院内新型冠状病毒肺炎患者IgG滴度的动态变化:一项基于组的轨迹分析
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R511

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上海市公共卫生体系建设三年行动计划学科建设项目(GWV-10.1-XK05),海军军医大学(第二军医大学)"三航"计划.


Dynamic change of IgG titers in hospitalized patients with coronavirus disease 2019:a group-based trajectory analysis
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Supported by Discipline Construction Program of Shanghai 3-Year Action Plan for Public Health System Construction (GWV-10.1-XK05) and "San Hang" Program of Naval Medical University (Second Military Medical University).

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    摘要:

    目的 研究新型冠状病毒肺炎(COVID-19)患者住院期间定量检测的IgG滴度的动态变化轨迹,揭示感染病毒后机体的免疫过程。方法 回顾性分析2020年2月5日至4月15日在武汉市火神山医院和湖北省妇幼保健院光谷院区住院治疗的COVID-19患者的临床资料及不同时间点IgG滴度定量检测数据。应用基于组的轨迹模型从患者抗体的时间序列数据中进行亚组识别,然后对各轨迹组患者的临床特征及结局进行比较。结果 共734例符合筛选标准的患者被纳入研究。从其抗体数据中识别出3个轨迹组:组1(持续低抗体组,60例,占8.17%)、组2(中等抗体组,38例,占5.18%)和组3(高抗体组,636例,占86.65%)。3组患者的住院天数和病毒清除时间差异有统计学意义(P均<0.001),组1的住院天数和病毒清除时间均最短;而全因死亡率和病情恶化率在3组间差异无统计学意义(P均>0.05)。结论 具有不同IgG发展轨迹的COVID-19患者可能有不同的预后及免疫特征,抗体滴度持续较高的患者可能需要更多的医疗关注。

    Abstract:

    Objective To study the dynamic trajectories of quantitative immunoglobulin G (IgG) titers of hospitalized coronavirus disease 2019 (COVID-19) patients and reveal the immune process of the organism after infection.Methods The clinical data and quantitative IgG titers at different time points of hospitalized COVID-19 patients in Wuhan Huoshenshan Hospital and Guanggu Branch of Maternity and Child Healthcare Hospital of Hubei Province from Feb. 5 to Apr. 15, 2020 were retrospectively analyzed. Group-based trajectory modeling was used to identify the subgroups from time-series data of patients’ antibody titers, and then the clinical characteristics and outcomes were compared among these trajectory groups.Results Totally, 734 patients who met the criteria were included. Three IgG trajectory groups were identified from the antibody data: group 1 (consistently low group, 60 cases[ 8.17%] ), group 2 (moderate group, 38 cases [5.18%]) and group 3 (high group, 636 cases[86.65%]). The hospitalization days and the virus clearance time of patients in the 3 groups were significantly different (both P<0.001), those in group 1 were the shortest, while the all-cause mortality and disease deterioration rate had no significant difference in the 3 groups (both P>0.05).Conclusion Patients with different IgG antibody developmental trajectories may have heterogeneous prognosis and immune process. Patients with consistently higher longitudinal antibody titers may require more medical attention.

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  • 收稿日期:2021-10-20
  • 最后修改日期:2021-12-17
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  • 在线发布日期: 2022-04-24
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