Immune response and laboratory markers in the spectrum of severity of COVID-19

BACKGROUND: Serum antibodies to SARS-CoV-2, when measured early after disease onset, may add value to the diagnosis of COVID-19. AIM: To examine the levels of serum antibodies to SARS-CoV-2 and laboratory blood parameters in hospitalized patients with COVID-19 of varying severity. MATERIALS AND METHODS: In this retrospective cohort study, we examined laboratory markers of inflammation in patients with acute COVID-19 during the 1st week of hospitalization. The levels of serum antibodies to SARS-CoV-2 were studied using commercial test systems. RESULTS: In 47% of hospitalized patients with COVID-19, during the first week of hospital stay, IgM and IgG antibodies to SARS-CoV-2 were detected, both in the case of a positive and negative PCR test. An average positive cor- relation of detected IgM and IgG with antibodies to the receptor-binding site of the S-protein of the SARS-CoV-2 virus is shown. In total, IgM and IgG antibodies to SARS-CoV-2 were most often detected in patients with a favorable course of the disease. Laboratory parameters in patients with moderate and severe COVID-19 were characterized by asignificant increase in the level of serum C-reactive protein, an increase in the neutrophil-leukocyte ratio and fibrinogen level, in comparison with data from patients with a mild course of the disease. In mild cases of infection, a moderately negative correlation was revealed between the levels of antibodies to SARS-CoV-2 and NLR. CONCLUSIONS: Detection of antibodies to SARS-CoV-2 in the early stages of hospitalization may be a predictor of a favorable outcome of the disease and serve as an additional criterion for the diagnosis of COVID-19 along with PCR analysis.