{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T20:04:23Z","timestamp":1779912263772,"version":"3.53.1"},"reference-count":27,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,6,13]],"date-time":"2021-06-13T00:00:00Z","timestamp":1623542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST-107-2811-B-182A-505 & MOST 108-2811-B-182A-517"],"award-info":[{"award-number":["MOST-107-2811-B-182A-505 & MOST 108-2811-B-182A-517"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005795","name":"Chang Gung Memorial Hospital, Linkou","doi-asserted-by":"publisher","award":["CMRPG3J1501"],"award-info":[{"award-number":["CMRPG3J1501"]}],"id":[{"id":"10.13039\/501100005795","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005795","name":"Chang Gung Memorial Hospital, Linkou","doi-asserted-by":"publisher","award":["CORPG5K0011"],"award-info":[{"award-number":["CORPG5K0011"]}],"id":[{"id":"10.13039\/501100005795","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>A total of 15 RT-PCR confirmed COVID-19 patients were admitted to our hospital during the in-itial outbreak in Taiwan. The average time of virus clearance was delayed in seven patients, 24.14 \u00b1 4.33 days compared to 10.25 \u00b1 0.56 days post-symptom onset (PSO) in the other eight pa-tients. There was strong antibody response in patients with viral persistence at the pharynx, with peak values of serum antibody 677.2 \u00b1 217.8 vs. 76.70 \u00b1 32.11 in patients with delayed versus rapid virus clearance. The patients with delayed viral clearance had excessive antibodies of compromised quality in an early stage with the delay in peak virus neutralization efficacy, 34.14 \u00b1 7.15 versus 12.50 \u00b1 2.35 days PSO in patients with rapid virus clearance. Weak antibody re-sponse of patients with rapid viral clearance was also effective, with substantial and comparable neutralization efficacy, 35.70 \u00b1 8.78 versus 41.37 \u00b1 11.49 of patients with delayed virus clearance. Human Cytokine 48-Plex Screening of the serial sera samples revealed elevated concentrations of proinflammatory cytokines and chemokines in a deceased patient with delayed virus clear-ance and severe disease. The levels were comparatively less in the other two patients who suf-fered from severe disease but eventually survived.<\/jats:p>","DOI":"10.3390\/pathogens10060752","type":"journal-article","created":{"date-parts":[[2021,6,14]],"date-time":"2021-06-14T22:25:46Z","timestamp":1623709546000},"page":"752","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Relative COVID-19 Viral Persistence and Antibody Kinetics"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0598-5684","authenticated-orcid":false,"given":"Chung-Guei","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan 33333, Taiwan"},{"name":"Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan"},{"name":"Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5372-629X","authenticated-orcid":false,"given":"Avijit","family":"Dutta","sequence":"additional","affiliation":[{"name":"Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan"},{"name":"Division of Infectious Diseases, Department of Medicine, Chang Gung Memorial Hospital, Taoyuan 33333, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching-Tai","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Chang Gung Memorial Hospital, Taoyuan 33333, Taiwan"},{"name":"Division of Infectious Diseases, Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pi-Yueh","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan 33333, Taiwan"},{"name":"Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei-Jen","family":"Hsiao","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan 33333, Taiwan"},{"name":"Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Chia","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan 33333, Taiwan"},{"name":"Division of Infectious Diseases, Department of Pediatrics, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu-Min","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan 33333, Taiwan"},{"name":"Department of Respiratory Therapy, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin-Ru","family":"Shih","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan 33333, Taiwan"},{"name":"Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan"},{"name":"Research Center for Emerging Viral Infections, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuo-Chien","family":"Tsao","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Chang Gung Memorial Hospital, Taoyuan 33333, Taiwan"},{"name":"Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1846-1027","authenticated-orcid":false,"given":"Cheng-Ta","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan 33333, Taiwan"},{"name":"Department of Respiratory Therapy, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Guo, L., Ren, L., Yang, S., Xiao, M., Chang, D., Yang, F., Dela Cruz, C.S., Wang, Y., Wu, C., and Xiao, Y. (2020). Profiling early humoral response to diagnose novel coronavirus disease (COVID-19). Clin. Infect. Dis., ciaa310.","DOI":"10.1093\/cid\/ciaa310"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Ong, D.S.Y., de Man, S.J., Lindeboom, F.A., and Koeleman, J.G.M. (2020). Comparison of diagnostic accuracies of rapid serological tests and ELISA to molecular diagnostics in patients with suspected coronavirus disease 2019 presenting to the hospital. Clin. Microbiol. Infect., S1198.","DOI":"10.1016\/j.cmi.2020.05.028"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"104468","DOI":"10.1016\/j.jcv.2020.104468","article-title":"Evaluation of the EUROIMMUN anti-SARS-CoV-2 ELISA Assay for detection of IgA and IgG antibodies","volume":"129","author":"Beavis","year":"2020","journal-title":"J. Clin. Virol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3945","DOI":"10.4049\/jimmunol.156.10.3945","article-title":"Stem cell factor (c-kit ligand) influences eosinophil recruitment and histamine levels in allergic airway inflammation","volume":"156","author":"Lukacs","year":"1996","journal-title":"J. Immunol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e20200321","DOI":"10.1084\/jem.20200321","article-title":"Lineage-specific regulation of inducible and constitutive mast cells in allergic airway inflammation","volume":"218","author":"Derakhshan","year":"2021","journal-title":"J. Exp. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1007\/s12250-020-00329-9","article-title":"Viral and antibody kinetics of COVID-19 patients with different disease severities in acute and convalescent phases: A 6-month follow-up study","volume":"35","author":"Zhang","year":"2020","journal-title":"Virol. Sin."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1690.e1","DOI":"10.1016\/j.cmi.2020.08.043","article-title":"The kinetics of viral load and antibodies to SARS-CoV-2","volume":"26","author":"Sun","year":"2020","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"5235","DOI":"10.1172\/JCI138759","article-title":"Kinetics of viral load and antibody response in relation to COVID-19 severity","volume":"130","author":"Wang","year":"2020","journal-title":"J. Clin. Investig."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Marklund, E., Leach, S., Axelsson, H., Nystr\u00f6m, K., Norder, H., Bemark, M., Angeletti, D., Lundgren, A., Nilsson, S., and Andersson, L.-M. (2020). Serum-IgG responses to SARS-CoV-2 after mild and severe COVID- 19 infection and analysis of IgG non-responders. PLoS ONE, 15.","DOI":"10.1101\/2020.07.11.20151324"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1598","DOI":"10.1038\/s41564-020-00813-8","article-title":"Longitudinal observation and decline of neutralizing antibody responses in the three months following SARS-CoV-2 infection in humans","volume":"5","author":"Seow","year":"2020","journal-title":"Nat. Microbiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1038\/s41467-020-20247-4","article-title":"Neutralizing antibody titres in SARS-CoV-2 infections","volume":"12","author":"Lau","year":"2021","journal-title":"Nat. Commun."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1038\/s41586-020-2456-9","article-title":"Convergent antibody responses to SARS-CoV-2 in convalescent individuals","volume":"584","author":"Robbiani","year":"2020","journal-title":"Nature"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.bbrc.2014.07.090","article-title":"Antibody-dependent SARS coronavirus infection is mediated by antibodies against spike proteins","volume":"451","author":"Wang","year":"2014","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1834","DOI":"10.3201\/eid2608.201097","article-title":"Prolonged persistence of SARS-CoV-2 RNA in body fluids","volume":"26","author":"Sun","year":"2020","journal-title":"Emerg. Infect. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2227","DOI":"10.1002\/jmv.26103","article-title":"Clearance and persistence of SARS-CoV-2 RNA in patients with COVID-19","volume":"92","author":"Carmo","year":"2020","journal-title":"J. Med. Virol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1730","DOI":"10.3201\/eid1111.040659","article-title":"Neutralizing antibody response and SARS severity","volume":"11","author":"Ho","year":"2005","journal-title":"Emerg. Infect. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1001\/jamainternmed.2020.0994","article-title":"Risk factors associated with acute respiratory distress syndrome and death in patients with Coronavirus disease 2019 pneumonia in Wuhan, China","volume":"180","author":"Wu","year":"2020","journal-title":"JAMA Intern. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1016\/S0140-6736(20)30628-0","article-title":"COVID-19: Consider cytokine storm syndromes and immunosuppression","volume":"395","author":"Mehta","year":"2020","journal-title":"Lancet"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1636","DOI":"10.1038\/s41591-020-1051-9","article-title":"An inflammatory cytokine signature helps predict COVID-19 severity and survival","volume":"26","author":"Beckmann","year":"2020","journal-title":"Nat. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1016\/j.chom.2020.03.021","article-title":"A dynamic immune response shapes COVID-19 progression","volume":"27","author":"Ong","year":"2020","journal-title":"Cell Host Microbe"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1016\/j.cell.2020.04.026","article-title":"Imbalanced host response to SARS-CoV-2 drives development of COVID-19","volume":"181","author":"Liu","year":"2020","journal-title":"Cell"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1038\/s41467-021-21444-5","article-title":"Evolution of immune responses to SARS-CoV-2 in mild-moderate COVID-19","volume":"12","author":"Wheatley","year":"2021","journal-title":"Nat. Commun."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1080\/07853890.2020.1840621","article-title":"IL-6 and other biomarkers as predictors of severity in COVID-19","volume":"53","author":"Broman","year":"2021","journal-title":"Ann. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1007\/s00134-020-05991-x","article-title":"Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China","volume":"46","author":"Ruan","year":"2020","journal-title":"Intensive Care Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2620","DOI":"10.1172\/JCI137244","article-title":"Clinical and immunological features of severe and moderate Coronavirus disease 2019","volume":"130","author":"Chen","year":"2020","journal-title":"J. Clin. Investig."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1056\/NEJMoa2021436","article-title":"Dexamethasone in hospitalized patients with Covid-19","volume":"384","author":"Horby","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2000045","DOI":"10.2807\/1560-7917.ES.2020.25.3.2000045","article-title":"Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR","volume":"25","author":"Corman","year":"2020","journal-title":"Euro Surveill."}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/10\/6\/752\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:13:54Z","timestamp":1760163234000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/10\/6\/752"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,13]]},"references-count":27,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,6]]}},"alternative-id":["pathogens10060752"],"URL":"https:\/\/doi.org\/10.3390\/pathogens10060752","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2020.07.01.20143917","asserted-by":"object"}]},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,13]]}}}