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Excessive inflammation is a characteristic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, particularly in patients that are hospitalized with coronavirus disease 2019 (COVID-19). Here, Hoepel et al. investigated how human antibodies specific to SARS-CoV-2 spike protein may contribute to exacerbated inflammation. The authors found that spike protein–specific antibodies from patients with COVID-19 who were hospitalized had altered glycosylation, with an enrichment in low-fucosylated antibodies. These antibodies were able to activate human macrophages in vitro to secrete proinflammatory cytokines. Thus, altered antibody glycosylation may contribute to disease severity in COVID-19. Patients diagnosed with coronavirus disease 2019 (COVID-19) become critically ill primarily around the time of activation of the adaptive immune response. Here, we provide evidence that antibodies play a role in the worsening of disease at the time of seroconversion. We show that e

Noord hollandUnited statesMiltenyi biotecU cytech biosciencesMelinda gates foundationDutch federation of university medical centersInnovative medicines initiativeAmsterdam cardiovascular sciencesAgilent technologiesDutch heart foundationNetherlands organization for health researchEuropean unionGraphpad softwareDiscovery workbench softwareEuropean union horizonProinflammatory panel