key: cord-340666-zl9pp2h3
authors: Reifer, Josh; Hayum, Nosson; Heszkel, Benzion; Klagsbald, Ikey; Streva, Vincent A.
title: SARS-CoV-2 IgG antibody responses in New York City
date: 2020-07-21
journal: Diagn Microbiol Infect Dis
DOI: 10.1016/j.diagmicrobio.2020.115128
sha: 
doc_id: 340666
cord_uid: zl9pp2h3

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a strain of coronavirus that causes coronavirus disease 2019 (Covid-19) and has been declared a global pandemic by the World Health Organization. Total cases of SARS-CoV-2 worldwide exceed 10.2 million, with over 503,000 deaths recorded. Little is known about the body's immune response to SARS-CoV-2 infection. In this paper, we describe SARS-CoV-2 IgG antibody responses in 28,523 patients from the New York City metropolitan area and report a SARS-CoV-2 IgG positivity rate of 44%, indicating the widespread nature of the pandemic in the city and state of New York. Additionally, for a subset of patients, we report on the correlation between SARS-CoV-2 patient symptom severity and level of SARS-CoV-2 IgG antibody found in the patient sample.

J o u r n a l P r e -p r o o f J o u r n a l P r e -p r o o f 6 The distribution of male and female patients in each of the SSI bins is shown in Table 3 . There was no significant difference in gender distribution between patients with SSIs from zero to two, however patients with an SSI four were disproportionately male, and there is a trend for increased severity of symptoms in male patients. Whether this difference is due to increased disease severity among male patients (21) or the relatively small number of patients with an SSI of three or greater remains to be seen. Additionally, the median age of each SSI group was also determined (Table 4 ). Generally, patients with a lower SSI were younger than those with a higher SSI ( Figure 1A ), possibly indicative of more severe disease in older patients. This difference was true for both male and female patients ( Figure 1B ) and was statistically significant (p-value < 0.01) using a linear regression model. We next sought to evaluate whether semi-quantitative SARS-CoV-2 IgG antibody levels were correlated to severity of symptoms as measured by the SSI. Levels of SARS-CoV-2 IgG antibody are plotted against SSI in Figure 2A . A linear regression analysis of the data indicates that SARS-CoV-2 IgG antibody levels are positively correlated with SSI (p-value < 0.01). This trend is true regardless of whether the patient was male or female ( Figure 2B ). These data imply that more severe SARS-CoV-2 infections are more likely than less severe infections to generate sufficient IgG antibodies to confer protective immunity.

In addition, we tested 28,523 patient specimens for SARS-CoV-2 IgG antibody levels for whom we did not obtain a SSI. Of these, 12 an SSI at the time of clinic visit. Of these, 36% were assigned an SSI of 0, 35% were assigned an SSI of 1, 21% were assigned an SSI of 2, 5% were assigned an SSI of 3, and 3% were assigned an SSI of 4. 

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The authors thank Dr. Dakai Liu and Sanford Moos for helpful discussions and critical reading of the manuscript, and Verniece Hudson, Rachelle Neri, Joyce Zhen, and Edward Chu for generating clinical laboratory testing results.

JR conceived the study, collected and analyzed data, and revised the manuscript; NH gathered clinical data and revised the manuscript; BH and IK analyzed data and revised the manuscript; VAS conceived the study, analyzed data, and wrote the manuscript.