The differences were highly significant, with p-values of < 0.0001, 0.0015, 0.0026, and 0.0029, respectively, when compared to ADE-negative ICU samples, and < 0.0001, <0.0001, 0.0012, and 0.0031 when compared to mild infection samples ( Figure 6 ).
43 , 44 Our analysis to characterize the association of serum complements (C1q, C3, C3a, and C5a) to ADE showed a trend of higher complement levels in ADE-positive samples compared to ADE-negative from the ICU group; however, the difference was not statistically significant.
Overall, a clear trend of reduced neutralizing activity was observed in ADE-positive samples relative to ADE-negative ones ( Figure 5 ).