įurther investigation of patients who fail to produce detectable levels of IgG is lacking and antibody responses in patients with mild symptoms are also poorly described.
For example, SARS-CoV-2-specific IgG levels in patients have both been found to remain stable approximately 82 days PSO and to wain 2–3 months after infection. Serological findings over a longer period than 30 days post symptom onset (PSO) and in patients with non-severe disease remain limited and conflicting. When patients remain seronegative, it is often concluded that seroconversion would likely occur later. Several short follow-up studies of mostly hospitalized patients have reported the development of IgG in serum against SARS-CoV-2 in the majority of patients. Whilst all patients infected by SARS-CoV were found to develop IgG antibodies, some patients with mild symptoms of MERS-CoV failed to develop detectable levels of IgG. The serological responses to other beta-coronaviruses vary. Seroprevalence studies usually measure SARS-CoV-2 S- and nucleocapsid (N-) protein specific IgG antibodies whether these antibodies correlate with protective immunity is however still unknown. Thus, antibodies targeting the S-protein may effectively neutralize the virus. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, gains entry to human cells by binding the angiotensin-converting enzyme 2 (ACE2) receptor with the receptor-binding domain (RBD) of its spike (S) protein. The severity of COVID-19 ranges from asymptomatic to fatal pneumonitis, with mildly symptomatic patients accounting for approximately 80% of all cases according to current understanding. The coronavirus disease 2019 (COVID-19) pandemic continues, causing considerable morbidity and mortality worldwide. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ĭompeting interests: The authors have declared that no competing interests exist. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: All files are available from the Zenodo database (DOI: ).įunding: This work was supported by the Swedish State Support for Clinical Research (, ALFGBG-717531 (MG) and 679621 (SL)) and by SciLifeLab/KAW national COVID-19 research program ( 19#nationalprogram, V-2020-0250 (MG) and 2020-0182 (DA, MB, AL)). Received: JAccepted: OctoPublished: October 21, 2020Ĭopyright: © 2020 Marklund et al. Walsh, Beth Israel Deaconess Medical Center, UNITED STATES (2020) Serum-IgG responses to SARS-CoV-2 after mild and severe COVID-19 infection and analysis of IgG non-responders. Citation: Marklund E, Leach S, Axelsson H, Nyström K, Norder H, Bemark M, et al.
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