Published online Sep 29, 2022. doi: 10.5495/wjcid.v12.i2.50
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
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.
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.
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.
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.
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.
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.
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.