Specific COVID-19 Symptoms Correlate with High Antibody Levels against SARS-CoV-2

• Published in: ImmunoHorizons Vol. 5; no. 6; pp. 466 - 476
• Main Authors: Amjadi, Maya F, O'Connell, Sarah E, Armbrust, Tammy, Mergaert, Aisha M, Narpala, Sandeep R, Halfmann, Peter J, Bashar, S Janna, Glover, Christopher R, Heffron, Anna S, Taylor, Alison, Flach, Britta, O'Connor, David H, Kawaoka, Yoshihiro, McDermott, Adrian B, Sethi, Ajay K, Shelef, Miriam A
• Format: Journal Article
• Language: English
• Published: United States 17.06.2021
• Subjects: Adult; Antibodies, Neutralizing - blood; Antibodies, Neutralizing - immunology; Antibodies, Viral - blood; Antibodies, Viral - immunology; Cohort Studies; COVID-19 - epidemiology; COVID-19 - immunology; COVID-19 - virology; Female; Hospitalization - statistics & numerical data; Humans; Immunoglobulin G - blood; Immunoglobulin G - immunology; Linear Models; Male; Middle Aged; Multivariate Analysis; Pandemics; SARS-CoV-2 - immunology; SARS-CoV-2 - physiology; Severity of Illness Index; Time Factors
• ISSN: 2573-7732; 2573-7732
• DOI: 10.4049/immunohorizons.2100022

Lasting immunity will be critical for overcoming COVID-19. However, the factors associated with the development of high titers of anti-SARS-CoV-2 Abs and how long those Abs persist remain incompletely defined. In particular, an understanding of the relationship between COVID-19 symptoms and anti-SARS-CoV-2 Abs is limited. To address these unknowns, we quantified serum anti-SARS- CoV-2 Abs in clinically diverse COVID-19 convalescent human subjects 5 wk ( = 113) and 3 mo ( = 79) after symptom resolution with three methods: a novel multiplex assay to quantify IgG against four SARS-CoV-2 Ags, a new SARS-CoV-2 receptor binding domain-angiotensin converting enzyme 2 inhibition assay, and a SARS-CoV-2 neutralizing assay. We then identified clinical and demographic factors, including never-before-assessed COVID-19 symptoms, that consistently correlate with high anti-SARS-CoV-2 Ab levels. We detected anti-SARS-CoV-2 Abs in 98% of COVID-19 convalescent subjects 5 wk after symptom resolution, and Ab levels did not decline at 3 mo. Greater disease severity, older age, male sex, higher body mass index, and higher Charlson Comorbidity Index score correlated with increased anti-SARS-CoV-2 Ab levels. Moreover, we report for the first time (to our knowledge) that COVID-19 symptoms, most consistently fever, body aches, and low appetite, correlate with higher anti-SARS-CoV-2 Ab levels. Our results provide robust and new insights into the development and persistence of anti-SARS-CoV-2 Abs.