levels of anti-SARS-CoV-2 IgG Ab or to the levels of neutralizing antibodies. There were also no significant changes in cytokine levels based on the period after the start of COVID-19 symptoms.
    UNASSIGNED: No elements which could potentially be responsible for preventing CCP from having a therapeutic effect were found.
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  • 文章类型: Journal Article
    背景:在COVID-19大流行期间快速引入疫苗的目的是减少SARS-CoV-2传播和减少严重COVID-19病程的发生频率。因此,我们评估了接种疫苗个体的COVID-19严重程度,以检查变异特异性症状特征及其对血清学免疫反应的临床影响.
    方法:总共有185个人以前接种并感染了SARS-CoV-2Delta(B.1.617.2)或Omicron(BA.4和BA.5)变体,参加抗SARS-CoV-2抗N-和抗RBD/S1-Ig水平检测。进行了关于病史的结构化调查。
    结果:在99.5%的病例中,门诊治疗令人满意。与变异相关的特定症状包括Delta感染患者的失语和失语症以及Omicron感染患者的咽喉疼痛。在有特定症状的三角洲感染者中,观察到明显更高水平的抗N抗体。
    结论:我们的研究确定了SARS-CoV-2抗体产生量和COVID-19症状的变异特异性差异。尽管如此,接种Omicron或Delta感染的个体通常经历轻度疾病过程。此外,无症状个体表现出较低的抗SARS-CoV-2抗体水平,表明疾病特异性抗体和不同症状之间的临床相关性,特别是在Delta变体的情况下。在后续研究中,探索COVID后综合征并关注Omicron感染急性期的认知症状至关重要,因为它有可能纵向影响受影响者的生活。
    BACKGROUND: The aim of the rapid introduction of vaccines during the COVID-19 pandemic was a reduction in SARS-CoV-2 transmission and a less frequent occurrence of severe COVID-19 courses. Thus, we evaluated COVID-19 severity in vaccinated individuals to examine variant-specific symptom characteristics and their clinical impact on the serological immune response.
    METHODS: A total of 185 individuals previously vaccinated against and infected with the SARS-CoV-2 Delta (B.1.617.2) or Omicron (BA.4 and BA.5) variant, were enrolled for anti-SARS-CoV-2 anti-N- and anti-RBD/S1-Ig level detection. A structured survey regarding medical history was conducted.
    RESULTS: In 99.5 percent of cases, outpatient treatment was satisfactory. Specific symptoms associated with variants included ageusia and anosmia in patients with Delta infections and throat pain in Omicron infections. Among Delta-infected individuals with specific symptoms, significantly higher levels of anti-N antibodies were observed.
    CONCLUSIONS: Our study identified variant-specific differences in the amount of SARS-CoV-2 antibody production and COVID-19 symptoms. Despite this, vaccinated individuals with Omicron or Delta infections generally experienced mild disease courses. Additionally, asymptomatic individuals exhibit lower anti-SARS-CoV-2 antibody levels, indicating a clinical correlation between disease-specific antibodies and distinct symptoms, particularly in the case of the Delta variant. In follow-up studies, exploring post-COVID syndrome and focusing on cognitive symptoms in the acute phase of Omicron infections is crucial as it has the potential to longitudinally impact the lives of those affected.
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  • 文章类型: Systematic Review
    目标:全球,已经报告了超过7.72亿例COVID-19病例。在病例编号中具有相应尖峰的感兴趣的新变体继续被鉴定。脆弱的病人,包括老年人或患有严重合并症的患者,继续处于危险之中。关于抗SARS-CoV-2-抗体和COVID-19的大量证据已经积累,但抗体测量的有用性仍不清楚。本系统综述旨在评估抗SARS-CoV-2抗体的预后价值及其对指导加强疫苗接种的有用性。
    方法:包括2020年1月至2023年10月发表的英文研究。依赖于多参数模型或包含少于100名参与者的研究被排除在外。PubMed和通过WHOCOVID-19研究数据库,检索Embase和Medline数据库。研究选择和质量评估由两名研究人员独立进行。
    结果:在筛选1,160项研究后,包括超过3000万个体的33项研究。抗SARS-CoV-2抗体与降低SARS-CoV-2感染的风险和更好的结果密切相关。包括死亡率。感染风险和COVID-19严重程度随着抗体水平的增加而降低。
    结论:抗SARS-CoV-2-抗体有助于早期识别高危患者并及时调整治疗方案。可以应用保护阈值来建议加强疫苗接种,但需要在单独的队列中进行验证。
    OBJECTIVE: Globally, over 772 million cases of COVID-19 have been reported. New variants of interest with corresponding spikes in case numbers continue to be identified. Vulnerable patients, including older adults or patients with severe comorbidities, continue to be at risk. A large body of evidence has been accumulated regarding anti-SARS-CoV-2-antibodies and COVID-19 but the usefulness of antibody measurements remains unclear. This systematic review aims to assess the prognostic value of anti-SARS-CoV-2-antibodies and their usefulness for guiding booster vaccinations.
    METHODS: Studies in English and published between January 2020 and October 2023 were included. Studies that relied on multiparameter-models or comprised fewer than 100 participants were excluded. PubMed and via the WHO COVID-19 research database, Embase and Medline databases were searched. Study selection and quality assessment was conducted independently by two researchers.
    RESULTS: After screening 1,160 studies, 33 studies comprising >30 million individuals were included. Anti-SARS-CoV-2-antibodies were strongly associated with reduced risk of SARS-CoV-2-infection and better outcomes, including mortality. Risk of infection and COVID-19 severity decreased with increasing antibody levels.
    CONCLUSIONS: Anti-SARS-CoV-2-antibodies are useful for early identification of high-risk patients and timely adjustment of therapy. Protective thresholds may be applied to advise booster vaccinations but verification in separate cohorts is required.
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  • 文章类型: Journal Article
    自2020年3月COVID-19大流行爆发以来,确诊病例超过7.69亿例,包括近700万例与COVID-19相关的死亡,已被报道。尽管与大流行的头几个月相比,死亡率显着下降,报告的病例和死亡率继续上升。最近病例数的激增和新变异的持续出现都表明,脆弱的患者群体,包括老年人,免疫力低下的患者,有严重合并症的病人,将继续受到COVID-19的影响。为了遏制大流行,减轻初级保健设施的压力,降低死亡率,世界卫生组织已经建立了全球疫苗接种计划,全球已经接种了超过135亿剂疫苗。在大多数有免疫能力的人中,针对COVID-19的疫苗接种导致抗SARS-CoV-2尖峰抗体的产生。然而,某些患者亚群的免疫反应不足或降低,已知免疫反应会随着年龄的增长而降低。因此,关于加强疫苗接种时间的一般建议可能不足以保护脆弱的患者。本文旨在评估抗SARS-CoV-2抗体的临床作用。专注于测量指示,预后价值,以及作为保护相关因素的潜力,以指导未来的加强疫苗接种策略。
    Since the onset of the COVID-19 pandemic in March 2020, over 769 million confirmed COVID-19 cases, including close to 7 million COVID-19-related deaths, have been reported. Although mortality rates have dropped notably compared to the first months of the pandemic, spikes in reported cases and mortality rates continue to be registered. Both recent spikes in case numbers and the continued emergence of new variants suggest that vulnerable patient groups, including older adults, immunocompromised patients, and patients with severe comorbidities, are going to continue to be affected by COVID-19. In order to curb the pandemic, relieve the pressure on primary care facilities, and reduce mortality rates, global vaccination programs have been established by the WHO, with over 13.5 billion vaccine doses having been administered globally. In most immunocompetent individuals, vaccination against COVID-19 results in the production of anti-SARS-CoV-2 spike antibodies. However, certain patient subsets have inadequate or reduced immune responses, and immune responses are known to decrease with age. General recommendations on the timing of booster vaccinations may therefore be insufficient to protect vulnerable patients. This review aims to evaluate the clinical role of anti-SARS-CoV-2 antibodies, focusing on measurement indications, prognostic value, and potential as a correlate of protection to guide future booster vaccination strategies.
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  • 文章类型: Journal Article
    目的:我们之前强调了这样一个事实,即在COVID-19大流行爆发几个月后发布了数百项SARS-CoV-2血清学检测。在调查测试套件性能的数百项研究中,很少有比较报告,在多个测试中使用相同的综合样本集。最近,我们报告了针对低收入和中等收入国家使用的35种快速诊断测试(RDT)或微量滴定板酶免疫测定(EIA)的比较评估,使用来自有COVID-19病史的个体的大样本集。只有少数测试符合世卫组织目标产品概况性能要求。本研究报告了使用相同样品组的另外25种自动化SARS-CoV-2免疫测定的性能。结果突出了自动血清学检测试剂盒与RDT相比具有更好的分析和临床性能,以及独立比较评估的重要性,以告知诊断和流行病学调查中这些测试的使用和采购。
    OBJECTIVE: We have previously highlighted the fact that hundreds of SARS-CoV-2 serology tests were released months after the onset of the COVID-19 pandemic. Of the hundreds of studies investigating the test kits\' performance, few were comparative reports, using the same comprehensive sample set across multiple tests. Recently, we reported a comparative assessment of 35 rapid diagnostic tests (RDTs) or microtiter plate enzyme immunoassays (EIA) for use in low- and middle-income countries, using a large sample set from individuals with a history of COVID-19. Only a few tests meet WHO Target Product Profile performance requirements. This study reports on the performance of a further 25 automated SARS-CoV-2 immunoassays using the same panel of samples. The results highlight the better analytical and clinical performance of automated serology test kits compared with RDTs, and the importance of independent comparative assessments to inform the use and procurement of these tests for both diagnostic and epidemiological investigations.
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  • 文章类型: Journal Article
    目的:在各个专业群体中评估抗SARS-CoV-2抗体的患病率非常重要。因此,以下研究的目的是分析SARS-CoV-2疫苗接种前从事医疗和非医疗职业的员工中抗SARS-CoV-2抗体的血清阳性率。
    方法:该研究是在1个机构的雇主中进行的:罗兹的瓦迪斯瓦夫·比加亨斯基省专科医院,波兰,罗兹广播电台和罗兹机场的边防部队。血液样本于2020年12月至2021年2月收集。筛选患者是否存在SARS-CoV-2抗体。同时,受访者被要求填写一份自行设计的问卷,包括人口统计数据,详细的职业,SARS-CoV-2感染史和愿意接种COVID-19疫苗。
    结果:农村居民组的血清阳性率明显更高(p<0.012),宣布既往感染COVID-19的参与者(p<0.001)和医护人员(HCWs)(p=0.002),尤其是护士(35.5%,p=0.003),医务人员在COVID-19专用领域的工作比在其他专业(38.7%vs.26.8%,分别,p=0.017)。抗体的存在与性别之间没有关联(p=0.118),年龄(p=0.559)或BMI(p=0.998)。
    结论:医疗工作者,特别是护士,在工作场所感染COVID-19的风险很高。职业感染可发生期间不仅发生在与患者接触期间,但也有医疗团队的成员谁不表现出典型的疾病症状。医务人员的短缺也可能增加医护人员的感染数量。在波兰COVID-19流行期间提供医疗服务的医疗和医院工作人员,如果发生与SARS-CoV-2感染有关的后果,可能会寻求赔偿。还应不断监测教育和自律在HCW遵守安全规则方面的有效性。IntJOccupMedEnvironHealth。2023年;36(5)。
    OBJECTIVE: The assessment of the prevalence of anti-SARS-CoV-2 antibodies in various professional groups is very important. Hence, the purpose of the following study was to analyze the seroprevalence of anti-SARS-CoV-2 antibodies among employees performing both medical and nonmedical professions before the launch of SARS-CoV-2 vaccination.
    METHODS: The study was conducted among employers of 1 of the institutions: The Provincial Specialist Hospital of Władysław Biegański in Łódź, Poland, Radio Łódź and the Border Guards of Łódź Airport. Blood samples were collected in December 2020-February 2021. Patients were screened for the presence of SARS-CoV-2 antibodies. Simultaneously respondents were asked to complete a self-designed questionnaire including demographic data, detailed profession, history of SARS-CoV-2 infection and willingness to be vaccinated against COVID-19.
    RESULTS: Seroprevalence was significantly higher in the group of rural residents (p < 0.012), participants who declared previous COVID-19 infection (p < 0.001) and healthcare workers (HCWs) (p = 0.002), especially nurses (35.5%, p = 0.003) and medics worked in areas dedicated to COVID-19 than in other specialties (38.7% vs. 26.8%, respectively, p = 0.017). There was no association between the presence of antibodies and the gender (p = 0.118), age (p = 0.559) or BMI (p = 0.998).
    CONCLUSIONS: Healthcare workers, in particular nurses, are at high risk of contracting COVID-19 in the workplace. Occupational infections can occur during occur not only during contact with the patient, but also with members of the medical team who do not show typical symptoms of the disease. Shortages in medical staff may also increase the number of infections among HCWs. Medical and hospital staff providing health services during the COVID-19 epidemic in Poland, may seek compensation in the event of consequences related to SARS-CoV-2 infection. The effectiveness of education and self-discipline in complying to safety rules among HCWs should also be constantly monitored. Int J Occup Med Environ Health. 2023;36(5):643-55.
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  • 文章类型: Journal Article
    背景:SARS-CoV-2的出现对老年人和免疫功能低下的个体造成生命威胁,而这些人群的治疗有限。据报道,间充质基质细胞(MSC)可用于SARS-CoV-2治疗并减少SARS-CoV-2相关后遗症。
    结果:在这项研究中,我们开发了一种自主的细胞机器,以临床级MSCs为基础,不断在体内秘密中和抗体,对抗SARS-CoV-2感染.首先,构建各种修饰的重组质粒,并通过电穿孔转染临床级MSCs,用于中和抗SARS-CoV-2抗体的组装和表达。第二,通过假病毒中和试验筛选出稳定的分泌抗体的MSCs克隆。最后,我们研究了工程化MSCs分泌的中和抗体在体内的药代动力学和生物分布。稳定的临床级MSCs克隆,表达XGv347-10和LY-CoV1404-5中和抗体,显示了它们对SARS-CoV-2感染的可行性和保护作用。移植的工程化临床级MSCs有效地将SARS-CoV-2抗体递送至肺部,由COVID-19引起的免疫高反应由MSC克隆通过抑制CD4T细胞分化为Th1和Th17亚群来协调。
    结论:我们的数据表明,作为细胞生产机器分泌有效中和抗体的工程化临床级MSCs具有对抗SARS-CoV-2感染的潜力,这为有效治疗老年和免疫功能低下的COVID-19患者提供了新的途径。
    BACKGROUND: The emergence of SARS-CoV-2 becomes life-threatening for the older and immunocompromised individuals, whereas limited treatment is available on these populations. Mesenchymal stromal cells (MSCs) have been reported to be useful in SARS-CoV-2 treatment and reduce SARS-CoV-2-related sequelae.
    RESULTS: In this study, we developed an autonomous cellular machine to secret neutralizing antibody in vivo constantly based on the clinical-grade MSCs, to combat SARS-CoV-2 infections. First, various modified recombinant plasmids were constructed and transfected into clinical-grade MSCs by electroporation, for assembly and expression of neutralizing anti-SARS-CoV-2 antibodies. Second, the stable antibody secreting MSCs clones were screened through pseudovirus neutralization assay. Finally, we investigated the pharmacokinetics and biodistribution of neutralizing antibody secreted by engineered MSCs in vivo. The stable clinical-grade MSCs clones, expressing XGv347-10 and LY-CoV1404-5 neutralizing antibodies, exhibited their feasibility and protective efficacy against SARS-CoV-2 infection. Transplanted engineered clinical-grade MSCs effectively delivered the SARS-CoV-2 antibodies to the lung, and the immune hyperresponsiveness caused by COVID-19 was coordinated by MSC clones through inhibiting the differentiation of CD4 + T cells into Th1 and Th17 subpopulations.
    CONCLUSIONS: Our data suggested that engineered clinical-grade MSCs secreting effective neutralizing antibodies as cellular production machines had the potential to combat SARS-CoV-2 infection, which provided a new avenue for effectively treating the older and immunocompromised COVID-19 patients.
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  • 文章类型: Journal Article
    背景:最近的研究表明,血脂水平和抗严重急性呼吸综合征冠状病毒-2(SARS-CoV-2)抗体水平均与2019年冠状病毒病(COVID-19)的预后相关。虽然这两个参数分别涉及严重感染期间病原体的中和和清除,目前尚不清楚这些参数的相互作用是否会影响COVID-19的结局。因此,我们的目标是确定脂蛋白之间是否存在关系,抗SARS-CoV-2抗体,和COVID-19死亡率。
    方法:在此前瞻性中,多中心队列研究,我们从5家医院招募了1152例COVID-19住院患者。总胆固醇(TC),LDL-C,HDL-C,甘油三酯,入院时测量抗SARS-CoV-2尖峰抗体。调查的终点是院内死亡率。
    结果:LDL-C,HDL-C,非幸存者的TC显着低于幸存者(mg/dL,95CI;56.1,50.4-61.8与72.6,70.2-75.0,p<0.001;34.2,31.7-36.8vs.38.1,37.2-39.1,p=0.025;139.3,130.9-147.7与157.4,54.1-160.6,p=0.002)。随着LDL-C水平的降低,死亡率风险逐渐增加,HDL-C,和TC(aOR为1.73,1.30-2.31,p<0.001;1.44,1.10-1.88,p=0.008;1.49,1.14-1.94,p<0.001)。高水平LDL-C和抗SARS-CoV-2抗体的死亡率为2.1%,低水平LDL-C和抗SARS-CoV-2抗体的死亡率为16.3%(aOR9.14,95CI3.17-26.34,p<0.001)。因此,总胆固醇和抗SARS-CoV-2抗体,死亡率介于2.1%和15.0%之间(aOR8.01,95CI2.77-23.18,p<0.001).
    结论:血清脂质水平和抗SARS-CoV-2抗体的联合与COVID-19患者的住院死亡率密切相关。LDL-C和总胆固醇水平低,抗SARS-CoV-2抗体水平低的患者死亡率最高。
    BACKGROUND: Recent studies suggest that both lipid levels and anti-severe-acute-respiratory-syndrome-coronavirus-2 (SARS-CoV-2) antibody levels are associated with outcome in coronavirus disease 2019 (COVID-19). While both parameters have separately been implicated in the neutralization and clearance of pathogens during severe infections, it is currently unclear whether the interplay of these parameters affects outcome in COVID-19. We therefore aimed to determine whether there was a relationship between lipoproteins, anti-SARS-CoV-2 antibodies, and COVID-19 mortality.
    METHODS: In this prospective, multicenter cohort study, we recruited 1152 hospitalized patients with COVID-19 from five hospitals. Total cholesterol (TC), LDL-C, HDL-C, triglycerides, and anti-SARS-CoV-2 spike antibodies were measured on hospital admission. The investigated endpoint was in-hospital mortality.
    RESULTS: LDL-C, HDL-C, and TC were significantly lower in non-survivors than in survivors (mg/dL, 95%CI; 56.1, 50.4-61.8 vs. 72.6, 70.2-75.0, p < 0.001; 34.2, 31.7-36.8 vs. 38.1, 37.2-39.1, p = 0.025; 139.3, 130.9-147.7 vs. 157.4, 54.1-160.6, p = 0.002). Mortality risk increased progressively with lower levels of LDL-C, HDL-C, and TC (aOR 1.73, 1.30-2.31, p < 0.001; 1.44, 1.10-1.88, p = 0.008; 1.49, 1.14-1.94, p < 0.001). Mortality rates varied between 2.1% for high levels of both LDL-C and anti-SARS-CoV-2 antibodies and 16.3% for low levels of LDL-C and anti-SARS-CoV-2 antibodies (aOR 9.14, 95%CI 3.17-26.34, p < 0.001). Accordingly, for total cholesterol and anti-SARS-CoV-2 antibodies, mortality rates varied between 2.1% and 15.0% (aOR 8.01, 95%CI 2.77-23.18, p < 0.001).
    CONCLUSIONS: The combination of serum lipid levels and anti-SARS-CoV-2 antibodies is strongly associated with in-hospital mortality of patients with COVID-19. Patients with low levels of LDL-C and total cholesterol combined with low levels of anti-SARS-CoV-2 antibodies exhibited the highest mortality rates.
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