Retrospective Cohort Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Infect Dis. Sep 29, 2022; 12(2): 50-60
Published online Sep 29, 2022. doi: 10.5495/wjcid.v12.i2.50
Clinical significance of anti-nucleocapsid-IgG sero-positivity in SARS-CoV-2 infection in hospitalized patients in North Dakota
Bakir Dzananovic, Mark Williamson, Casmiar Nwaigwe, Chittaranjan Routray
Bakir Dzananovic, Department of Medicine, Idaho College of Osteopathic Medicine, Meridian, ID 83642, United States
Mark Williamson, Department of Biostatistics, Epidemiology and Research Design Core, University of North Dakota, Grand Forks, ND 58202, United States
Casmiar Nwaigwe, Department of Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Minot, ND 58701, United States
Chittaranjan Routray, Family Medicine, University of North Dakota School of Medicine and Health Sciences, Minot, ND 58701, United States
Chittaranjan Routray, Department of Internal Medicine, Trinity Health, Minot, ND 58701, United States
Author contributions: Routray C was the principal investigator and designed the study; Nwaigwe C was the co-investigator, participating in study design and revision of manuscript for intellectual content; Dzananovic B helped with data acquisition, analysis and initial manuscript writing; Williamson M performed the biostatistical analysis and interpretation of the data.
Supported by the National Institute of General Medical Sciences of the National Institutes of Health under Award, No. U54GM128729.
Institutional review board statement: Institutional review board statement: This study was reviewed and approved by the Trinity Hospital, Institutional Review Board Committee.
Informed consent statement: Obtaining informed consent was waived by the IRB committee since this was a retrospective cohort study.
Conflict-of-interest statement: There are no conflict of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE statement- checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Chittaranjan Routray, MD, Clinical Assistant Professor (Honorary), Family Medicine, University of North Dakota School of Medicine and Health Sciences, Minot, ND 58701, United States.
Received: June 18, 2022
Peer-review started: June 18, 2022
First decision: July 14, 2022
Revised: August 2, 2022
Accepted: September 21, 2022
Article in press: September 21, 2022
Published online: September 29, 2022
Research background

During the peak of the coronavirus disease 2019 (COVID-19) pandemic, hospitals and clinicians had to adapt quickly to the rapid spread of the infection in the community. In the absence of adequate literature, clinicians hypothesized and studied the utility of various protein markers to prognosticate their patients. We intended to study the correlation of anti-nucleocapsid-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody (IgG-N) presence with the clinical outcome in severely ill hospitalized COVID-19 patients.

Research motivation

We were interested in characterizing a correlation between presence or absence of IgG-N and clinical outcome in hospitalized COVID-19 patients. We wanted to test the ability of IgG-N in predicting the severity of illness, maximal oxygen support needed and final outcome in order to mobilize staff, manage intensive care unit (ICU) beds and ventilators as a part of the crisis management planning.

Research objectives

To study the effect of SARS-CoV-2 anti-nucleocapsid-IgG on COVID-19 diseases severity and outcome. We studied the effect of presence or absence of IgG-N on mean length of stay in the hospital, maximal oxygen support needed and mortality.

Research methods

We conducted a retrospective cohort study on adults aged between 28-96, being admitted to the hospital with severe or critical COVID-19 illness. Blood sample was collected either at or within 48 h of admission to the hospital to check for SARS-CoV-2-IgG-N. A total of fifty nine patients were enrolled into the study. We utilized a binary logistic regression model to analyze the outcome data.

Research results

Our data demonstrated that the need for maximal oxygen support, mean length of stay in the hospital and mortality were not significantly different between the groups with or without IgG-N at the time of admission.

Research conclusions

We concluded that IgG-N seroconversion had no significant correlation with the need for maximal oxygen support as well as mortality during the course of hospitalization. Length of stay in the hospital was not significantly different across the IgG-N status.

Research perspectives

Our study demonstrated that presence of anti-nucleocapsid-IgG against SARS-CoV-2 infection had no impact on the clinical outcome or diseases severity in hospitalized COVID-19 patients. We did not find a correlation of statistical significance to use IgG-N as a biomarker to predict clinical outcome in COVID-19 patients admitted to a community hospital in North Dakota. Acknowledging the limitation of our study, we look forward to a future study with larger sample size and risk-adjusted comorbidities to investigate the association with better clarity.