The relationship between the nasopharyngeal virus load, IgA and IgG antibodies to both the S1-RBD-protein and the N-protein, as well as the neutralizing activity (NAbs) against SARS-CoV-2 in the blood of moderately afflicted COVID-19 patients, needs further longitudinal investigation. Several new serological methods to examine these parameters were developed, validated and applied in three patients of a family which underwent an ambulatory course of COVID-19 for six months. The virus load had almost completely disappeared after about four weeks. Serum IgA levels to the S1-RBD-protein and, to a lesser extent, to the N-protein, peaked about three weeks after clinical disease onset but declined soon thereafter. IgG levels rose continuously, reaching a plateau at approximately six weeks, and stayed elevated over the observation period. Virus-neutralizing activity reached a peak about 4 weeks after disease onset but dropped slowly. The longitudinal associations of virus neutralization and the serological immune response suggest immunity in patients even after a mild clinical course of COVID-19.
In this paper the major processes governing the persistence and underground transport of viruses and bacteria are reviewed in respect to their importance under naturally occurring conditions. In general, the simulation of the governing processes is based on the macroscopic mass-conservation equation with the addition of some filter and/or retardation factor and a decay coefficient, representing the natural “die-off” of the microorganisms. More advanced concepts try to incorporate growth and decay coefficients together with deposition and declogging factors. At present, none of the reported concepts has been seriously validated.
Due to the complexity of natural systems and the pathogenic properties of some of the microorganisms, experiments under controlled laboratory conditions are required. A laboratory setup is presented in which a great variety of natural conditions can be simulated. This comprises a set of 1 metre columns and an 8 metre stainless-steel flume with 24 sampling ports. The columns are easily filled and conditioned and therefore used to study the effects of different soil-microorganism combinations under various environmental conditions. In the artificial flume natural underground conditions are simulated using sand and gravel aquifer material from the river Neckar alluvium.
A first set of results from the laboratory experiments is presented together with preliminary model simulations. The large variety of observed breakthrough curves and recovery for the bacteria and viruses under investigation demonstrates the great uncertainty encountered in microbiological risk assessment.
Background: Patients infected with SARS-CoV-2 exhibit a highly variable clinical course, varying from barely discernible signs of disease, to moderate flu-like symptoms and, occasionally, with life-threatening pneumonia and/or cytokine storm. The relationship between the nasopharyngeal virus load, IgA and IgG antibodies to both the S1-RBD-protein and the N-protein as well the neutralizing activity (NAbs) against SARS-CoV-2 in the blood of moderately afflicted COVID-19 patients has not been investigated longitudinally so far.
Methods: Several new serological methods to examine these parameters were developed and validated for the longitudinal investigation in three patients of a family which underwent a mild course of COVID-19.
Findings: We observed that the virus load had almost completely disappeared after about four weeks, whereas serum antibodies showed a contrasting course. IgA levels to S1-RBD-protein and, to a lesser extent, to the N-protein, peaked about three weeks after clinical disease onset but declined soon thereafter. IgG levels rose continuously, reaching a plateau approximately six weeks after disease onset. NAbs in serum reached a peak about four weeks after disease onset but dropped to a lower level about six weeks later.
Interpretation: Our data establishes associations of virus neutralization and a serological immune response foremost against Sars-CoV-2 S1-RDB-protein in a longitudinal manner.
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