tetano
Editor, Senior Moderator
Open Forum Infect Dis
. 2022 May 20;9(7)
fac262.
doi: 10.1093/ofid/ofac262. eCollection 2022 Jul.
Antibody Level Predicts the Clinical Course of Breakthrough Infection of COVID-19 Caused by Delta and Omicron Variants: A Prospective Cross-Sectional Study
Min Hyung Kim[SUP] 1 [/SUP], Yooju Nam[SUP] 2 [/SUP], Nak Hoon Son[SUP] 3 [/SUP], Namwoo Heo[SUP] 1 [/SUP], Bongyoung Kim[SUP] 4 [/SUP], Eawha Kang[SUP] 2 [/SUP], Areum Shin[SUP] 2 [/SUP], Andrew Jihoon Yang[SUP] 2 [/SUP], Yoon Soo Park[SUP] 1 [/SUP], Heejung Kim[SUP] 5 [/SUP], Taeyoung Kyong[SUP] 2 [/SUP], Yong Chan Kim[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Omicron variant viruses spread rapidly, even in individuals with high vaccination rates. This study aimed to determine the utility of the antibody against spike protein level as a predictor of the disease course of coronavirus disease 2019 (COVID-19) in vaccinated patients.
Methods: Between December 11, 2021, and February 10, 2022, we performed a prospective observational cohort study in South Korea, which included patients infected with Delta and Omicron variants. A multivariable logistic regression analysis to determine the association between antibody levels and outcomes was conducted. The relationship between antibody levels and cycle threshold (Ct) values was confirmed using a generalized linear model.
Results: From 106 vaccinated patients (39 Delta and 67 Omicron), the geometric mean titers of antibodies in patients with fever (≥37.5°C), hypoxia (≤94% of SpO[SUB]2[/SUB]), pneumonia, C-reactive protein (CRP) elevation (>8 mg/L), or lymphopenia (<1100 cells/μL) were 1201.5 U/mL, 98.8 U/mL, 774.1 U/mL, 1335.1 U/mL, and 1032.2 U/mL, respectively. Increased antibody levels were associated with a decrease in the occurrence of fever (adjusted odds ratio [aOR], 0.23; 95% CI, 0.12-0.51), hypoxia (aOR, 0.23; 95% CI, 0.08-0.7), CRP elevation (aOR, 0.52; 95% CI, 0.29-0.0.94), and lymphopenia (aOR, 0.57; 95% CI, 0.33-0.98). Ct values showed a positive correlation between antibody levels (P = .02).
Conclusions: Antibody levels are predictive of the clinical course of COVID-19 in vaccinated patients with Delta and Omicron variant infections. Our data highlight the need for concentrated efforts to monitor patients with severe acute respiratory syndrome coronavirus 2 infection who are at risk of low antibody levels.
Keywords: COVID-19 breakthrough infection; Delta variant; Omicron variant; antibody level.
. 2022 May 20;9(7)
fac262.doi: 10.1093/ofid/ofac262. eCollection 2022 Jul.
Antibody Level Predicts the Clinical Course of Breakthrough Infection of COVID-19 Caused by Delta and Omicron Variants: A Prospective Cross-Sectional Study
Min Hyung Kim[SUP] 1 [/SUP], Yooju Nam[SUP] 2 [/SUP], Nak Hoon Son[SUP] 3 [/SUP], Namwoo Heo[SUP] 1 [/SUP], Bongyoung Kim[SUP] 4 [/SUP], Eawha Kang[SUP] 2 [/SUP], Areum Shin[SUP] 2 [/SUP], Andrew Jihoon Yang[SUP] 2 [/SUP], Yoon Soo Park[SUP] 1 [/SUP], Heejung Kim[SUP] 5 [/SUP], Taeyoung Kyong[SUP] 2 [/SUP], Yong Chan Kim[SUP] 1 [/SUP]
Affiliations
- PMID: 35855960
- PMCID: PMC9129209
- DOI: 10.1093/ofid/ofac262
Abstract
Background: Omicron variant viruses spread rapidly, even in individuals with high vaccination rates. This study aimed to determine the utility of the antibody against spike protein level as a predictor of the disease course of coronavirus disease 2019 (COVID-19) in vaccinated patients.
Methods: Between December 11, 2021, and February 10, 2022, we performed a prospective observational cohort study in South Korea, which included patients infected with Delta and Omicron variants. A multivariable logistic regression analysis to determine the association between antibody levels and outcomes was conducted. The relationship between antibody levels and cycle threshold (Ct) values was confirmed using a generalized linear model.
Results: From 106 vaccinated patients (39 Delta and 67 Omicron), the geometric mean titers of antibodies in patients with fever (≥37.5°C), hypoxia (≤94% of SpO[SUB]2[/SUB]), pneumonia, C-reactive protein (CRP) elevation (>8 mg/L), or lymphopenia (<1100 cells/μL) were 1201.5 U/mL, 98.8 U/mL, 774.1 U/mL, 1335.1 U/mL, and 1032.2 U/mL, respectively. Increased antibody levels were associated with a decrease in the occurrence of fever (adjusted odds ratio [aOR], 0.23; 95% CI, 0.12-0.51), hypoxia (aOR, 0.23; 95% CI, 0.08-0.7), CRP elevation (aOR, 0.52; 95% CI, 0.29-0.0.94), and lymphopenia (aOR, 0.57; 95% CI, 0.33-0.98). Ct values showed a positive correlation between antibody levels (P = .02).
Conclusions: Antibody levels are predictive of the clinical course of COVID-19 in vaccinated patients with Delta and Omicron variant infections. Our data highlight the need for concentrated efforts to monitor patients with severe acute respiratory syndrome coronavirus 2 infection who are at risk of low antibody levels.
Keywords: COVID-19 breakthrough infection; Delta variant; Omicron variant; antibody level.