Abstract
The purpose of this study is to monitor specific anti-severe acute respiratory syndrome coronavirus 2 (anti-SARS-CoV-2) IgG and IgM antibody production in patients with severe forms of coronavirus disease 2019 (COVID-19) using various commercially available quantitative and qualitative tests. The sera of 23 confirmed COVID-19 patients were processed for anti-SARS-CoV-2 IgG and IgM detection. Three different immunoassays, viz. Abbott Architect® SARS-CoV-2 IgG assay, and two quantitative tests, ANSH® SARS-CoV-2 and AESKULISA® SARS-CoV-2 Nucleocapsid Protein (NP), were performed and the results pooled, from diagnosis to serum collection. Seroconversion rates were computed for all 3 assays, and possible correlations were tested using the Pearson correlation coefficient and Cohen’s kappa coefficient. Overall, 70 combinations of qualitative and quantitative IgG and IgM results were pooled and analyzed. In the early phase (0-4 days after diagnosis), in all tests, IgG seroconversion rates were 43%-61%, and increased in all tests gradually to 100% after 15 days. The Pearson correlation coefficient showed a strong positive relationship between the qualitative IgG test results and both quantitative IgG tests. IgM detection was inconsistent, with maximal concentrations and seroconversion rates between 10-15 days after diagnosis and slight-to-fair agreement between the two quantitative immunoassays. There was no significant association between mortality with IgG or IgM seroconversion or concentrations. Patients with severe COVID-19 develop an early, robust anti-SARS-CoV-2 specific humoral immune response involving IgG immunoglobulins. Further comparative studies are warranted to analyze the value of serological testing in predicting the severity of COVID-19 and detecting prior exposure.
Highlights
Following several months of an unprecedented global struggle against the COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the long-term efficacy of the deployed preventive, diagnostic, and therapeutic strategies remain uncertain
This study examined specific anti-SARS-CoV-2 IgG and IgM antibody production in a sample of hospitalized patients with severe COVID-19, using three different immunoassays including one IgG qualitative test and two IgG and IgM quantitative tests
This study included adults admitted as inpatients for management and treatment of severe COVID-19, which was defined in our institution as any case having a documented pneumonia with decreased oxygen saturation, with or without signs of respiratory distress
Summary
Following several months of an unprecedented global struggle against the COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the long-term efficacy of the deployed preventive, diagnostic, and therapeutic strategies remain uncertain. The feasibility and effectiveness of radical measures, such as public lockdowns and mandatory social distancing, must be reconciled with social and economic costs. Other reports underscore the negative socioeconomic impact of lockdowns and the difficulty in implementing social-distancing rules and enforcing control measures, in underprivileged populations [3, 4]. In light of the above concerns, it is suggested that at this stage management of the pandemic may require reappraisal. Forecasting effective detection and quarantining of individuals with active disease, coupled with enhancement of the long-term immunity of a population, should be prioritized
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