Role of IgG against N-protein of SARS-CoV2 in COVID19 clinical outcomes

Abstract The Nucleocapsid Protein (N Protein) of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV2) is located in the viral core. Immunoglobulin G (IgG) targeting N protein is detectable in the serum of infected patients. The effect of high titers of IgG against N-protein on clinical outcom...

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Main Authors: Mayank Batra, Runxia Tian, Chongxu Zhang, Emile Clarence, Camila Sofia Sacher, Justin Nestor Miranda, Justin Rafa O. De La Fuente, Megan Mathew, Desmond Green, Sayari Patel, Maria Virginia Perez Bastidas, Sara Haddadi, Mukunthan Murthi, Miguel Santiago Gonzalez, Shweta Kambali, Kayo H. M. Santos, Huda Asif, Farzaneh Modarresi, Mohammad Faghihi, Mehdi Mirsaeidi
Format: Article
Language:English
Published: Nature Portfolio 2021-02-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-021-83108-0
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author Mayank Batra
Runxia Tian
Chongxu Zhang
Emile Clarence
Camila Sofia Sacher
Justin Nestor Miranda
Justin Rafa O. De La Fuente
Megan Mathew
Desmond Green
Sayari Patel
Maria Virginia Perez Bastidas
Sara Haddadi
Mukunthan Murthi
Miguel Santiago Gonzalez
Shweta Kambali
Kayo H. M. Santos
Huda Asif
Farzaneh Modarresi
Mohammad Faghihi
Mehdi Mirsaeidi
author_facet Mayank Batra
Runxia Tian
Chongxu Zhang
Emile Clarence
Camila Sofia Sacher
Justin Nestor Miranda
Justin Rafa O. De La Fuente
Megan Mathew
Desmond Green
Sayari Patel
Maria Virginia Perez Bastidas
Sara Haddadi
Mukunthan Murthi
Miguel Santiago Gonzalez
Shweta Kambali
Kayo H. M. Santos
Huda Asif
Farzaneh Modarresi
Mohammad Faghihi
Mehdi Mirsaeidi
author_sort Mayank Batra
collection DOAJ
description Abstract The Nucleocapsid Protein (N Protein) of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV2) is located in the viral core. Immunoglobulin G (IgG) targeting N protein is detectable in the serum of infected patients. The effect of high titers of IgG against N-protein on clinical outcomes of SARS-CoV2 disease has not been described. We studied 400 RT-PCR confirmed SARS-CoV2 patients to determine independent factors associated with poor outcomes, including Medical Intensive Care Unit (MICU) admission, prolonged MICU stay and hospital admissions, and in-hospital mortality. We also measured serum IgG against the N protein and correlated its concentrations with clinical outcomes. We found that several factors, including Charlson comorbidity Index (CCI), high levels of IL6, and presentation with dyspnea were associated with poor clinical outcomes. It was shown that higher CCI and higher IL6 levels were independently associated with in-hospital mortality. Anti-N protein IgG was detected in the serum of 55 (55%) patients at the time of admission. A high concentration of antibodies, defined as signal to cut off ratio (S/Co) > 1.5 (75 percentile of all measurements), was found in 25 (25%) patients. The multivariable logistic regression models showed that between being an African American, higher CCI, lymphocyte counts, and S/Co ratio > 1.5, only S/Co ratio were independently associated with MICU admission and longer length of stay in hospital. This study recommends that titers of IgG targeting N-protein of SARS-CoV2 at admission is a prognostic factor for the clinical course of disease and should be measured in all patients with SARS-CoV2 infection.
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spelling doaj.art-581137ccf5854a13a0c73fa00760ace22022-12-21T19:26:44ZengNature PortfolioScientific Reports2045-23222021-02-011111910.1038/s41598-021-83108-0Role of IgG against N-protein of SARS-CoV2 in COVID19 clinical outcomesMayank Batra0Runxia Tian1Chongxu Zhang2Emile Clarence3Camila Sofia Sacher4Justin Nestor Miranda5Justin Rafa O. De La Fuente6Megan Mathew7Desmond Green8Sayari Patel9Maria Virginia Perez Bastidas10Sara Haddadi11Mukunthan Murthi12Miguel Santiago Gonzalez13Shweta Kambali14Kayo H. M. Santos15Huda Asif16Farzaneh Modarresi17Mohammad Faghihi18Mehdi Mirsaeidi19Division of Pulmonary and Critical Care, University of MiamiDivision of Pulmonary and Critical Care, University of MiamiDivision of Pulmonary and Critical Care, University of MiamiSchool of Medicine, University of MiamiSchool of Medicine, University of MiamiSchool of Medicine, University of MiamiSchool of Medicine, University of MiamiSchool of Medicine, University of MiamiSchool of Medicine, University of MiamiSchool of Medicine, University of MiamiDivision of Pulmonary and Critical Care, University of MiamiDivision of Pulmonary and Critical Care, University of MiamiDivision of Pulmonary and Critical Care, University of MiamiDivision of Pulmonary and Critical Care, University of MiamiDivision of Pulmonary and Critical Care, University of MiamiDivision of Pulmonary and Critical Care, University of MiamiDivision of Pulmonary and Critical Care, University of MiamiExpress Gene LaboratoryExpress Gene LaboratoryDivision of Pulmonary and Critical Care, University of MiamiAbstract The Nucleocapsid Protein (N Protein) of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV2) is located in the viral core. Immunoglobulin G (IgG) targeting N protein is detectable in the serum of infected patients. The effect of high titers of IgG against N-protein on clinical outcomes of SARS-CoV2 disease has not been described. We studied 400 RT-PCR confirmed SARS-CoV2 patients to determine independent factors associated with poor outcomes, including Medical Intensive Care Unit (MICU) admission, prolonged MICU stay and hospital admissions, and in-hospital mortality. We also measured serum IgG against the N protein and correlated its concentrations with clinical outcomes. We found that several factors, including Charlson comorbidity Index (CCI), high levels of IL6, and presentation with dyspnea were associated with poor clinical outcomes. It was shown that higher CCI and higher IL6 levels were independently associated with in-hospital mortality. Anti-N protein IgG was detected in the serum of 55 (55%) patients at the time of admission. A high concentration of antibodies, defined as signal to cut off ratio (S/Co) > 1.5 (75 percentile of all measurements), was found in 25 (25%) patients. The multivariable logistic regression models showed that between being an African American, higher CCI, lymphocyte counts, and S/Co ratio > 1.5, only S/Co ratio were independently associated with MICU admission and longer length of stay in hospital. This study recommends that titers of IgG targeting N-protein of SARS-CoV2 at admission is a prognostic factor for the clinical course of disease and should be measured in all patients with SARS-CoV2 infection.https://doi.org/10.1038/s41598-021-83108-0
spellingShingle Mayank Batra
Runxia Tian
Chongxu Zhang
Emile Clarence
Camila Sofia Sacher
Justin Nestor Miranda
Justin Rafa O. De La Fuente
Megan Mathew
Desmond Green
Sayari Patel
Maria Virginia Perez Bastidas
Sara Haddadi
Mukunthan Murthi
Miguel Santiago Gonzalez
Shweta Kambali
Kayo H. M. Santos
Huda Asif
Farzaneh Modarresi
Mohammad Faghihi
Mehdi Mirsaeidi
Role of IgG against N-protein of SARS-CoV2 in COVID19 clinical outcomes
Scientific Reports
title Role of IgG against N-protein of SARS-CoV2 in COVID19 clinical outcomes
title_full Role of IgG against N-protein of SARS-CoV2 in COVID19 clinical outcomes
title_fullStr Role of IgG against N-protein of SARS-CoV2 in COVID19 clinical outcomes
title_full_unstemmed Role of IgG against N-protein of SARS-CoV2 in COVID19 clinical outcomes
title_short Role of IgG against N-protein of SARS-CoV2 in COVID19 clinical outcomes
title_sort role of igg against n protein of sars cov2 in covid19 clinical outcomes
url https://doi.org/10.1038/s41598-021-83108-0
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