Longitudinal Serology of SARS-CoV-2-Infected Individuals in India: A Prospective Cohort Study

Am J Trop Med Hyg. 2021 May 18;105(1):66-72. doi: 10.4269/ajtmh.21-0164.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Viral / blood
  • COVID-19 / blood*
  • COVID-19 / epidemiology
  • COVID-19 / virology*
  • Child
  • Child, Preschool
  • Cohort Studies
  • Female
  • Humans
  • Immunoglobulin G / blood
  • India / epidemiology
  • Infant
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk Factors
  • SARS-CoV-2* / immunology
  • Seroconversion
  • Young Adult

Substances

  • Antibodies, Viral
  • Immunoglobulin G