Imperial College London
Portrait Picture

Professor Anthony Gordon

Faculty of Medicine, Department of Surgery & Cancer

Chair in Anaesthesia and Critical Care
 
 
 
//

Contact

 

anthony.gordon

 
 
//

Location

 

ICUQueen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Ratcliff:2021:infdis/jiab283,
author = {Ratcliff, J and Nguyen, D and Fish, M and Rynne, J and Jennings, A and Williams, S and Al-Beidh, F and Bonsall, D and Evans, A and Golubchik, T and Gordon, AC and Lamikanra, A and Tsang, P and Ciccone, NA and Leuscher, U and Slack, W and Laing, E and Mouncey, PR and Ziyenge, S and Oliveira, M and Ploeg, R and Rowan, KM and Shankar-Hari, M and Roberts, DJ and Menon, DK and Estcourt, L and Simmonds, P and Harvala, H},
doi = {infdis/jiab283},
journal = {Journal of Infectious Diseases},
pages = {595--605},
title = {Virological and serological characterization of critically ill patients with COVID-19 in the UK: Interactions of viral load, antibody status and B.1.1.7 variant infection.},
url = {http://dx.doi.org/10.1093/infdis/jiab283},
volume = {224},
year = {2021}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Convalescent plasma containing neutralising antibody to SARS-CoV-2 is under investigation for COVID-19 treatment. We report diverse virological characteristics of UK intensive care patients enrolled in the Immunoglobulin Domain of the REMAP-CAP randomised controlled trial that potentially influence treatment outcomes. METHODS: SARS-CoV-2 RNA in nasopharyngeal swabs collected pre-treatment was quantified by PCR. Antibody status was determined by spike-protein ELISA. B.1.1.7 was differentiated from other SARS-CoV-2 strains using allele-specific probes or restriction site polymorphism (SfcI) targeting D1118H. RESULTS: Of 1274 subjects, 90% were PCR-positive with viral loads 118-1.7x10 11 IU/ml. Median viral loads were 40-fold higher in those seronegative for IgG antibodies (n=354; 28%) compared to seropositives (n=939; 72%). Frequencies of B.1.1.7 increased from <1% in early November, 2020 to 82% of subjects in January 2021. Seronegative individuals with wild-type SARS-CoV-2 had significantly higher viral loads than seropositives (medians 5.8x10 6 and 2.0 x10 5 IU/ml respectively; p=2x10 -15). However, viral load distributions were elevated in both seronegative and seropositive subjects infected with B.1.1.7 (4.0x10 6 and 1.6x10 6 IU/ml respectively). CONCLUSIONS: High viral loads in seropositive B.1.1.7-infected subjects and resistance to seroconversion indicate less effective clearance by innate and adaptive immune responses. SARS-CoV-2 strain, viral loads and antibody status define subgroups for analysis of treatment efficacy.
AU  - Ratcliff,J
AU  - Nguyen,D
AU  - Fish,M
AU  - Rynne,J
AU  - Jennings,A
AU  - Williams,S
AU  - Al-Beidh,F
AU  - Bonsall,D
AU  - Evans,A
AU  - Golubchik,T
AU  - Gordon,AC
AU  - Lamikanra,A
AU  - Tsang,P
AU  - Ciccone,NA
AU  - Leuscher,U
AU  - Slack,W
AU  - Laing,E
AU  - Mouncey,PR
AU  - Ziyenge,S
AU  - Oliveira,M
AU  - Ploeg,R
AU  - Rowan,KM
AU  - Shankar-Hari,M
AU  - Roberts,DJ
AU  - Menon,DK
AU  - Estcourt,L
AU  - Simmonds,P
AU  - Harvala,H
DO  - infdis/jiab283
EP  - 605
PY  - 2021///
SN  - 0022-1899
SP  - 595
TI  - Virological and serological characterization of critically ill patients with COVID-19 in the UK: Interactions of viral load, antibody status and B.1.1.7 variant infection.
T2  - Journal of Infectious Diseases
UR  - http://dx.doi.org/10.1093/infdis/jiab283
UR  - https://www.ncbi.nlm.nih.gov/pubmed/34031695
UR  - https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiab283/6283590
UR  - http://hdl.handle.net/10044/1/89200
VL  - 224
ER  -
Download