Serum and mucosal antibodies fail as prognostic markers during critical XXXX .

@entity1 @entity683 @entity281 @entity55
BACKGROUND: Previous studies have indicated that the absence of serum antibodies to @entity683 virus on day 4 after onset of symptoms predicted a fatal outcome in @entity1 critically ill with @entity683 . The underlying mechanism was suggested to be the trapping of anti- @entity683 antibodies in pulmonary immune complexes. OBJECTIVES: To study serum and mucosal antibodies as prognostic markers in @entity1 with severe @entity281 . STUDY DESIGN: Blood and respiratory samples (n=324) from 12 @entity1 with severe @entity683 were analysed for anti-H1N1 antibodies with and without immune complex dissociation from symptom onset until convalescence or death (follow up 14-169 days). Eleven healthy subjects were analysed for comparison. RESULTS: One of the 12 @entity1 died from @entity683 @entity55 and had no detectable anti-H1N1 serum antibodies. However, also 2 of the 11 surviving @entity1 remained negative for anti-H1N1 serum antibodies during follow-up (20 and 41 days, respectively). In six of the 11 survivors serum antibodies on day 4 were negative, but turned positive between day 7 and 23. In the remaining 3 patients antibodies were detected in the first 4 days of illness. Mucosal IgG or IgA was detected in all of the @entity1 regardless of their clinical outcome and in 4 of 11 healthy subjects. No mucosal immune complexes were found in the @entity1 who died but were detected in 3 of the 11 survivors. CONCLUSIONS: This study suggests that no prognostic conclusions can be drawn from anti-H1N1 serum and mucosal antibodies in @entity1 with severe @entity683 .
