Serologic studies of persons with COVID-19 infection

National Institute Of Allergy And Infectious Diseases

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Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), is associated with respiratory-related disease and death. While most infected persons recover from the virus without serious illness, some require hospitalization and other may die of the disease. At present, it is not clear why some apparently healthy persons become very ill with SARS-CoV-2. We collaborated with a group at the NIH Clinical Center and found that in patients who are hospitalized with COVID-19, antibody titers to SARS-CoV-2 and neutrophil activation are associated with the severity of their disease. We found a correlation between levels of virus antibody levels, markers of neutrophil degranulation, excessive formation of neutrophil extracellular traps (NETs). NETs are structures containing neutrophil DNA and proteins which form web-like structures that may trap invading pathogens. In addition, we found immune complexes consisting of SARS-CoV-2 antigen-antibody can stimulate increased formation of NETs. Taken together, these findings provide further information on the pathogenesis of severe COVID-19.