Role of IgG against N-protein of SARS-CoV2 in COVID19 clinical outcomes

The Nucleocapsid Protein (N Protein) of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV2) is located in the viral core. Immunoglobulin G (IgG) targeting N protein is detectable in the serum of infected patients. The effect of high titers of IgG against N-protein on clinical outcomes of SAR...

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Published in:	Scientific reports Vol. 11; no. 1; p. 3455
Main Authors:	Batra, Mayank, Tian, Runxia, Zhang, Chongxu, Clarence, Emile, Sacher, Camila Sofia, Miranda, Justin Nestor, De La Fuente, Justin Rafa O., Mathew, Megan, Green, Desmond, Patel, Sayari, Bastidas, Maria Virginia Perez, Haddadi, Sara, Murthi, Mukunthan, Gonzalez, Miguel Santiago, Kambali, Shweta, Santos, Kayo H. M., Asif, Huda, Modarresi, Farzaneh, Faghihi, Mohammad, Mirsaeidi, Mehdi
Format:	Journal Article
Language:	English
Published:	London Nature Publishing Group UK 10-02-2021 Nature Publishing Group Nature Portfolio
Subjects:	631/250 692/699 Adult Aged Aged, 80 and over Antibodies, Viral - blood Antibodies, Viral - immunology Clinical outcomes Coronaviruses COVID-19 COVID-19 - blood COVID-19 - immunology Dyspnea Female Humanities and Social Sciences Humans Immunoglobulin G Immunoglobulin G - blood Immunoglobulin G - immunology Intensive Care Units Interleukin 6 Length of Stay Lymphocytes Male Middle Aged Mortality multidisciplinary N protein Nucleocapsid Proteins - immunology Nucleocapsids Patients Polymerase chain reaction Prognosis Proteins Regression analysis Respiration SARS-CoV-2 - immunology Science Science (multidisciplinary) Severe acute respiratory syndrome Severe acute respiratory syndrome coronavirus 2 Spike Glycoprotein, Coronavirus - immunology
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Summary:	The Nucleocapsid Protein (N Protein) of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV2) is located in the viral core. Immunoglobulin G (IgG) targeting N protein is detectable in the serum of infected patients. The effect of high titers of IgG against N-protein on clinical outcomes of SARS-CoV2 disease has not been described. We studied 400 RT-PCR confirmed SARS-CoV2 patients to determine independent factors associated with poor outcomes, including Medical Intensive Care Unit (MICU) admission, prolonged MICU stay and hospital admissions, and in-hospital mortality. We also measured serum IgG against the N protein and correlated its concentrations with clinical outcomes. We found that several factors, including Charlson comorbidity Index (CCI), high levels of IL6, and presentation with dyspnea were associated with poor clinical outcomes. It was shown that higher CCI and higher IL6 levels were independently associated with in-hospital mortality. Anti-N protein IgG was detected in the serum of 55 (55%) patients at the time of admission. A high concentration of antibodies, defined as signal to cut off ratio (S/Co) > 1.5 (75 percentile of all measurements), was found in 25 (25%) patients. The multivariable logistic regression models showed that between being an African American, higher CCI, lymphocyte counts, and S/Co ratio > 1.5, only S/Co ratio were independently associated with MICU admission and longer length of stay in hospital. This study recommends that titers of IgG targeting N-protein of SARS-CoV2 at admission is a prognostic factor for the clinical course of disease and should be measured in all patients with SARS-CoV2 infection.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2045-2322 2045-2322
DOI:	10.1038/s41598-021-83108-0