Specific COVID-19 Symptoms Correlate with High Antibody Levels against SARS-CoV-2
Maya F. Amjadi, Sarah O’Connell, Tammy Armbrust, Aisha M. Mergaert, Sandeep Narpala, Peter Halfmann, S. Janna Bashar, Christopher R. Glover, Anna S. Heffron, Alison Taylor, Britta Flach, David H. O’Connor, Yoshihiro Kawaoka, Adrian B. McDermott, Ajay K. Sethi, Miriam A. Shelef
Abstract
Abstract 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 (n = 113) and 3 mo (n = 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.