Different longitudinal patterns of nucleic acid and serology testing results based on disease severity of COVID-19 patients

Abstract

Effective strategy to mitigate the ongoing pandemic of 2019 novel coronavirus (COVID-19) require a comprehensive understanding of humoral responses against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the emerging virus causing COVID-19. The dynamic profile of viral replication and shedding along with viral antigen specific antibody responses among COVID-19 patients started to be reported but there is no consensus on their patterns. Here, we conducted a serial investigation on 21 individuals infected with SARS-CoV-2 in two medical centres from Jiangsu Province, including 11 non-severe COVID-19 patients, and 5 severe COVID-19 patients and 5 asymptomatic carriers based on nucleic acid test and clinical symptoms. The longitudinal swab samples and sera were collected from these people for viral RNA testing and antibody responses, respectively. Our data revealed different pattern of seroconversion among these groups. All 11 non-severe COVID-19 patients and 5 severe COVID-19 patients were seroconverted during hospitalization or follow-up period, suggesting that serological testing is a complementary assay to nucleic acid test for those symptomatic COVID-19 patients. Of note, immediate antibody responses were identified among severe cases, compared to non-severe cases. On the other hand, only one were seroconverted for asymptomatic carriers. The SARS-CoV-2 specific antibody responses were well-maintained during the observation period. Such information is of immediate relevance and would assist COVID-19 clinical diagnosis, prognosis and vaccine design.

Keywords: COVID-19; SARS-CoV-2; antibody responses; serology testing; viral nucleic acid.

Figure 1.

Detailed timeline of nucleic acid testing results for throat or anal samples along with the anti-SARS-CoV-2 IgM and IgG responses in 21 individuals infected with SARS-CoV-2, including 11 non-severe COVID-19 patients, 5 severe COVID-19 patients and 5 asymptomatic carriers. The timeline started from the symptom onset for both non-severe and severe COVID-19 patients, whereas the timelines started from the day of the diagnosis for asymptomatic carriers. F, female; M, male.