Neutralizing antibody response and SARS severity

Emerg Infect Dis. 2005 Nov;11(11):1730-7. doi: 10.3201/eid1111.040659.


Using the Taiwan nationwide laboratory-confirmed severe acute respiratory syndrome (SARS) database, we analyzed neutralizing antibody in relation to clinical outcomes. With a linear mixed model, neutralizing antibody titer was shown to peak between week 5 and week 8 after onset and to decline thereafter, with a half-life of 6.4 weeks. Patients with a longer illness showed a lower neutralizing antibody response than patients with a shorter illness duration (p = 0.008). When early responders were compared with most patients, who seroconverted on and after week 3 of illness, the small proportion (17.4%) of early responders (antibody detectable within 2 weeks) had a higher death rate (29.6% vs. 7.8%) (Fisher exact test, p = 0.004), had a shorter survival time of <2 weeks (Fisher exact test, p = 0.013), and were more likely to be > 60 years of age (Fisher exact test, p = 0.01). Our findings have implications for understanding the pathogenesis of SARS and for SARS vaccine research and development.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antibodies, Viral / blood*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neutralization Tests
  • SARS Virus / immunology*
  • Severe Acute Respiratory Syndrome / immunology
  • Severe Acute Respiratory Syndrome / mortality
  • Severe Acute Respiratory Syndrome / physiopathology*
  • Severe Acute Respiratory Syndrome / virology
  • Severity of Illness Index


  • Antibodies, Viral