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?:abstract
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We assessed the relationship between disease severity and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) load, IgG antibody levels, and prognostic indicators. Twenty-one patients hospitalized with COVID-19 were classified as having severe or mild disease based on their average respiratory rate during hospitalization (severe: ≥22 breaths/min; mild: <22 breaths/min). The viral load in nasopharyngeal samples, and blood levels of C-reactive protein (CRP), lymphocytes, and D-dimer on admission and plasma immunoglobulin G (IgG) index on Day 7 ±2 from symptom onset were compared according to disease severity. Of the participants, 7 had severe and 14 had mild disease. Participants with severe disease had a significantly higher IgG index (median: 3.75 vs 0.56, p=0.01), CRP (median: 8.6 vs 1.0 mg/dL, p<0.001), and D-dimer levels (median: 1.65 vs 0.75µg/mL; p=0.002), and a significantly lower lymphocyte count (median: 1176 vs 666 cells/µL, p=0.005) and viral load (median: 8.7×106 vs 2.3×104 copies/mL, p=0.005). Furthermore, time from symptom onset to virus disappearance was significantly longer (median: 24 vs 17 days, p=0.03). A high IgG index in the early phase of the disease may be associated with disease severity and might serve as a prognostic indicator.
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