Rxivist logo

Fever, Diarrhea, and Severe Disease Correlate with High Persistent Antibody Levels against SARS-CoV-2

By Maya F. Amjadi, Sarah E. O’Connell, Tammy Armbrust, Aisha M. Mergaert, Sandeep R. 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

Posted 06 Jan 2021
medRxiv DOI: 10.1101/2021.01.05.21249240

Lasting immunity will be critical for overcoming the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, factors that drive the development of high titers of anti-SARS-CoV-2 antibodies and how long those antibodies persist remain unclear. Our objective was to comprehensively evaluate anti-SARS-CoV-2 antibodies in a clinically diverse COVID-19 convalescent cohort at defined time points to determine if anti-SARS-CoV-2 antibodies persist and to identify clinical and demographic factors that correlate with high titers. Using a novel multiplex assay to quantify IgG against four SARS-CoV-2 antigens, a receptor binding domain-angiotensin converting enzyme 2 inhibition assay, and a SARS-CoV-2 neutralization assay, we found that 98% of COVID-19 convalescent subjects had anti-SARS-CoV-2 antibodies five weeks after symptom resolution (n=113). Further, antibody levels did not decline three months after symptom resolution (n=79). As expected, greater disease severity, older age, male sex, obesity, and higher Charlson Comorbidity Index score correlated with increased anti-SARS-CoV-2 antibody levels. We demonstrated for the first time that COVID-19 symptoms, namely fever, abdominal pain, diarrhea and low appetite, correlated consistently with higher anti-SARS-CoV-2 antibody levels. Our results provide new insights into the development and persistence of anti-SARS-CoV-2 antibodies.

Download data

  • Downloaded 2,075 times
  • Download rankings, all-time:
    • Site-wide: 8,936
    • In infectious diseases: 1,346
  • Year to date:
    • Site-wide: 1,612
  • Since beginning of last month:
    • Site-wide: 14,005

Altmetric data

Downloads over time

Distribution of downloads per paper, site-wide