Antigen-Specific Antibody Signature Is Associated with COVID-19 Outcome

Bárbara Batista Salgado, Maele Ferreira Jordão, Thiago Barros do Nascimento de Morais, Danielle Severino Sena da Silva, Ivanildo Vieira Pereira Filho, Wlademir Braga Salgado Sobrinho, Nani Oliveira Carvalho, Rafaella Oliveira dos Santos, Julia Forato, Priscilla Paschoal Barbosa, Daniel A. Toledo-Teixeira, Kerollen Runa Pinto, Ingrid Silva Correia, Isabelle Bezerra Cordeiro, Júlio Nino de Souza Neto, Enedina Nogueira de Assunção, Fernando Fonseca Almeida Val, Gisely Cardoso Melo, Vanderson de Souza Sampaio, Wuelton Marcelo MonteiroFabiana Granja, William Souza, Spartaco Astolfi Filho, Jose Luiz Proenca-Modena, Jaila Dias Borges Lalwani, Marcus Vinícius Guimarães de Lacerda, Paulo Afonso Nogueira, Pritesh Lalwani

Research output: Contribution to journalArticlepeer-review


Numerous studies have focused on inflammation-related markers to understand COVID-19. In this study, we performed a comparative analysis of spike (S) and nucleocapsid (N) protein-specific IgA, total IgG and IgG subclass response in COVID-19 patients and compared this to their disease outcome. We observed that the SARS-CoV-2 infection elicits a robust IgA and IgG response against the N-terminal (N1) and C-terminal (N3) region of the N protein, whereas we failed to detect IgA antibodies and observed a weak IgG response against the disordered linker region (N2) in COVID-19 patients. N and S protein-specific IgG1, IgG2 and IgG3 response was significantly elevated in hospitalized patients with severe disease compared to outpatients with non-severe disease. IgA and total IgG antibody reactivity gradually increased after the first week of symptoms. Magnitude of RBD-ACE2 blocking antibodies identified in a competitive assay and neutralizing antibodies detected by PRNT assay correlated with disease severity. Generally, the IgA and total IgG response between the discharged and deceased COVID-19 patients was similar. However, significant differences in the ratio of IgG subclass antibodies were observed between discharged and deceased patients, especially towards the disordered linker region of the N protein. Overall, SARS-CoV-2 infection is linked to an elevated blood antibody response in severe patients compared to non-severe patients. Monitoring of antigen-specific serological response could be an important tool to accompany disease progression and improve outcomes.

Original languageEnglish (US)
Article number1018
Issue number4
StatePublished - Apr 2023
Externally publishedYes


  • COVID-19
  • IgG subclass
  • SARS-CoV-2
  • antibody isotypes
  • nucleocapsid

ASJC Scopus subject areas

  • Infectious Diseases
  • Virology


Dive into the research topics of 'Antigen-Specific Antibody Signature Is Associated with COVID-19 Outcome'. Together they form a unique fingerprint.

Cite this