The interplay of viral loads, clinical presentation, and serological responses in SARS-CoV-2 – Results from a prospective cohort of outpatient COVID-19 cases
Kerstin Puchinger, Noemi Castelletti, Raquel Rubio‐Acero, Christof Geldmacher, Tabea M. Eser, Flora Deák, Ivana Paunović, Abhishek Bakuli, Elmar Saathoff, Alexander Meyer, Alisa Markgraf, Philine Falk, Jakob Reich, Friedrich Riess, Philipp Girl, Katharina Müller, Katja Radon, Jessica Michelle Guggenbüehl Noller, Roman Wölfel, Michael Höelscher, Inge Kroidl, Andreas Wieser, Laura Olbrich, Emad Alamoudi, Jared L. Anderson, Maximilian Baumann, Marieke Behlen, Jessica Beyerl, Rebecca Böhnlein, Anna Brauer, Vera Britz, Jan Bruger, Friedrich Caroli, Lorenzo Contento, Jana Diekmannshemke, Anna Do, Gerhard Dobler, Ute Eberle, Judith Eckstein, Jonathan Frese, Felix Forster, Turid Frahnow, Günter Fröschl, Otto Geisenberger, Kristina Gillig, Arlett Heiber, Christian Hinske, Janna Hoefflin, Tim Hofberger, Michael Höfinger, Larissa Hofmann, Sacha Horn, Kristina Huber, Christian Janke, Ursula Kappl, Charlotte Kiani, Arne Kroidl, Michael Laxy, Reiner Leidl, Felix Lindner, Rebecca Mayrhofer, Anna‐Maria Mekota, Hannah Müller, Dafni Metaxa, Leonie Pattard, Michel Pletschette, Stephan Prückner, Konstantin Pusl, Elba Raimúndez, Camila Rothe, Nicole Schäfer, Paul Schandelmaier, Lara Schneider, Sophie Schultz, Mirjam Schunk, Lars Schwettmann, Heidi Seibold, Peter Sothmann, Paul Stapor, Fabian J. Theis, Verena Thiel, Sophie Thiesbrummel, Niklas Thur, Julia Waibel, Claudia Wallrauch, Simon Winter, Julia Wolff, Pia Wullinger, Houda Yaqine, Sabine Zange, Eleftheria Zeggini, Thomas Zimmermann, Anna Zielke, Mohamed Ibraheem, Mohamed I. M. Ahmed, Marc Becker, Paulina Diepers, Yannik Schälte, Mercè Garí, Peter Pütz
Abstract
Risk factors for disease progression and severity of SARS-CoV-2 infections require an understanding of acute and long-term virological and immunological dynamics. Fifty-one RT-PCR positive COVID-19 outpatients were recruited between May and December 2020 in Munich, Germany, and followed up at multiple defined timepoints for up to one year. RT-PCR and viral culture were performed and seroresponses measured. Participants were classified applying the WHO clinical progression scale. Short symptom to test time (median 5.0 days; p = 0.0016) and high viral loads (VL; median maximum VL: 3∙108 copies/mL; p = 0.0015) were indicative for viral culture positivity. Participants with WHO grade 3 at baseline had significantly higher VLs compared to those with WHO 1 and 2 (p = 0.01). VLs dropped fast within 1 week of symptom onset. Maximum VLs were positively correlated with the magnitude of Ro-N-Ig seroresponse (p = 0.022). Our results describe the dynamics of VLs and antibodies to SARS-CoV-2 in mild to moderate cases that can support public health measures during the ongoing global pandemic.