Corona Virus Disease-19 serology, inflammatory markers, hospitalizations, case finding, and aging.
Most deaths from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection occur in older subjects. We assessed the utility of serum inflammatory markers interleukin-6 (IL-6), C reactive protein (CRP), and ferritin (Roche, Indianapolis, IN), and SARS-CoV-2 immunoglobulin G (IgG), immuno...
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doaj-063b80c667fa44b8aaa8fc14333c20412021-06-26T04:31:31ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01166e025281810.1371/journal.pone.0252818Corona Virus Disease-19 serology, inflammatory markers, hospitalizations, case finding, and aging.Ernst J SchaeferLatha DulipsinghFlorence ComiteJessica JimisonMartin M GrajowerNathan E LebowitzMaxine LangAndrew S GellerMargaret R DiffenderferLihong HeGary BretonMichael L DansingerBen SaidaChong YuanMost deaths from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection occur in older subjects. We assessed the utility of serum inflammatory markers interleukin-6 (IL-6), C reactive protein (CRP), and ferritin (Roche, Indianapolis, IN), and SARS-CoV-2 immunoglobulin G (IgG), immunoglobulin M (IgM), and neutralizing antibodies (Diazyme, Poway, CA). In controls, non-hospitalized subjects, and hospitalized subjects assessed for SARS-CoV-2 RNA (n = 278), median IgG levels in arbitrary units (AU)/mL were 0.05 in negative subjects, 14.83 in positive outpatients, and 30.61 in positive hospitalized patients (P<0.0001). Neutralizing antibody levels correlated significantly with IgG (r = 0.875; P<0.0001). Having combined values of IL-6 ≥10 pg/mL and CRP ≥10 mg/L occurred in 97.7% of inpatients versus 1.8% of outpatients (odds ratio 3,861, C statistic 0.976, P = 1.00 x 10-12). Antibody or ferritin levels did not add significantly to predicting hospitalization. Antibody testing in family members and contacts of SARS-CoV-2 RNA positive cases (n = 759) was invaluable for case finding. Persistent IgM levels were associated with chronic COVID-19 symptoms. In 81,624 screened subjects, IgG levels were positive (≥1.0 AU/mL) in 5.21%, while IgM levels were positive in 2.96% of subjects. In positive subjects median IgG levels in AU/mL were 3.14 if <30 years of age, 4.38 if 30-44 years of age, 7.89 if 45-54 years of age, 9.52 if 55-64 years of age, and 10.64 if ≥65 years of age (P = 2.96 x 10-38). Our data indicate that: 1) combined IL-6 ≥10 pg/mL and CRP ≥10 mg/L identify SARS-CoV-2 positive subjects requiring hospitalization; 2) IgG levels were significantly correlated with neutralizing antibody levels with a wide range of responses; 3) IgG levels have significant utility for case finding in exposed subjects; 4) persistently elevated IgM levels are associated with chronic symptoms; and 5) IgG levels are significantly higher in positive older subjects than their younger counterparts.https://doi.org/10.1371/journal.pone.0252818 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ernst J Schaefer Latha Dulipsingh Florence Comite Jessica Jimison Martin M Grajower Nathan E Lebowitz Maxine Lang Andrew S Geller Margaret R Diffenderfer Lihong He Gary Breton Michael L Dansinger Ben Saida Chong Yuan |
spellingShingle |
Ernst J Schaefer Latha Dulipsingh Florence Comite Jessica Jimison Martin M Grajower Nathan E Lebowitz Maxine Lang Andrew S Geller Margaret R Diffenderfer Lihong He Gary Breton Michael L Dansinger Ben Saida Chong Yuan Corona Virus Disease-19 serology, inflammatory markers, hospitalizations, case finding, and aging. PLoS ONE |
author_facet |
Ernst J Schaefer Latha Dulipsingh Florence Comite Jessica Jimison Martin M Grajower Nathan E Lebowitz Maxine Lang Andrew S Geller Margaret R Diffenderfer Lihong He Gary Breton Michael L Dansinger Ben Saida Chong Yuan |
author_sort |
Ernst J Schaefer |
title |
Corona Virus Disease-19 serology, inflammatory markers, hospitalizations, case finding, and aging. |
title_short |
Corona Virus Disease-19 serology, inflammatory markers, hospitalizations, case finding, and aging. |
title_full |
Corona Virus Disease-19 serology, inflammatory markers, hospitalizations, case finding, and aging. |
title_fullStr |
Corona Virus Disease-19 serology, inflammatory markers, hospitalizations, case finding, and aging. |
title_full_unstemmed |
Corona Virus Disease-19 serology, inflammatory markers, hospitalizations, case finding, and aging. |
title_sort |
corona virus disease-19 serology, inflammatory markers, hospitalizations, case finding, and aging. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2021-01-01 |
description |
Most deaths from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection occur in older subjects. We assessed the utility of serum inflammatory markers interleukin-6 (IL-6), C reactive protein (CRP), and ferritin (Roche, Indianapolis, IN), and SARS-CoV-2 immunoglobulin G (IgG), immunoglobulin M (IgM), and neutralizing antibodies (Diazyme, Poway, CA). In controls, non-hospitalized subjects, and hospitalized subjects assessed for SARS-CoV-2 RNA (n = 278), median IgG levels in arbitrary units (AU)/mL were 0.05 in negative subjects, 14.83 in positive outpatients, and 30.61 in positive hospitalized patients (P<0.0001). Neutralizing antibody levels correlated significantly with IgG (r = 0.875; P<0.0001). Having combined values of IL-6 ≥10 pg/mL and CRP ≥10 mg/L occurred in 97.7% of inpatients versus 1.8% of outpatients (odds ratio 3,861, C statistic 0.976, P = 1.00 x 10-12). Antibody or ferritin levels did not add significantly to predicting hospitalization. Antibody testing in family members and contacts of SARS-CoV-2 RNA positive cases (n = 759) was invaluable for case finding. Persistent IgM levels were associated with chronic COVID-19 symptoms. In 81,624 screened subjects, IgG levels were positive (≥1.0 AU/mL) in 5.21%, while IgM levels were positive in 2.96% of subjects. In positive subjects median IgG levels in AU/mL were 3.14 if <30 years of age, 4.38 if 30-44 years of age, 7.89 if 45-54 years of age, 9.52 if 55-64 years of age, and 10.64 if ≥65 years of age (P = 2.96 x 10-38). Our data indicate that: 1) combined IL-6 ≥10 pg/mL and CRP ≥10 mg/L identify SARS-CoV-2 positive subjects requiring hospitalization; 2) IgG levels were significantly correlated with neutralizing antibody levels with a wide range of responses; 3) IgG levels have significant utility for case finding in exposed subjects; 4) persistently elevated IgM levels are associated with chronic symptoms; and 5) IgG levels are significantly higher in positive older subjects than their younger counterparts. |
url |
https://doi.org/10.1371/journal.pone.0252818 |
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