Disease characteristics and serological responses in patients with differing severity of COVID-19 infection: A longitudinal cohort study in Dhaka, Bangladesh

• Published in: PLoS neglected tropical diseases Vol. 16; no. 1; p. e0010102
• Main Authors: Akter, Afroza, Ahmed, Tasnuva, Tauheed, Imam, Akhtar, Marjahan, Rahman, Sadia Isfat Ara, Khaton, Fatema, Ahmmed, Faisal, Ferdous, Jannatul, Afrad, Mokibul Hassan, Kawser, Zannat, Hossain, Mohabbat, Khondaker, Rabeya, Hasnat, Mohammad Abul, Sumon, Mostafa Aziz, Rashed, Asif, Ghosh, Shuvro, Calderwood, Stephen B, Charles, Richelle C, Ryan, Edward T, Khatri, Purvesh, Maecker, Holden Terry, Obermoser, Gerlinde, Pulendran, Bali, Clemens, John D, Banu, Sayera, Shirin, Tahmina, LaRocque, Regina C, Harris, Jason B, Bhuiyan, Taufiqur Rahman, Chowdhury, Fahima, Qadri, Firdausi
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01.01.2022; Public Library of Science (PLoS)
• Subjects: Adult; Age; Antibodies; Antibodies, Viral - immunology; Antibody Formation; Antibody response; Asymptomatic; Asymptomatic infection; Bangladesh; Biology and life sciences; Cohort analysis; Cohort Studies; Cohorts; Coronaviruses; COVID-19; COVID-19 - diagnosis; COVID-19 - immunology; COVID-19 Testing; Disease transmission; Diseases; Enrollments; Female; Ferritin; Fibrin Fibrinogen Degradation Products; Gender; Hospitals; Humans; IgG antibody; Immunoglobulin G; Immunoglobulin M; Immunology; Infections; Leukocytes (neutrophilic); Longitudinal Studies; Lymphocytes; Male; Medical laboratories; Medicine and Health Sciences; Middle Aged; Neutrophils; Pandemics; Parameters; Patients; Research and Analysis Methods; Risk analysis; Risk Factors; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Severity of Illness Index; Sociodemographics; Tropical diseases; Viral diseases; Viral Load; Bangladesh; United States > US; China
• ISSN: 1935-2735; 1935-2727; 1935-2735
• DOI: 10.1371/journal.pntd.0010102

COVID-19 caused by SARS-CoV-2 ranges from asymptomatic to severe disease and can cause fatal and devastating outcome in many cases. In this study, we have compared the clinical, biochemical and immunological parameters across the different disease spectrum of COVID-19 in Bangladeshi patients. This longitudinal study was conducted in two COVID-19 hospitals and also around the community in Dhaka city in Bangladesh between November 2020 to March 2021. A total of 100 patients with COVID-19 infection were enrolled and classified into asymptomatic, mild, moderate and severe cases (n = 25/group). In addition, thirty age and sex matched healthy participants were enrolled and 21 were analyzed as controls based on exclusion criteria. After enrollment (study day1), follow-up visits were conducted on day 7, 14 and 28 for the cases. Older age, male gender and co-morbid conditions were the risk factors for severe COVID-19 disease. Those with moderate and severe cases of infection had low lymphocyte counts, high neutrophil counts along with a higher neutrophil-lymphocyte ratio (NLR) at enrollment; this decreased to normal range within 42 days after the onset of symptom. At enrollment, D-dimer, CRP and ferritin levels were elevated among moderate and severe cases. The mild, moderate, and severe cases were seropositive for IgG antibody by day 14 after enrollment. Moderate and severe cases showed significantly higher IgM and IgG levels of antibodies to SARS-CoV-2 compared to mild and asymptomatic cases. We report on the clinical, biochemical, and hematological parameters associated with the different severity of COVID-19 infection. We also show different profile of antibody response against SARS-CoV-2 in relation to disease severity, especially in those with moderate and severe disease manifestations compared to the mild and asymptomatic infection.