COVID-19康复患者出院后1年血清特异性抗体及免疫功能分析  

Analysis of the SARS-CoV-2 specific antibodies and immune function of COVID-19 patients one year after discharge

作　　者：赵本南 钟晶 周觅 刘大凤 王冬梅 袁媛[4] ZHAO Bennan;ZHONG Jing;ZHOU Mi;LIU Dafeng;WANG Dongmei;YUAN Yuan(Department of Comprehensive Internal Medicine,Chengdu Public Health Clinical Medical Center,Chengdu,610061,P.R.China;Department of Clinical Laboratory,Chengdu Public Health Clinical Medical Center,Chengdu,610061,P.R.China;Department of Science and Education Division,Chengdu Public Health Clinical Medical Center,Chengdu,610061,P.R.China;Department of Infection Division,The First Affiliated Hospital of Chengdu Medical College,Chengdu,610513,P.R.China)

机构地区：[1]成都市公共卫生临床医疗中心综合内科,成都610061 [2]成都市公共卫生临床医疗中心检验科,成都610061 [3]成都市公共卫生临床医疗中心科教科,成都610061 [4]成都医学院第一附属医院感染科,成都610513

出　　处：《中国胸心血管外科临床杂志》2021年第11期1277-1282,共6页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：中国医学科学院中央级公益性科研院所基本科研业务费专项资金资助项目(2020-PT330-005);四川省科技厅新型冠状病毒科技攻关应急项目(2020YFS0564);成都市卫生健康委员会项目(2021250)。

摘　　要：目的总结新型冠状病毒肺炎(新冠肺炎)康复期患者出院后1年的特异性IgG抗体、总抗体及细胞免疫功能结果,并分析特异性抗体与细胞及体液免疫功能各指标的相关性。方法纳入2020年1~4月在成都市公共卫生临床医疗中心治愈出院并在出院后1年到我院复诊的41例新冠肺炎确诊患者作为试验组,其中男18例、女23例,年龄(47.83±12.95)岁。收集复诊时的严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)特异性IgG抗体、总抗体及免疫功能指标,探讨特异性抗体与细胞免疫功能的相关性。随机选取与试验组病例年龄相近且接种过两剂新型冠状病毒灭活疫苗的我院健康职工40人作为疫苗接种组,其中男10人、女30人,年龄(43.90±6.86)岁。比较两组SARS-CoV-2特异性抗体结果。结果男性患者CD8+T细胞计数高于女性患者,CD4+T/CD8+T低于女性患者(P均<0.05)。病程中曾出现核酸"复阳"患者的IgG及总抗体量高于未"复阳"者,但差异无统计学意义(P=0.158,0.060)。试验组SARS-CoV-2 IgG阳性率为80.5%(33/41);SARS-CoV-2 IgG与总抗体量呈正相关(rs=0.614,P<0.001);CD4+T细胞计数与SARS-CoV-2 IgG存在正相关性(r=0.455,P=0.003)。试验组SARS-CoV-2 IgG阳性率、SARS-CoV-2 IgG量及总抗体量均显著高于疫苗接种组(P均<0.001)。结论大部分新冠肺炎患者在出院后1年的特异性IgG抗体仍为阳性,总抗体显著高于疫苗接种者,提示感染SARS-CoV-2后可获得持久的保护,但保护力可能会随时间逐渐减弱。核酸"复阳"者的抗体衰减程度可能弱于未"复阳"者。在康复期患者中,SARS-CoV-2 IgG的动力学可能与细胞免疫功能密切相关。Objective To summarize the results of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) IgG antibody, total antibody and cellular immune function of COVID-19 convalescent patients one year after discharge,and to analyze the correlation between the SARS-CoV-2 antibody and the indexes of immune function. Methods A total of 41 confirmed COVID-19 patients discharged from Chengdu Public Health Clinical Medical Center from January to April 2020 and followed up one year after discharge were included in the study as the research group, including 18 males and 23 females with an average age of 47.83±12.95 years. The results of SARS-Co V-2 IgG, total antibody and immune function indexes one year after discharge were collected in order to discuss the correlation of SARS-CoV-2 and cellular immune function. A total of 40 healthy employees of the hospital vaccinated against COVID-19 were randomly selected as the vaccine group, including 10 males and 30 females with an average age of 43.90±6.86 years. The SARS-CoV-2 antibodies between the two groups were compared. Results CD8+T cell count was higher and CD4+T/CD8+T was lower in male patients than those in female patients(all P<0.05). The IgG and total antibodies in patients with re-detectable positive RNA test were both higher than those in patients without re-detectable positive RNA test, but the differences were not statistically significant(P=0.158, 0.060). The positive rate of SARS-CoV-2 IgG in the research group was 80.5%(33/41).SARS-CoV-2 IgG was positively correlated with total antibody(P<0.001). There was a positive correlation between CD4+T cell count and SARS-CoV-2 IgG(r=0.455, P=0.003). The positive rate of SARS-CoV-2 IgG, SARS-CoV-2 IgG amount and total antibody amount in the research group were significantly higher than those in the vaccine group(all P<0.001).Conclusion SARS-CoV-2 IgG of most COVID-19 patients one year after discharge is positive, and their SARS-CoV-2 total antibody is significantly higher than people vaccinated against COVID-19, which s

关 键 词：新型冠状病毒肺炎 严重急性呼吸综合征冠状病毒2型 IGG抗体 细胞免疫功能 

分 类 号：R563.1[医药卫生—呼吸系统]