Fig. 2: Serum antibody kinetics reveals distinct COVID-19 outcomes.
From: Delayed production of neutralizing antibodies correlates with fatal COVID-19
a, Patientsʼ plasma reactivity to S protein and RBD measured by ELISA. Anti-S and Anti-RBD IgM and IgG comparison in discharged or deceased patients. Longitudinal data plotted over time continuously. Regression lines are shown as light blue (discharged), purple (deceased) and red (high neutralizers). Lines indicates cross-sectional averages from each group, with shading representing 95% CI and colored accordingly. Anti-S IgM (discharged, n = 126; deceased, n = 14). Anti-S IgG (discharged, n = 127; deceased, n = 33). Anti-RBD IgM (discharged, n = 88; deceased, n = 11). Anti-S RBD (discharged, n = 87; deceased, n = 30). b,c, Viral loads measured by nasopharyngeal swabs are plotted as log10 of genome equivalents (GEs). b, Viral loads against time after symptom onset accordingly with patient outcome. Regression lines are shown as light blue (discharged) or purple (deceased), with shading representing 95% CI. Pearson’s correlation coefficients and linear regression significance are colored accordingly. c, Viral load measured in discharged, deceased and high neutralizer (HN) patients. (HN, n = 6; discharged, n = 53; deceased, n = 12). Each dot represents the viral load of a single individual at their maximum antibody titer over the disease course. One-way ANOVA corrected for multiple comparisons using Tukey’s method were used to determine significance. ***P = 0.0005, **P = 0066. d, Heat map correlation analysis between Anti-S IgG (OD450 nm) levels and plasma cytokine/chemokine measurements in discharged (n = 146) or deceased (n = 26) patients. Patients are arranged across columns based on anti-S IgG levels. Each row represents a cytokine/chemokine and is normalized by its maximum value (assigned value of 1). Color intensity indicates the relative cytokine concentration (log10) normalized against the same population across all subjects. k-means clustering was used to arrange patients and measurements. Significance was assessed by one-way ANOVA testing corrected for multiple comparisons using Tukey’s method. sCD40L, FGF2, IL-1β, IL-1RA, IL-2, IL-6, IL-12, MCSF, TNF-β, CCL1, TPO, IFN-L2 (P < .05); fractalkine, IL-4, IL-17F, CCL7, CXCL9, eotaxin2, CC17, SCF, TSLP, IL-33 (P < .01); GCSF, IFN-α, IFN-γ, IL-8, IL-10, IL-15, CXCL10, CCL2, TGF-α, TNF-α, CCL8, CXCL13, CCL21, LIF, TRAIL, CCL27 (P < 0.001). ***P < .001 **P < .01, *P < .05. CI, confidence interval; NS, not significant; OD, optical density.
