key: cord-1011825-1aknmk3h
authors: Xia, Zhiping; Liu, Xiaojun; Hu, Xiaoyan; Zhong, Zibiao; Wang, Yanfeng; Peng, Guizhu; Ye, Qifa
title: Failed antibody response in a renal transplant recipient with SARS‐CoV‐2 infected
date: 2020-06-05
journal: Transpl Infect Dis
DOI: 10.1111/tid.13349
sha: e71601488d844827f65cfc7979bf7eaba5cbf713
doc_id: 1011825
cord_uid: 1aknmk3h

In late December 2019, severe acute respiratory syndrome corona virus 2 (SARS‐CoV‐2) has been identified as a novel pathogen causing Coronavirus Disease 2019 (COVID‐19) in Wuhan, China, subsequently spread to the rest of China and has been demonstrating a rapid global spread. Nucleic acid testing (NAT, tested by real‐time polymerase chain reaction) of SARS‐CoV‐2 virus in oropharyngeal/nasal swab samples has been described to be extremely sensitive for the diagnose of SARS‐CoV‐2 infection, but false‐negative results have been reported. Recent months, researches demonstrated the importance of IgM/IgG antibody detecting due to the unsatisfied positive rate of NAT, and the increasement IgM/IgG antibody was considered as a confirmed criteria of diagnosis in the official guides of the diagnosis and treatment of COVID‐19 in China (7(th) Edition) .

In general population, both cell-mediated and humoral immune response to the SARS-CoV-2 virus 6,7 . The virus enters the cell via the angiotensin-converting enzyme-2 (ACE-2) by Toll-like receptor -7 (TLR -7) 8 . TLR -7 activation leads to the production of TNF-alpha, alpha-interferon, and the secretion of interleukin (IL)-6 and IL-12. This results in the formation of CD8+-specific cytotoxic T-cells and, through the CD4+ helper T-cell, leads to the formation of antigen-specific B-cells and antibody production 9 . In SOT infected patients, the suppressive naïve T-cells caused by immunosuppressant drugs failed to recognize the pathogens, which most probably leads to the delayed or failed response of specific cellular and humoral immunity 10 .

In conclusion, SOT recipients represent a frail immune status due to the long-term

This article is protected by copyright. All rights reserved immunosuppressive therapy, the diagnosis of COVID-19 is more complex and they may more susceptible to SARS-CoV-2 virus re-infected. For this reason, clinical manifestations may differ from general population and different diagnostics and treatment approaches may be needed.

SARS-CoV-2, COVID-19, renal transplant, solid organ transplant, antibody

Understanding of COVID-19 based on current evidence

Improved Molecular Diagnosis of COVID-19 by the Novel, Highly Sensitive and Specific COVID-19-RdRp/Hel Real-Time Reverse Transcription-PCR Assay Validated In Vitro and with Clinical Specimens

Negative Nasopharyngeal and Oropharyngeal Swabs Do Not Rule Out COVID-19

Detection of antibodies against SARS-CoV-2 in patients with COVID-19

Analytical performances of a chemiluminescence immunoassay for SARS-CoV-2 IgM/IgG and antibody kinetics

Coronavirus infections and immune responses

This research was supported by the National Natural Science Foundation of China, Grant No. 81600587 to Zhiping Xia.

The authors of this manuscript have no conflicts of interest.

Xia Z and Liu X contributed equally and shared first authorship. Hu X collected the study data.All authors contributed to the drafting, review, and final approval of this manuscript.Zhiping Xia 1,# , Xiaojun Liu 2,# , Xiaoyan Hu 1 ,