Longitudinal Serology of SARS-CoV-2-Infected Individuals in India: A Prospective Cohort Study
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Abstract
Clinical and epidemiological characteristics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are now widely available, but there are few data regarding longitudinal serology in large cohorts, particularly those from low-income and middle-income countries. We established an ongoing prospective cohort of 3,840 SARS-CoV-2-positive individuals according to RT-PCR in the Delhi-National Capital Region of India to document clinical and immunological characteristics during illness and convalescence. The immunoglobulin G (IgG) responses to the receptor binding domain (RBD) and nucleocapsid were assessed at 0 to 7 days, 10 to 28 days, and 6 to 10 weeks after infection. The clinical predictors of seroconversion were identified by multivariable regression analysis. The seroconversion rates during the postinfection windows of 0 to 7 days, 10 to 28 days, and 6 to 10 weeks were 46%, 84.7%, and 85.3%, respectively ( N = 743). The proportion with a serological response increased with the severity of coronavirus disease 2019 (COVID-19). All participants with severe disease, 89.6% with mild to moderate infection, and 77.3% of asymptomatic participants had IgG antibodies to the RBD antigen. The threshold values for the nasopharyngeal viral RNA RT-PCR of a subset of asymptomatic and symptomatic seroconverters were comparable ( P = 0.48) to those of nonseroconverters ( P = 0.16) ( N = 169). This is the first report of longitudinal humoral immune responses to SARS-CoV-2 over a period of 10 weeks in South Asia. The low seropositivity of asymptomatic participants and differences between assays highlight the importance of contextualizing the understanding of population serosurveys.
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SciScore for 10.1101/2021.02.04.21251140: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IRB: The study protocol was approved by the Institute Ethics Committees of all participating institutions.
Consent: The eligibility criteria was a positive RT-PCR done as per the National Testing Strategy of India and written informed consent [2].Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the …SciScore for 10.1101/2021.02.04.21251140: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IRB: The study protocol was approved by the Institute Ethics Committees of all participating institutions.
Consent: The eligibility criteria was a positive RT-PCR done as per the National Testing Strategy of India and written informed consent [2].Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:However, there are some limitations. Due to lack of robust IgM and IgA assays, we were unable to evaluate the immune response with respect to these isotypes. Further, due to the heterogeneity of RT-PCR assays used by the participating hospitals for molecular diagnosis, we do not have a comparable viral load data for all participants in our study. However, analysis in a subset of the individuals who had a similar RT-PCR assay showed no difference in nasopharyngeal viral load between seroconverters and non-seroconverters. In conclusion, we systematically report clinical and epidemiological characteristics, and longitudinal humoral immune response to SARS-CoV-2 infection in a large Indian cohort. We will continue to study the kinetics of the immune response in a unique platform to evaluate the more complex and emerging questions on cellular immunity, reinfections, long COVID syndrome and population-level post immunization surveillance, when the cohort participants are immunized.
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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