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Antibody Responses after COVID-19 Infection in Patients Who Are Mildly Symptomatic or Asymptomatic in Bangladesh

27 Pages Posted: 10 Oct 2020

See all articles by Tahmina Shirin

Tahmina Shirin

Disease Control and Research - Institute of Epidemiology

Taufiqur R. Bhuiyan

International Centre for Diarrhoeal Disease Research - Infectious Disease Division

Richelle C. Charles

Massachusetts General Hospital - Division of Infectious Diseases

Shaheena Amin

International Centre for Diarrhoeal Disease Research - Infectious Disease Division

Imran Bhuiyan

Institute for Developing Science & Health Initiatives (ideSHi)

Zannat Kawser

Institute for Developing Science & Health Initiatives (ideSHi)

Asifuzaman Rahat

Institute for Developing Science & Health Initiatives (ideSHi)

Ahmed Nawsher Alam

Disease Control and Research - Institute of Epidemiology

Sharmin Sultana

Disease Control and Research - Institute of Epidemiology

Md Abdul Aleem

International Centre for Diarrhoeal Disease Research - Infectious Disease Division

Manjur Hossain Khan

Disease Control and Research - Institute of Epidemiology

Samsad Rabbani Khan

Disease Control and Research - Institute of Epidemiology

Regina C. LaRocque

Massachusetts General Hospital - Division of Infectious Diseases

Stephen B. Calderwood

Massachusetts General Hospital - Division of Infectious Diseases

Edward T. Ryan

Massachusetts General Hospital - Division of Infectious Diseases

Damien M. Slater

Massachusetts General Hospital - Division of Infectious Diseases

Sayera Banu

International Centre for Diarrhoeal Disease Research - Infectious Disease Division

John D. Clemens

International Centre for Diarrhoeal Disease Research - Infectious Disease Division

Jason B. Harris

Massachusetts General Hospital - Division of Infectious Diseases

Meerjady Sabrina Flora

Disease Control and Research - Institute of Epidemiology

Firdausi Qadri

International Centre for Diarrhoeal Disease Research - Infectious Disease Division

More...

Abstract

Studies on serologic responses following COVID-19 have been published primarily in individuals who are moderately or severely symptomatic, but there are few data from individuals who are only mildly symptomatic or asymptomatic. To generate such data, we used World Health Organization disease severity categorization, and measured IgG, IgM, and IgA antibodies to the receptor binding domain (RBD) of   spike protein of SARS-CoV-2 by ELISA in infected individuals, both mildly symptomatic (n=108) and asymptomatic (n=63) on days 1, 7, 14, and 30 following RT-PCR-based confirmation of infection in Bangladesh, and compared   these results to those detected in pre-pandemic samples, including healthy controls (n=73) and individuals infected with other viruses commonly seen in this area (n = 79). Mildly symptomatic individuals developed IgM and IgA antibody responses by day 14 after detection of infection in 72% and 83% of individuals, respectively, while 95% of these individuals developed an IgG antibody response by day 14, and rose to 100% by day 30. In contrast, individuals infected with SARS-CoV-2 but who remained asymptomatic developed antibody responses significantly less frequently, with only 20% positive for IgA by day 14, 22% positive for IgM by day 14, and 45% positive for IgG by day 30 after detection of infection. These results confirm that immune responses are generated following COVID in individuals who develop mildly symptomatic illness. However, those with asymptomatic infection do not respond or have lower antibody levels. These results will impact modelling needed for determining herd immunity generated by natural infection or vaccination.

Funding Statement: World Health Organization, Fogarty International Center TW005572 and Emerging Global Leader Award; K43 TW010362, the Fondation Merieux and the Bill and Melinda Gates Foundation (BMGF). This study was carried out with the support of the United States Agency for International Development (USAID) under the terms of USAID’s Alliance for Combating TB in Bangladesh activity cooperative agreement no. CA # 72038820CA00002.

Declaration of Interests: The authors declare no conflict of interest.

Ethics Approval Statement: The study was also approved by the IRB of the IEDCR and icddr,b.

Keywords: Seroconversion, COVID-19, immune responses, symptomatic, asymptomatic

Suggested Citation

Shirin, Tahmina and Bhuiyan, Taufiqur R. and Charles, Richelle C. and Amin, Shaheena and Bhuiyan, Imran and Kawser, Zannat and Rahat, Asifuzaman and Alam, Ahmed Nawsher and Sultana, Sharmin and Aleem, Md Abdul and Khan, Manjur Hossain and Khan, Samsad Rabbani and LaRocque, Regina C. and Calderwood, Stephen B. and Ryan, Edward T. and Slater, Damien M. and Banu, Sayera and Clemens, John D. and Harris, Jason B. and Flora, Meerjady Sabrina and Qadri, Firdausi, Antibody Responses after COVID-19 Infection in Patients Who Are Mildly Symptomatic or Asymptomatic in Bangladesh. Available at SSRN: https://ssrn.com/abstract=3675451 or http://dx.doi.org/10.2139/ssrn.3675451

Tahmina Shirin

Disease Control and Research - Institute of Epidemiology ( email )

Bangladesh

Taufiqur R. Bhuiyan

International Centre for Diarrhoeal Disease Research - Infectious Disease Division ( email )

Bangladesh

Richelle C. Charles

Massachusetts General Hospital - Division of Infectious Diseases

MA
United States

Shaheena Amin

International Centre for Diarrhoeal Disease Research - Infectious Disease Division ( email )

Bangladesh

Imran Bhuiyan

Institute for Developing Science & Health Initiatives (ideSHi) ( email )

Zannat Kawser

Institute for Developing Science & Health Initiatives (ideSHi) ( email )

Asifuzaman Rahat

Institute for Developing Science & Health Initiatives (ideSHi) ( email )

Ahmed Nawsher Alam

Disease Control and Research - Institute of Epidemiology ( email )

Bangladesh

Sharmin Sultana

Disease Control and Research - Institute of Epidemiology

Bangladesh

Md Abdul Aleem

International Centre for Diarrhoeal Disease Research - Infectious Disease Division ( email )

Bangladesh

Manjur Hossain Khan

Disease Control and Research - Institute of Epidemiology ( email )

Bangladesh

Samsad Rabbani Khan

Disease Control and Research - Institute of Epidemiology ( email )

Bangladesh

Regina C. LaRocque

Massachusetts General Hospital - Division of Infectious Diseases

MA
United States

Stephen B. Calderwood

Massachusetts General Hospital - Division of Infectious Diseases ( email )

MA
United States

Edward T. Ryan

Massachusetts General Hospital - Division of Infectious Diseases

MA
United States

Damien M. Slater

Massachusetts General Hospital - Division of Infectious Diseases ( email )

MA
United States

Sayera Banu

International Centre for Diarrhoeal Disease Research - Infectious Disease Division ( email )

Bangladesh

John D. Clemens

International Centre for Diarrhoeal Disease Research - Infectious Disease Division

68 Shaheed Tajuddin Ahmed Sarani
Dhaka, 1212
Bangladesh

Jason B. Harris

Massachusetts General Hospital - Division of Infectious Diseases

MA
United States

Meerjady Sabrina Flora

Disease Control and Research - Institute of Epidemiology ( email )

Bangladesh

Firdausi Qadri (Contact Author)

International Centre for Diarrhoeal Disease Research - Infectious Disease Division ( email )

Bangladesh

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