Immunoglobulins response of COVID-19 patients, COVID-19 vaccine recipients, and random individuals

Al‐Akchar, Mohammad; Tarifi, Amjed A; Qaqish, Arwa; Abbas, Manal M.; Albalawi, Hadeel; Abu-Raideh, Jumanah; Salameh, Muna A.; Khasawneh, Ashraf I

doi:10.1371/journal.pone.0281689

Cited by 13 publications

(9 citation statements)

References 61 publications

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“…The study found that the peak response for COVID-19 patients was between 16 and 30 days for IgG, 15 to 22 days for IgM, and 0 to 60 days for IgA. The levels of these antibodies gradually decreased after peaking, but were still detectable up to 300 days, with the exception of IgM antibodies which disappeared between 61 and 90 days in all patients [ 58 ]. It has been described that IgA antibodies, present in the serum, saliva, and bronchoalveolar washings of patients, are more effective in neutralizing virus than IgG antibodies [ 59 ].…”

Section: Discussionmentioning

confidence: 99%

Kinetics of specific anti-SARS-CoV-2 IgM, IgA, and IgG responses during the first 12 months after SARS-CoV-2 infection: A prospective longitudinal study

et al. 2023

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Coronavirus 2019 (COVID-19) is a global health threat. The kinetics of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) need to be assessed, as the long-term duration of these immunoglobulins remains largely controversial. The aim of this study was to assess the longitudinal dynamics of anti-SARS-CoV-2 antibodies against the nucleocapsid (N) protein and the receptor-binding domain (RBD) of the spike protein up to one year in a cohort of 190 COVID-19 patients. Between March and September 2021, we enrolled patients from two regional hospitals in Casablanca, Morocco. Blood samples were collected and analyzed for antibody levels. We used the commercial Euroimmun ELISA for the determination of anti-N IgM, the Abbott Architect™ SARS-CoV-2 IgG test for the detection of anti-RBD IgG, and an in-house kit for the assay of anti-N IgG and anti-N IgA. IgM and IgA antibodies were assessed 2–5, 9–12, 17–20 and 32–37 days after symptom onset. IgG antibodies were also assessed 60, 90, 120 and 360 days after symptom onset. One-third of patients developed IgM (32%), while two-thirds developed IgA (61%). One month of symptom onset, most patients developed IgG, with 97% and 93% positivity for anti-RBD IgG and anti-N IgG, respectively. The anti-RBD IgG positivity rate remained high up to one year of follow-up. However, the anti-N IgG positivity rate decreased over time, with only 41% of patients testing positive after one year’s follow-up. IgG levels were significantly higher in older people (over 50 years) than in other study participants. We also found that patients who had received two doses of ChAdOx1 nCoV-19 vaccine prior to infection had a lower IgM response than unvaccinated patients. This difference was statistically significant two weeks after the onset of symptoms. We present the first study in Africa to measure the kinetics of antibody response (IgA, IgM and IgG) to SARS-CoV-2 over one year. Most participants remained seropositive for anti-RBD IgG after one year but showed a significant decline in antibody titers.

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Section: Discussionmentioning

confidence: 99%

Kinetics of specific anti-SARS-CoV-2 IgM, IgA, and IgG responses during the first 12 months after SARS-CoV-2 infection: A prospective longitudinal study

et al. 2023

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“…As SARS-CoV-2 infection initiates in the upper respiratory tract, we sought to evaluate whether differences in mucosal IgG responses between non-pregnant and pregnant people may account for differences in clinical severity. IgG was quantified rather than IgA because titers of IgG and seroconversion rates of IgG are higher in response to mRNA vaccines ( 17 , 19 – 22 ). Vaccinated individuals had greater anti-S IgG titers than unvaccinated individuals, regardless of pregnancy status ( P < 0.0001; Fig.…”

Section: Resultsmentioning

confidence: 99%

Reduced control of SARS-CoV-2 infection associates with lower mucosal antibody responses in pregnancy

St Clair,

Eldesouki,

Sachithanandham

et al. 2024

mSphere

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Pregnant patients are at greater risk of hospitalization with severe COVID-19 than non-pregnant people. This was a retrospective observational cohort study of remnant clinical specimens from patients who visited acute care hospitals within the Johns Hopkins Health System in the Baltimore, MD–Washington DC, area between October 2020 and May 2022. Participants included confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected pregnant people and matched non-pregnant people (the matching criteria included age, race/ethnicity, area deprivation index, insurance status, and vaccination status to ensure matched demographics). The primary dependent measures were clinical COVID-19 outcomes, infectious virus recovery, viral RNA levels, and mucosal anti-spike (S) IgG titers from upper respiratory tract samples. A total of 452 individuals (117 pregnant and 335 non-pregnant) were included in the study, with both vaccinated and unvaccinated individuals represented. Pregnant patients were at increased risk of hospitalization (odds ratio [OR] = 4.2; confidence interval [CI] = 2.0–8.6), intensive care unit admittance (OR = 4.5; CI = 1.2–14.2), and being placed on supplemental oxygen therapy (OR = 3.1; CI = 1.3–6.9). Individuals infected during their third trimester had higher mucosal anti-S IgG titers and lower viral RNA levels ( P < 0.05) than those infected during their first or second trimesters. Pregnant individuals experiencing breakthrough infections due to the Omicron variant had reduced anti-S IgG compared to non-pregnant patients ( P < 0.05). The observed increased severity of COVID-19 and reduced mucosal antibody responses particularly among pregnant participants infected with the Omicron variant suggest that maintaining high levels of SARS-CoV-2 immunity through booster vaccines may be important for the protection of this at-risk population. IMPORTANCE In this retrospective observational cohort study, we analyzed remnant clinical samples from non-pregnant and pregnant individuals with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections who visited the Johns Hopkins Hospital System between October 2020 and May 2022. Disease severity, including intensive care unit admission, was greater among pregnant than non-pregnant patients. Vaccination reduced recovery of infectious virus and viral RNA levels in non-pregnant patients, but not in pregnant patients. In pregnant patients, increased nasopharyngeal viral RNA levels and recovery of infectious virus were associated with reduced mucosal IgG antibody responses, especially among women in their first trimester of pregnancy or experiencing breakthrough infections from Omicron variants. Taken together, this study provides insights into how pregnant patients are at greater risk of severe COVID-19. The novelty of this study is that it focuses on the relationship between the mucosal antibody response and its association with virus load and disease outcomes in pregnant people, whereas previous studies have focused on serological immunity. Vaccination status, gestational age, and SARS-CoV-2 omicron variant impact mucosal antibody responses and recovery of infectious virus from pregnant patients.

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“…However, in patients with low antigen exposure and mild symptoms, mucosal IgA may be detected in only about 15-20% of the cases [ 18 ], whereas serum IgA is usually absent. In addition, it is worth mentioning that vaccination, especially with mRNA vaccines, generally induces the expression of SARS-CoV-2 IgA antibodies [ 19 ], but their levels decrease quickly, whereas higher levels are observed in infected individuals [ 20 ]. In our case, the PCR tests acquired one day before and three weeks after the acute neurologic manifestation were negative.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 related acute necrotizing encephalopathy presenting in the early postoperative period

et al. 2023

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Besides respiratory and gastrointestinal symptoms, SARS-CoV-2 also has potential neurotropic effects. Acute hemorrhagic necrotizing encephalopathy is a rare complication of Covid-19. This article presents a case of an 81-year-old female, fully vaccinated, who underwent laparoscopic transhiatal esophagectomy due to gastroesophageal junction cancer. In the early postoperative period, the patient developed persistent fever accompanied by acute quadriplegia, impaired consciousness, and no signs of respiratory distress. Imaging with Computed Tomography and Magnetic Resonance revealed multiple bilateral lesions both in gray and white matter, as well as pulmonary embolism. Covid-19 infection was added to the differential diagnosis three weeks later, after other possible causes were excluded. The molecular test obtained at that time for coronavirus was negative. However, the high clinical suspicion index led to Covid-19 antibody testing (IgG and IgΑ), which confirmed the diagnosis. The patient was treated with corticosteroids with noticeable clinical improvement. She was discharged to a rehabilitation center. Six months later, the patient was in good general condition, although a neurological deficit was still present. This case indicates the significance of a high clinical suspicion index, based on a combination of clinical manifestations and neuroimaging, and the confirmation of the diagnosis with molecular and antibody testing. Constant awareness of a possible Covid-19 infection among hospitalized patients is mandatory.

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Immunoglobulins response of COVID-19 patients, COVID-19 vaccine recipients, and random individuals

Cited by 13 publications

References 61 publications

Kinetics of specific anti-SARS-CoV-2 IgM, IgA, and IgG responses during the first 12 months after SARS-CoV-2 infection: A prospective longitudinal study

Kinetics of specific anti-SARS-CoV-2 IgM, IgA, and IgG responses during the first 12 months after SARS-CoV-2 infection: A prospective longitudinal study

Reduced control of SARS-CoV-2 infection associates with lower mucosal antibody responses in pregnancy

COVID-19 related acute necrotizing encephalopathy presenting in the early postoperative period

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