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Abstract
Combined kinetic analysis of plasma SARS-CoV-2 RNAemia, Nucleocapsid (N)-antigenemia and virus-specific antibodies may help ascertain the role of antibodies in preventing virus dissemination in COVID-19 patients. We performed this analysis in a cohort of 71 consecutive critically ill COVID-19 patients (49 male; median age, 65 years) using RT-PCR assay, lateral flow immunochromatography method and receptor binding domain (RBD) and N-based immunoassays. A total of 338 plasma specimens collected at a median of 12 days after symptoms onset were available for analyses. SARS-CoV-2 RNAemia and N-antigenemia were detected in 37 and 43 specimens from 26 (36.5%) and 30 (42.2%) patients, respectively. Free RNA was the main biological form of SARS-CoV-2 found in plasma. The detection rate for both viral components was associated with viral load at the upper respiratory tract. Median time to SARS-CoV-2-RBD antibody detection was 14 days (range, 4–38) from onset of symptoms. Decreasing antibody levels were observed in parallel to increasing levels of both RNAemia and N-antigenemia, yet overall a fairly modest inverse correlation (Rho = −0.35; P < 0.001) was seen between virus RNAemia and SARS-CoV-2-RBD antibody levels. The data cast doubts on a major involvement of antibodies in virus clearance from the bloodstream within the timeframe examined.
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1 Clinic University Hospital, INCLIVA Health Research Institute, Microbiology Service, Valencia, Spain (GRID:grid.411308.f)
2 University of Valencia, Department of Microbiology, School of Medicine, Valencia, Spain (GRID:grid.5338.d) (ISNI:0000 0001 2173 938X)
3 Institute of Agrochemistry and Food Technology, IATA-CSIC, Department of Preservation and Food Safety Technologies, Valencia, Spain (GRID:grid.419051.8) (ISNI:0000 0001 1945 7738)
4 Clinic University Hospital, INCLIVA Health Research Institute, Medical Intensive Care Unit, Valencia, Spain (GRID:grid.411308.f)
5 Clinic University Hospital, INCLIVA Health Research Institute, Microbiology Service, Valencia, Spain (GRID:grid.411308.f); University of Valencia, Department of Microbiology, School of Medicine, Valencia, Spain (GRID:grid.5338.d) (ISNI:0000 0001 2173 938X)