Vasso Skouridou, Ana Serna-Gallego, Manuel Crespo, Ezequiel Ruiz-Mateos, Alexandre Pérez, Alicia Gutierrez-Valencia, Esperanza Muñoz-Muela, Ciara K. O'Sullivan, Maria Trujillo-Rodriguez, María M Bobillo, Cristina Martínez, Jorge Julio Cabrera-Alvar, Lucia Patiño, Irene Vieitez, Eva Poveda, Mariluz Botero-Gallego, Helena Codina, [Codina,H, Patiño,L, Bobillo,MM, Pérez,A, Poveda,E] Group of Virology and Pathogenesis, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVigo, Vigo, Spain. [Vieitez,I] Rare Diseases & Pediatric Medicine Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-Uvigo, Vigo, Spain. [Gutierrez-Valencia,A, Serna-Gallego,A, Trujillo-Rodríguez,M, Muñoz-Muela,E, Ruiz-Mateos,E] Clinic Unit of Infectious Diseases, Microbiology and Preventive Medicine, Institute of Biomedicine of Seville, IBiS, Virgen del Rocío University Hospital/CSIC/University of Seville, Seville, Spain. [Skouridou,V, Botero-Gallego,M, O’Sullivan,CK] INTERFIBIO Consolidated Research Group, Departament d’ Enginyeria Quimica, Universitat Rovira i Virgili, Tarragona, Spain. [Martínez,C] Methodology and Statistics Unit, Galicia Sur Health Research Institute (IIS Galicia Sur)-Complexo Hospitalario Universitario de Vigo, SERGAS-UVigo, Vigo, Spain. [Pérez,A, Crespo,M] Infectious Diseases Unit, Department of Internal Medicine, Complexo Hospitalario Universitario de Vigo, IIS Galicia Sur, SERGAS-UVigo, Vigo, Spain. [Cabrera-Alvar,JJ] Microbiology Service, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-Uvigo, Vigo, Spain. [O'Sullivan,CK] Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain., This work was supported by the Plan Estatal de I+D+I 2013-2016 and 2017–2020 and cofinanced by the Instituto de Salud Carlos III (ISCIII)—Subdirección General de Evaluación y Fomento de la investigación del Fondo Europeo de Desarrollo Regional (FEDER), Fondo COVID19 of Instituto de Salud Carlos III (COV20/00698), RETICS, Red de Investigación en SIDA [RD16/0025/0026], and Fundación Biomédica Galicia Sur. E.R-M. was supported by the Spanish Research Council (CSIC) and by the research grant CV20-85418 from the Consejería de Transformación Económica, Industria, Conocimiento y Universidades (Junta de Andalucía). A.P. was supported by the Instituto de Salud Carlos III, Subprograma Rio Hortega (CM20/00243). A.G.-V. was supported by the Instituto de Salud Carlos III, cofinanced by the European Development Regional Fund ('A way to achieve Europe'), Subprograma Miguel Servet (CP19/00159). E.M.M. was supported by the Instituto de Salud Carlos III, cofinanced by the European Development Regional Fund ('A way to achieve Europe'), Subprogram PFIS (FI19/00304). C.K. was supported by Fondo COVID19 of Instituto de Salud Carlos III (COV20/00823)., Instituto de Salud Carlos III, European Commission, Fundación Biomédica Galicia Sur, Consejo Superior de Investigaciones Científicas (España), Junta de Andalucía, Vieitez, Irene [0000-0001-9241-0207], Poveda, Eva [0000-0003-4835-9875], Vieitez, Irene, Poveda, Eva, Red Española de Investigación en SIDA, Martínez, Cristina, Trujillo-Rodríguez, María, Muñoz-Muela, Esperanza, Pérez-González, Alexandre, Cabrera-Alvar, Jorge Julio, Martínez, Cristina [0000-0002-9073-3464], Trujillo-Rodríguez, María [0000-0002-4716-4294], Muñoz-Muela, Esperanza [0000-0002-5432-986X], Pérez-González, Alexandre [0000-0003-4836-6768], and Cabrera-Alvar, Jorge Julio [0000-0002-0397-0868]
Viral and host immune kinetics during acute COVID-19 and after remission of acute symptoms need better characterization. SARS-CoV-2 RNA, anti-SARS-CoV-2 IgA, IgM, and IgG antibodies, and proinflammatory cytokines were measured in sequential samples from hospitalized COVID-19 patients during acute infection and six months following diagnosis. Twenty four laboratory confirmed COVID-19 patients with mild/moderate and severe COVID-19 were included. Most were males (83%) with a median age of 61 years. Twenty one percent were admitted to the intensive care unit (ICU) and eight of them (33.3%) met the criteria for severe COVID-19 disease. A delay in SARS-CoV-2 levels’ decline during the first six days of follow up, and viral load persistence until month 3 were related to severe COVID-19, but not viral load levels at the diagnosis. Higher levels of anti-SARS-CoV-2 IgA, IgM, IgG and the cytokines IL-6, IL-8 and MIP-1β at the diagnosis time were related to the severe COVID-19 outcome. Higher levels of MIP-1β, IL-1β, MIP-1α and IFN-γ were observed at month 1 and 3 during mild/moderate disease, compared to severe COVID-19. IgG persisted at low levels after six months of diagnosis. In conclusion, higher concentrations of IgA, IgM, and IgG, and IL-6, IL-8 and MIP-1β are identified as early predictors of COVID-19 severity, whereas no significant association is found between baseline SARS-COV-2 viral load and COVID-19 severity., This work was supported by the Plan Estatal de I+D+I 2013-2016 and 2017–2020 and cofinanced by the Instituto de Salud Carlos III (ISCIII)—Subdirección General de Evaluación y Fomento de la investigación del Fondo Europeo de Desarrollo Regional (FEDER), Fondo COVID19 of Instituto de Salud Carlos III (COV20/00698), RETICS, Red de Investigación en SIDA [RD16/0025/0026]; and Fundación Biomédica Galicia Sur. E.R-M. was supported by the Spanish Research Council (CSIC) and by the research grant CV20-85418 from the Consejería de Transformación Económica, Industria, Conocimiento y Universidades (Junta de Andalucía). A.P. was supported by the Instituto de Salud Carlos III, Subprograma Rio Hortega (CM20/00243). A.G.-V. was supported by the Instituto de Salud Carlos III, cofinanced by the European Development Regional Fund (“A way to achieve Europe”), Subprograma Miguel Servet (CP19/00159). E.M.M. was supported by the Instituto de Salud Carlos III, cofinanced by the European Development Regional Fund (“A way to achieve Europe”), Subprogram PFIS (FI19/00304). C.K. was supported by Fondo COVID19 of Instituto de Salud Carlos III (COV20/00823).