Monitoring algorithm of hospitalized patients in a medical center with SARS-CoV-2 (Omicron variant) infection: clinical epidemiological surveillance and immunological assessment

Chi-Sheng Chen; Ming-Jr Jian; Chih-Kai Chang; Hsing-Yi Chung; Shih-Yi Li; Jung-Chung Lin; Kuo-Ming Yeh; Ya-Sung Yang; Chien-Wen Chen; Shan-Shan Hsieh; Sheng-Hui Tang; Cherng-Lih Perng; Feng-Yee Chang; Hung-Sheng Shang

doi:10.7717/peerj.14666

Monitoring algorithm of hospitalized patients in a medical center with SARS-CoV-2 (Omicron variant) infection: clinical epidemiological surveillance and immunological assessment

PeerJ. 2023 Jan 23:11:e14666. doi: 10.7717/peerj.14666. eCollection 2023.

Affiliations

¹ Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, Taipei, Taiwan.
² Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Tri-Service General Hospital, Taipei, Taiwan.
³ Division of Pulmonary and Critical Care Medicine, Department of Medicine, Tri-Service General Hospital, Taipei, Taiwan.

^# Contributed equally.

Abstract

Purpose: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a major healthcare threat worldwide. Since it was first identified in November 2021, the Omicron (B.1.1.529) variant of SARS-CoV-2 has evolved into several lineages, including BA.1, BA.2-BA.4, and BA.5. SARS-CoV-2 variants might increase transmissibility, pathogenicity, and resistance to vaccine-induced immunity. Thus, the epidemiological surveillance of circulating lineages using variant phenotyping is essential. The aim of the current study was to characterize the clinical outcome of Omicron BA.2 infections among hospitalized COVID-19 patients and to perform an immunological assessment of such cases against SARS-CoV-2.

Patients and methods: We evaluated the analytical and clinical performance of the BioIC SARS-CoV-2 immunoglobulin (Ig)M/IgG detection kit, which was used for detecting antibodies against SARS-CoV-2 in 257 patients infected with the Omicron variant.

Results: Poor prognosis was noted in 38 patients, including eight deaths in patients characterized by comorbidities predisposing them to severe COVID-19. The variant-of-concern (VOC) typing and serological analysis identified time-dependent epidemic trends of BA.2 variants emerging in the outbreak of the fourth wave in Taiwan. Of the 257 specimens analyzed, 108 (42%) and 24 (9.3%) were positive for anti-N IgM and IgG respectively.

Conclusion: The VOC typing of these samples allowed for the identification of epidemic trends by time intervals, including the B.1.1.529 variant replacing the B.1.617.2 variant. Moreover, antibody testing might serve as a complementary method for COVID-19 diagnosis. The combination of serological testing results with the reverse transcription-polymerase chain reaction cycle threshold value has potential value in disease prognosis, thereby aiding in epidemic investigations conducted by clinicians or the healthcare department.

Keywords: Anti-N IgG; Anti-N IgM; B.1.1.529; BA.2; COVID-19 immunoglobulin; Epidemiological surveillance; Immunology; SARS-CoV-2; VOC genotyping.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Algorithms
Antibodies, Viral
COVID-19 Testing
COVID-19* / diagnosis
Humans
Immunoglobulin G
Immunoglobulin M
SARS-CoV-2* / genetics

Substances

Antibodies, Viral
Immunoglobulin G
Immunoglobulin M

Supplementary concepts

SARS-CoV-2 variants

Grants and funding

This work was supported by the Tri-Service General Hospital, Taipei, Taiwan, R.O.C. [grant number: TSGH-D-111086]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.