Immune response and laboratory markers in the spectrum of severity of COVID-19

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Abstract

BACKGROUND: Serum antibodies to SARS-CoV-2, when measured early after disease onset, may add value to the diagnosis of COVID-19.

AIM: To examine the levels of serum antibodies to SARS-CoV-2 and laboratory blood parameters in hospitalized patients with COVID-19 of varying severity.

MATERIALS AND METHODS: In this retrospective cohort study, we examined laboratory markers of inflammation in patients with acute COVID-19 during the 1st week of hospitalization. The levels of serum antibodies to SARS-CoV-2 were studied using commercial test systems.

RESULTS: In 47% of hospitalized patients with COVID-19, during the first week of hospital stay, IgM and IgG antibodies to SARS-CoV-2 were detected, both in the case of a positive and negative PCR test. An average positive cor- relation of detected IgM and IgG with antibodies to the receptor-binding site of the S-protein of the SARS-CoV-2 virus is shown. In total, IgM and IgG antibodies to SARS-CoV-2 were most often detected in patients with a favorable course of the disease. Laboratory parameters in patients with moderate and severe COVID-19 were characterized by a significant increase in the level of serum C-reactive protein, an increase in the neutrophil-leukocyte ratio and fibrinogen level, in comparison with data from patients with a mild course of the disease. In mild cases of infection, a moderately negative correlation was revealed between the levels of antibodies to SARS-CoV-2 and NLR.

CONCLUSIONS: Detection of antibodies to SARS-CoV-2 in the early stages of hospitalization may be a predictor of a favorable outcome of the disease and serve as an additional criterion for the diagnosis of COVID-19 along with PCR analysis.

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About the authors

Yulia A. Desheva

Institute of Experimental Medicine; Saint Petersburg State University

Email: desheva@mail.ru
ORCID iD: 0000-0001-9794-3520
SPIN-code: 4881-3786
Scopus Author ID: 9939567500
ResearcherId: I-1493-2013

MD, Dr. Sci. (Med.), Professor of the Department of Fundamental Problems of Medicine and Medical Technologies

Russian Federation, 12 Academician Pavlov St., Saint Petersburg, 197022; Saint Petersburg

Tamara N. Shvedova

Vsevolozhsk Clinical Interdistrict Hospital

Email: toma_nn@mail.ru
ORCID iD: 0000-0002-6649-8150

Head of the Clinical and Diagnostic Laboratory

Russian Federation, Leningrad Region

Polina A. Kudar

Institute of Experimental Medicine

Email: polina6226@mail.ru
ORCID iD: 0000-0002-3342-5828

Junior Research Associate at the World-Class Scientific Center “Center for Personalized Medicine”

Russian Federation, 12 Academician Pavlov St., Saint Petersburg, 197022

Daria S. Petrachkova

Institute of Experimental Medicine

Author for correspondence.
Email: ya.dashook@ya.ru
ORCID iD: 0009-0004-0045-4886

Document specialist of Department of Translational Medicine

Russian Federation, 12 Academician Pavlov St., Saint Petersburg, 197022

Anna A. Lerner

Vsevolozhsk Clinical Interdistrict Hospital; North-Western State Medical University named after I.I. Mechnikov

Email: sever67@bk.ru
ORCID iD: 0000-0001-5848-6486

MD, Cand. Sci. (Med.), Doctor of the Clinical Diagnostic Laboratory; Chief Staff Specialist in Clinical Laboratory Diagnostics

Russian Federation, Leningrad Region; Saint Petersburg

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Supplementary files

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2. Figure 1.
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3. Fig. 1. Seropositivity rates of IgM and IgG antibodies to SARS-CoV-2 (ELISA, Vector-Best) (а); correlation indicators be- tween the levels of IgM and IgG antibodies to SARS-CoV-2 (b); proportions of individuals with antibodies to SARS-CoV-2 with different outcomes of COVID-19 (c)

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4. Fig. 2. Antibodies to SARS-CoV-2 in individual sera of patients with a positive and negative test for SARS-CoV-2

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5. Fig. 3. Study of antibodies to SARS-CoV-2 in paired sera of patients with COVID-19: 1 point — blood samples obtained upon admission to the hospital, n = 20; point 2 — blood serum obtained after 5–7 days of hospital stay, n = 20. IgM to SARS-CoV-2 (ELISA, Vector-Best) (a); IgG to SARS-CoV-2 (ELISA, Vector-Best) (b); anti-RBD antibodies (c); in- creases in IgG and anti-RBD antibodies in paired blood sera of patients with positive PCR confirmation COVID-19 (n = 8) and without PCR confirmation (n = 12) (d); correlation rates of anti-RBD antibody levels with IgM and IgG to SARS-CoV-2, n = 12 (e)

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6. Fig. 4. Analysis of blood parameters depending on the severity of the disease. Hierarchical clustering based on raw signal intensity for blood tests (n = 70 samples obtained on hospital admission). The data has been processed using the mean nor- malization method (Z-score normalization). The pattern of feature intensity was obtained using the built-in functions of the Seaborn library in Python B (а); correlation analysis of NLO and fibrinogen indices in sera with different CRP contents (b); correlation rates between antibody levels to SARS-CoV-2 and UFO among patients with mild COVID-19. The level of seropositivity was determined using the Vector-Best test system (c, d)

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