SARS-CoV-2 Seroconversion and Viral Clearance in Patients Hospitalized With COVID-19: Viral Load Predicts Antibody Response
Por:
Masia, M, Telenti, G, Fernandez, M, Garcia, J, Agullo, V, Padilla, S, Garcia-Abellan, J, Guillen, L, Mascarell, P, Asenjo, J and Gutierrez, F
Publicada:
1 feb 2021
Ahead of Print:
1 ene 2021
Resumen:
Background. The interdependencies of viral replication and the host immune response in patients with coronavirus disease 2019 (COVID-19) remain to be defined. We investigated the viral determinants of antibody response, the predictors of nonseroconversion, and the role of antibodies on viral dynamics.
Methods. This was a prospective study in patients hospitalized with COVID-19 that was microbiologically confirmed by real-time polymerase chain reaction (RT-PCR). Serial nasopharyngeal and oropharyngeal swabs and plasma samples were obtained for measuring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA and antibodies (total and S-IgG/N-IgG), respectively.
Results. Of 132 patients included, 99 (75%) showed positive antibody titers after a median (Q1-Q3) of 11 (8-14) days. The median (Q1-Q3) follow-up was 74.5 (63.0-87.0) days. In an adjusted linear regression model, time to seropositivity was inversely associated with peak log SARS-CoV-2 viral load (P = .009) and positively with time to viral clearance (P = .004). Adjusted predictors of S-IgG levels were time to viral clearance (P < .001), bilateral lung infiltrates on admission (P = .011), and the time-dependent SARS-CoV-2 RNA (P < .001) and SARS-CoV-2 RNA area under the curve (P = .001). Thirty-three (25%) patients showed undetectable antibody titers. Patients who did not seroconvert had higher cycle threshold values of RT-PCR (38.0 vs 28.0; P < .001), had shorter time to viral clearance (3.0 vs 41.0; P < .001), and were more likely to have SARS-CoV-2 only detected on fecal samples (P < .001). Nonseroconvertors had also lower levels of blood inflammatory biomarkers on admission and lower disease severity.
Conclusions. Viral replication determines the magnitude of antibody response to SARS-CoV-2, which, in turn, contributes to viral clearance. COVID-19 patients who do not seroconvert exhibit a differential virological and clinical profile.
Filiaciones:
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Hosp Gen Univ Elche, Alicante, Spain
Univ Miguel Hernandez, Cami Almazara S-N, Alicante 03203, Spain
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Hosp Gen Univ Elche, Alicante, Spain
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Hosp Gen Univ Elche, Alicante, Spain
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Univ Miguel Hernandez, Operat Res Ctr, Alicante, Spain
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Hosp Gen Univ Elche, Alicante, Spain
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Hosp Gen Univ Elche, Alicante, Spain
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Hosp Gen Univ Elche, Alicante, Spain
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Hosp Gen Univ Elche, Alicante, Spain
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Hosp Gen Univ Elche, Alicante, Spain
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Hosp Gen Univ Elche, Alicante, Spain
:
Hosp Gen Univ Elche, Alicante, Spain
Univ Miguel Hernandez, Cami Almazara S-N, Alicante 03203, Spain
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