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. 2021 Dec 1;60(23):3827–3831. doi: 10.2169/internalmedicine.7884-21

Figure 2.

Figure 2.

Detailed serological description of the patient. (A) The anti-nucleocapsid IgG response of the patient measured by the Abbott Architect immunoassay resembled that of other immunocompetent COVID-19 subjects (left). The anti-spike IgG titer of the patient was below the detection limit of the Mokobio immunoassay (middle). The neutralizing activity of the patient’s serum against in vitro SARS-CoV-2 infection was negligible, correlating with the attenuated anti-spike IgG response. Neutralizability results were plotted against three seroconverted immunocompetent COVID-19 subjects (COVID-19 #1–3) and a SARS-CoV-2 negative control (negative control) (right). The patient’s serum was obtained 25 days after the symptom onset. Dashed lines indicate the cut-off values for assays. (B) A time-course analysis of the patient’s serum showed anti-nucleocapsid antibody responses comparable to those of other immunocompetent severe COVID-19 subjects (COVID-19 #1–3), both in magnitude and kinetics, while the anti-spike IgG titer remained below the detection limit of the EUROIMMUN Anti-SARS-CoV-2 ELISA assay. (C) The level of RNAemia, determined by the cycle threshold for N and ORF1ab gene amplification, remained persistently high in the patient, while that of the other immunocompetent COVID-19 subjects (COVID-19 #1–3) gradually declined as their illness subsided. The ORF1ab gene amplicon was never amplified in subject COVID-19 #2.