Published online Mar 27, 2023. doi: 10.4331/wjbc.v14.i2.52
Peer-review started: October 10, 2022
First decision: January 3, 2023
Revised: January 12, 2023
Accepted: February 13, 2023
Article in press: February 13, 2023
Published online: March 27, 2023
Predicting the severity of inflammatory response helps in managing critical patients using serology tests immunoglobulin G (IgG) and immunoglobulin M (IgM).
The importance of doing coronavirus disease (COVID) serology at a particular time as antibody titers may vary with the duration of the disease.
The objectivity was the correlation of the serology (IgM and IgG) with reverse transcriptase polymerase chain reaction (RT-PCR) status, disease severity (mild to critical), intensive care unit (ICU) admission, septic shock, acute kidney injury, and in-hospital mortality.
This was a longitudinal study to correlate serum SARS-CoV-2 IgM and IgG serology with clinical outcomes in COVID-19 patients. We analyzed patient data from March to December 2020 for those who were admitted at All India Institute of Medical Sciences Rishikesh. Clinical and laboratory data of these patients were collected from the e-hospital portal and analyzed. A correlation was seen with clinical outcomes and was assessed using SPSS software.
Out of 494 patients, the mean age of patients was 48.95 ± 16.40 years and there were more male patients in the study (66.0%). The patients were classified as mild-moderate 328 (67.1%), severe 131 (26.8%), and critical 30 (6.1%). The mean duration from symptom onset to serology testing was 19.87 ± 30.53 d. In-hospital mortality was observed in 25.1% of patients. The seropositivity rate (i.e., either IgG or IgM > 10 AU) was 50%. IgM levels (AU/mL) (W = 33428.000, P ≤ 0.001) and IgG levels (AU/mL) (W = 39256.500, P ≤ 0.001), with the median IgM/IgG levels (AU/mL), were highest in the RT-PCR-Positive group compared to RT-PCR-Negative clinical COVID-19. There was no significant difference between the two groups in terms of all other clinical outcomes (disease severity, septic shock, ICU admission, mechanical ventilation, and mortality).
The study showed that serology levels are high in RT-PCR positive group compared to clinical COVID-19. The study also highlights the importance of doing serology at a particular time as antibody titers vary with the duration of the disease.
The serology cannot be useful for the prediction of disease outcomes. In week intervals there is a significant correlation between clinical outcomes and serology on week 3.