Determinants and Dynamics of SARS-CoV-2 Infection in a Diverse Population: 6-Month Evaluation of a Prospective Cohort Study
Daniel B Horton, Emily S Barrett, Jason Roy, Maria Laura Gennaro, Tracy Andrews, Patricia Greenberg, Natalie Bruiners, Pratik Datta, Rahul Ukey, Senthil K Velusamy, Daniel Fine, William J Honnen, Yue Sandra Yin, Abraham Pinter, Andrew Brooks, Jay Tischfield, Sabiha Hussain, Sugeet Jagpal, Shobha Swaminathan, Veenat Parmar, Nancy Reilly, Sunanda Gaur, Reynold A Panettieri, Jeffrey L Carson, Martin J Blaser, Daniel B Horton, Emily S Barrett, Jason Roy, Maria Laura Gennaro, Tracy Andrews, Patricia Greenberg, Natalie Bruiners, Pratik Datta, Rahul Ukey, Senthil K Velusamy, Daniel Fine, William J Honnen, Yue Sandra Yin, Abraham Pinter, Andrew Brooks, Jay Tischfield, Sabiha Hussain, Sugeet Jagpal, Shobha Swaminathan, Veenat Parmar, Nancy Reilly, Sunanda Gaur, Reynold A Panettieri, Jeffrey L Carson, Martin J Blaser
Abstract
Background: We studied risk factors, antibodies, and symptoms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in a diverse, ambulatory population.
Methods: A prospective cohort (n = 831) previously undiagnosed with SARS-CoV-2 infection underwent serial testing (SARS-CoV-2 polymerase chain reaction, immunoglobulin G [IgG]) for 6 months.
Results: Ninety-three participants (11.2%) tested SARS-CoV-2-positive: 14 (15.1%) asymptomatic, 24 (25.8%) severely symptomatic. Healthcare workers (n = 548) were more likely to become infected (14.2% vs 5.3%; adjusted odds ratio, 2.1; 95% confidence interval, 1.4-3.3) and severely symptomatic (29.5% vs 6.7%). IgG antibodies were detected after 79% of asymptomatic infections, 89% with mild-moderate symptoms, and 96% with severe symptoms. IgG trajectories after asymptomatic infections (slow increases) differed from symptomatic infections (early peaks within 2 months). Most participants (92%) had persistent IgG responses (median 171 days). In multivariable models, IgG titers were positively associated with symptom severity, certain comorbidities, and hospital work. Dyspnea and neurologic changes (including altered smell/taste) lasted ≥ 120 days in ≥ 10% of affected participants. Prolonged symptoms (frequently more severe) corresponded to higher antibody levels.
Conclusions: In a prospective, ethnically diverse cohort, symptom severity correlated with the magnitude and trajectory of IgG production. Symptoms frequently persisted for many months after infection.Clinical Trials Registration. NCT04336215.
Keywords: COVID-19; SARS-CoV-2 infection; humoral immunity; longitudinal data analysis; postacute sequelae of COVID-19; prospective cohort; risk factors; symptoms.
© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.
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Source: PubMed