# Temporal Trends in SARS-CoV-2 Antibody Levels Among COVID-19 Patients in Kerala During the First Wave and Pre-vaccination Period

## TL;DR

This study examines how IgG antibody levels against the SARS-CoV-2 spike protein change over time in Kerala's COVID-19 patients and their relation to disease severity.

## Contribution

The study identifies temporal patterns in IgG responses and links them to disease severity, offering insights into immune dynamics during the first wave.

## Key findings

- A significant IgG response (76.4%) was observed in patients post-infection.
- IgG levels peaked between two to four and four to eight weeks post-infection.
- Higher IgG levels correlated with disease severity and hospitalization needs.

## Abstract

Background: The SARS-CoV-2 virus interacts with host cells through the S1 domain of its spike protein. This study measures the IgG immune response to this domain in COVID-19 patients from Kerala, India, and explores its association with various health factors.

Methods: A cohort of 258 COVID-19 patients was analyzed for IgG antibodies targeting the S1 spike protein domain. The temporal pattern of the IgG response and its correlation with hospitalization needs, intensive care, and pre-existing conditions such as diabetes, hypertension, and coronary artery disease were assessed.

Results: A significant IgG response (76.4%) was detected, indicating robust immune activation post-infection. The IgG levels peaked between two to four and four to eight weeks post-infection, with a notable increase at 12 weeks, hinting at possible secondary exposure or an immune memory response. No correlation was found between IgG levels and the presence of diabetes mellitus, hypertension, or coronary artery disease. However, higher IgG responses correlated with the severity of the infection, as seen in patients requiring hospitalization or intensive care.

Conclusions: The IgG response to the S1 spike protein domain serves as a potential marker of immune activation in COVID-19. It reflects the body’s defense mechanism against the virus and may predict disease severity and outcomes. The findings suggest that IgG levels could be indicative of the viral load, inflammatory response, and possibly the likelihood of protection against reinfection.