Antibody responses to SARS-CoV2 are distinct in children with MIS-C compared to adults with COVID-19
clinical diagnostics immunology/immunity
Authors: Weisberg et al.
Link to paper: https://doi.org/10.1101/2020.07.12.20151068
Journal/ Pre-Print: MedRxiv
Tags; Immunology/Immunity, Clinical/ Diagnostics
1. Measured anti-SARS-CoV-2 Spike (S) and anti-SARS-CoV-2 Nucleocapsid (N) antibodies levels as well as neutralisation activity of plasma/sera in MIS-C, convalescent plasma donors, and severe COVID-19 ARDS adult patients.
2. MIS-C patients had a reduced antibody breadth and specificity for CoV-2; with IgG responses mainly directed against S protein.
3. MIS-C patients had reduced neutralising activity compared to the other cohorts.
Weisberg et al. examined a cohort of 15 MIS-C patients, 14 COVID-19 adult ARDS patients, 19 convalescent plasma donors (CPD), and 8 pre-pandemic healthy controls. They compared levels of IgM, IgA and IgG to SARS-CoV-2 S and IgG to SARS-CoV-2 N proteins for the different groups. CPD and MIS-C patients had similar levels of antibodies against S protein, with higher levels in the COVID-19 ARDS group. However, MIS-C patients had reduced levels of anti-N antibodies compared with the other groups. Neutralizing activity of sera from MIS-C patients was reduced compared with the other CoV-infected groups.
Impact for SARS-CoV2/COVID19 research efforts
Understand the immune response to SARS-CoV2/COVID19
· Clinical Cohort study (e.g. drug trials)
Strengths and limitations of the paper
Novelty: Comparison of IgM, IgA and IgG antibody levels to anti-S and anti-N in COVID-ARDS, MIS-C and donated convalescent plasma showing interesting differences that may be linked to the pathogenesis
Standing in the field: Anti-SARS-CoV-2 antibodies measured for COVID-19 ARDS and CPD in previous studies. New information regarding antibodies in MIS-C patients with an analysis of specificity against S and N proteins.
Appropriate statistics: Accurate and appropriate statistics, but more p-values needed for graphs.
Viral model used: SARS-CoV-2 antigens and pseudovirus neutralisation assay
Translatability: May be useful for diagnostic/prognostic purposes, and in the future to direct potential antibody-based therapies (e.g. using convalescent plasma when needed)
Would have been interest to include other proteins such as RBD to the anti-SARS-CoV-2 antibody measurements
P-values needed for comparison between negative controls and comparison groups
No antibody comparison to recovered children without MIS-C.
Pseudovirus neutralization assay has a relatively high negative control measurement.
More information needed on whether any children received IVIG which may impact antibody data.