Viral load and antibody levels in patients with COVID-19

Authors

  • Iva Christova Department of Microbiology, National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria.
  • Iva Trifonova Department of Microbiology, National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria.
  • Teodora Gladnishka Department of Microbiology, National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria.
  • Elena Dragusheva Department of Microbiology, National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria.
  • Georgi Popov Infectious Diseases Clinic, Military Medical Academy.
  • Vladislava Ivanova Department of Microbiology, National Centre of Infectious and Parasitic Diseases, Sofia, Bulgaria.

DOI:

https://doi.org/10.30574/gscarr.2021.8.3.0180

Keywords:

SARS-CoV-2, COVID-19, Antibody levels, Viral load

Abstract

Relations between viral load, antibody levels and COVID-19 severity are not well studied and results from such investigations are controversial. In this study, we investigated kinetics of viral load and antibody responses to SARS-CoV-2 in 20 patients with COVID-19 and analysed the association with disease severity. The patients were followed on weekly basis within the first month after the onset and then once per month for the next 4 months. Serum samples were tested for IgA, IgM, and IgG antibodies against SARS-CoV-2 using ELISA tests. SARS-CoV-2 viral load in nasopharyngeal swabs was measured by quantitative Realtime RT-PCR. For vast majority of the patients, the viral loads were at their highest levels at presentation and then declined gradually. Despite development of specific antibody response 7-11 days after the onset of COVID-19, SARS-CoV-2 RNA was still detected in nasopharyngeal swabs of most of the patients. There was no direct link between viral load and severity of COVID-19: some of mild and some of severe cases started with a high viral load. There was a relationship between the time from the onset of the disease and the viral load: the highest viral load was in the first days. In more severe cases, there was a tendency for slower reduction in viral load and longer detection of SARS-CoV-2 virus. Levels of the specific antibodies increased earlier and to higher levels and were present for longer time in patients with more severe manifestations of COVID-19 than in those with milder disease.

Metrics

Metrics Loading ...

References

Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, Si HR, Zhu Y, Li B, Huang CL, Chen HD, Chen J, Luo Y, Guo H, Jiang RD, Liu MQ, Chen Y, Shen XR, Wang X, Zheng XS, Zhao K, Chen QJ, Deng F, Liu LL, Yan B, Zhan FX, Wang YY, Xiao GF, Shi ZL. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020; 579 (7798): 270–273.

Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qui Y, Wang J, Liu Y, Wei Y, Xia J, Yu T, Zhang X, Zhang L. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020; 395(10223): 507–513.

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, Xiang H, Cheng Z, Xiong Y, Zhao Y, Li Y, Wang X, Peng Z. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus infected pneumonia in Wuhan, China. JAMA. 2020; 323(11): 1061-1069.

Guan WJ, Ni Z, Hu Y, Liang W, Ou C, He J, Liu L, Shan H, Lei C, Hui D, Du B, Li L, Zeng G, Yuen K, Chen R, Tang C, Wang T, Chen P, Xiang J, Li S, Wang J, Liang Z, Chen Z, Wei L, Liu Y, Hu Y, Peng P, Wang J, Liu J, Chen Z, Li G, Zheng Z, Qui S, Luo J, Ye C, Zhu S, Zhong N. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020; 382(18): 1708–1720.

World Health Organization, 2020. Clinical Management of COVID-19. Geneva, Switzerland: WHO. WHO Reference Number: WHO/2019-nCoV/clinical/2020.5.

Zou L, Ruan F, Huang M, Liang L, Huang H, Hong Z, Yu J, Kang M, Song Y, Xia J, Guo Q, Song T, He J, Yen HL, Peiris M, Wu J. SARS-CoV-2 viral load in upper respiratory specimens of infected patients. N Engl J Med. 2020; 382(12): 1177-1179.

Zheng S, Fan J, Yu F, Feng B, Lou B, Zou Q, Xie G, Lin S, Wang R, Yang X, Chen W, Wang Q, Zhang D, Liu Y, Gong R, Ma Z, Lu S, Xiao Y, Gu Y, Zhang J, Yao H, Xu K, Lu X, Wei G, Zhou J, Fang Q, Cai H, Qui Y, Sheng J, Chen Y, Liang T. Viral load dynamics and disease severity in patients infected with SARS-CoV-2 in Zhejiang province, China, January-March 2020: retrospective cohort study. BMJ. 21 Apr 2020; 369: m1443.

Chu CM, Poon LL, Cheng VC, Chan K, Hung I, Wong M, Chan KH, Leung WS, Tang BS, Chan VL, Ng WL, Sim TC, Ng PW, Law KI, Tse DM, Peiris JS, Yuen KY. Initial viral load and the outcomes of SARS. CMAJ. 2004; 171(11): 1349-1352.

Zhang W, Du RH, Li B, Zheng XS, Yang XL, Hu B, Wang YY, Xiao GF, Yan B, Shi ZL, Zhou P. Molecular and serological investigation of 2019-nCoV infected patients: implication of multiple shedding routes. Emerg Microbes Infect. 2020; 9(1): 386–389.

To KK, Tsang OT, Leung WS, Tam AR, Wu TC, Lung DC, Yip CC, Cai JP, Chan JM, Chik TS, Lau DP, Choi CY, Chen LL, Chan WM, Chan KH, Ip JD, Ng AC, Poon RW, Luo CT, Cheng VC, Chan JF, Hung IF, Chen Z, Chen H, Yuen KY. Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARS-CoV-2: an observational cohort study. Lancet Infect Dis. 2020; 20(5): 565-574.

Kwon JS, Kim JY, Kim MC, Park BN, Bae S, Cha HH, Jung J, Kim MJ, Lee MJ, Choi SH, Chung JW, Shin EC, Kim SH. Factors of severity in patients with COVID-19: cytokine/ chemokine concentrations, viral load and antibody response. Am. J. Trop. Med. Hyg. 2020; 103(6): 2412-2418.

Shi F, Wu T, Zhu X, Ge Y, Zeng X, Chi Y, Du X, Zhu L, Zhu F, Zhu B, Cui L, Wu B. Association of viral load with serum biomarkers among COVID-19 cases. Virology. 2020; 546: 122-126.

Fajnzylber J, Regan J, Coxen K, Corry H, Wong C, Rosenthal A, Worrall D, Giguel F, Piechocka-Trocha A, Atyeo C, Fischinger S, Chan A, Flaherty KT, Hall K, Dougan M, Ryan ET, Gillespie E, Chishti R, Li Y, Jilg N, Hanidziar D, Baron RM, Baden L, Tsibris AM, Armstrong KA, Kuritzkes DR, Alter G, Walker BD, Yu X, Li JZ. SARS-CoV-2 viral load is associated with increased disease severity and mortality. Nat Commun. 2020; 11(1): 5493.

Maltezou H, Raftopoulos V, Vorou R, Papadima K, Mellou K, Spanakis N, Kossyvakis A, Gioula G, Exindari M, Froukala E, Martinez-Gonzalez B, Panayiotakopoulos G, Papa A, Mentis A, Tsakris A. Association between upper respiratory tract viral load, comorbidities, disease severity and outcome of patients with SARS-CoV-2 infection. J Infect Dis. 2021; 223(7): 1132-1138.

Downloads

Published

2021-09-30

How to Cite

Christova, I. ., Trifonova, I. ., Gladnishka, T. ., Dragusheva, E. ., Popov, G. ., & Ivanova, V. . (2021). Viral load and antibody levels in patients with COVID-19. GSC Advanced Research and Reviews, 8(3), 010–018. https://doi.org/10.30574/gscarr.2021.8.3.0180

Issue

Section

Original Article