Low anti-SARS-CoV-2 S antibody levels predict increased mortality and dissemination of viral components in the blood of critical COVID-19 patients

Martin-Vicente, MariaAlmansa, RaquelMartinez, IsidoroTedim, Ana PBustamante, ElenaTamayo, LuisAldecoa, CésarGómez, José ManuelRenedo, GloriaBerezo, Jose ÁngelCedeño, Jamil AntonioMamolar, NuriaGarcía Olivares, PabloHerrán-Monge, RubénCicuendez, RamónEnríquez, PedroOrtega, AliciaJorge, NoeliaDoncel, Cristinade la Fuente, AmandaBustamante-Munguira, JuanMuñoz-Gómez, María JoséGonzález-Rivera, MilagrosPuertas, CarolinaMas-Lloret, VicenteVazquez-Alcaraz, MonicaPerez-Garcia, FelipeRico-Feijoo, JesúsMartín, SilviaMotos, AnnaFernandez-Barat, LaiaEiros, José MaríaDomínguez-Gil, MartaFerrer, RicardBarbé, FerránTrapiello, WysaliKelvin, David JBermejo-Martin, Jesús FResino, SalvadorTorres, Antoni2024-11-152024-11-152022-02J Intern Med. 2022 Feb;291(2):232-240.0954-6820https://pmc.ncbi.nlm.nih.gov/articles/PMC8661581/https://hdl.handle.net/20.500.12105/25519Background: Anti-SARS-CoV-2 S antibodies prevent viral replication. Critically ill COVID-19 patients show viral material in plasma, associated with a dysregulated host response. If these antibodies influence survival and viral dissemination in ICU-COVID patients is unknown. Patients/methods: We studied the impact of anti-SARS-CoV-2 S antibodies levels on survival, viral RNA-load in plasma, and N-antigenaemia in 92 COVID-19 patients over ICU admission. Results: Frequency of N-antigenaemia was >2.5-fold higher in absence of antibodies. Antibodies correlated inversely with viral RNA-load in plasma, representing a protective factor against mortality (adjusted HR [CI 95%], p): (S IgM [AUC ≥ 60]: 0.44 [0.22; 0.88], 0.020); (S IgG [AUC ≥ 237]: 0.31 [0.16; 0.61], <0.001). Viral RNA-load in plasma and N-antigenaemia predicted increased mortality: (N1-viral load [≥2.156 copies/ml]: 2.25 [1.16; 4.36], 0.016); (N-antigenaemia: 2.45 [1.27; 4.69], 0.007). Conclusions: Low anti-SARS-CoV-2 S antibody levels predict mortality in critical COVID-19. Our findings support that these antibodies contribute to prevent systemic dissemination of SARS-CoV-2.engVoRhttp://creativecommons.org/licenses/by/4.0/COVID-19RNAAntibodiesAntigenaemiaMortalityAntibodies, ViralAntigens, ViralCOVID-19Critical IllnessHumansRNA, ViralSARS-CoV-2Low anti-SARS-CoV-2 S antibody levels predict increased mortality and dissemination of viral components in the blood of critical COVID-19 patientsAttribution 4.0 International346119272912232-24010.1111/joim.133861365-2796Journal of internal medicineopen access