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Predicting COVID-19 Severity with a Specific Nucleocapsid Antibody plus Disease Risk Factor Score

ABSTRACT: Effective methods for predicting COVID-19 disease trajectories are urgently needed. Here, enzyme-linked immunosorbent assay (ELISA) and coronavirus antigen microarray (COVAM) analysis mapped antibody epitopes in the plasma of COVID-19 patients (n = 86) experiencing a wide range of disease states. The experiments identified antibodies to a 21-residue epitope from nucleocapsid (termed Ep9) associated with severe disease, including admission to the intensive care unit (ICU), requirement for ventilators, or death. Importantly, anti-Ep9 antibodies can be detected within 6 days post-symptom onset and sometimes within 1 day. Furthermore, anti-Ep9 antibodies correlate with various comorbidities and hallmarks of immune hyperactivity. We introduce a simple-to-calculate, disease risk factor score to quantitate each patient’s comorbidities and age. For patients with anti-Ep9 antibodies, scores above 3.0 predict more severe disease outcomes with a 13.42 likelihood ratio (96.7% specificity). The results lay the groundwork for a new type of COVID-19 prognostic to allow early identification and triage of high-risk patients. Such information could guide more effective therapeutic intervention.

ORGANISM(S): Human parainfluenza virus 4b Human respirovirus 3 Human adenovirus sp. Severe acute respiratory syndrome coronavirus 2 Human coronavirus 229E Human respirovirus 1 Human coronavirus NL63 Homo sapiens Influenza A virus Human coronavirus HKU1 Severe acute respiratory syndrome-related coronavirus Human respiratory syncytial virus A Human orthorubulavirus 2 human metapneumovirus Human respiratory syncytial virus B Human coronavirus OC43 Influenza B virus Dromedary camel coronavirus

PROVIDER: GSE172471 | GEO | 2021/04/21

REPOSITORIES: GEO

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