Clinical Presentation of COVID-19 and Antibody Responses in Bangladeshi Patients Infected with the Delta or Omicron Variants of SARS-CoV-2

Asish Kumar Ghosh; Olfert Landt; Mahmuda Yeasmin; Mohiuddin Sharif; Rifat Hossain Ratul; Maruf Ahmed Molla; Tasnim Nafisa; Mymuna Binte Mosaddeque; Nur Hosen; Md Rakibul Hassan Bulbul; Rashid Mamunur; Alimul Islam; Shahjahan Siddike Shakil; Marco Kaiser; Md Robed Amin; Simon D Lytton

doi:10.3390/vaccines10111959

Clinical Presentation of COVID-19 and Antibody Responses in Bangladeshi Patients Infected with the Delta or Omicron Variants of SARS-CoV-2

Vaccines (Basel). 2022 Nov 18;10(11):1959. doi: 10.3390/vaccines10111959.

Authors

Asish Kumar Ghosh¹, Olfert Landt², Mahmuda Yeasmin³, Mohiuddin Sharif⁴, Rifat Hossain Ratul⁴, Maruf Ahmed Molla³, Tasnim Nafisa³, Mymuna Binte Mosaddeque⁵, Nur Hosen³, Md Rakibul Hassan Bulbul⁶, Rashid Mamunur⁷, Alimul Islam⁸, Shahjahan Siddike Shakil⁹, Marco Kaiser², Md Robed Amin⁴, Simon D Lytton¹⁰

Affiliations

¹ Department of Virology, Dhaka Medical College Hospital, Dhaka 1000, Bangladesh.
² TIB Molbiol GmbH, Eresburgstraße 22-23, 12103 Berlin, Germany.
³ National Institute of Laboratory Medicine and Referral Center, Sher E-Bangla Nagar, Dhaka 1207, Bangladesh.
⁴ Department of Medicine, Dhaka Medical College Hospital, Dhaka 1000, Bangladesh.
⁵ Department of Virology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka 1000, Bangladesh.
⁶ Institute for Developing Science & Health Initiatives, Dhaka 1216, Bangladesh.
⁷ Bangladesh Institute Tropical Infectious Disease (BITID), Fouzderhat, Chittagong 4317, Bangladesh.
⁸ Department of Microbiology and Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh 2202, Bangladesh.
⁹ National Institute of Diseases of the Chest and Hospital, Mohakhali, Dhaka 1212, Bangladesh.
¹⁰ SeraDiaLogistics, 81545 Munich, Germany.

Abstract

The clinical presentation of COVID-19 and the specific antibody responses associated with SARS-CoV-2 variants have not been investigated during the emergence of Omicron variants in Bangladesh. The Delta and Omicron variants were identified by post-PCR melting curve analysis of the spike (S) protein receptor binding domain amplicons. Anti-S-protein immunoglobulin-G anti-nucleocapsid (N)-protein immunoglobulin-G and immunoglobulin-A levels were measured by ELISA. The Delta variant was found in 40 out of 40 (100%) SARS-CoV-2 RT-PCR positive COVID-19 patients between 13 September and 23 October 2021 and Omicron variants in 90 out of 90 (100%) RT-PCR positive COVID-19 patients between 9 January and 10 February 2022. The Delta variant associated with hospitalization (74%, 80%, and 40%) and oxygen support (60%, 57%, and 40%) in the no vaccine, dose-1, and dose-2 vaccinated cases, respectively, whereas the Omicron COVID-19 required neither hospitalization nor oxygen support (0%, p < 0.0001). Fever, cough, and breathlessness were found at a significantly higher frequency among the Delta than Omicron variants (p < 0.001). The viral RNA levels of the Delta variant were higher than that of the Omicron variants (Ct median 19.9 versus 23.85; p < 0.02). Anti-spike protein immunoglobulin-G and anti-N-protein immunoglobulin-G within 1 week post onset of Delta variant COVID-19 symptoms indicate prior SARS-CoV-2 infection. The Delta variant and Omicron BA.1 and BA.2 breakthrough infections in the Dhaka region, at 240 days post onset of COVID-19 symptoms, negatively correlated with the time interval between the second vaccine dose and serum sampling. The findings of lower anti-spike protein immunoglobulin-G reactivity after booster vaccination than after the second vaccine dose suggest that the booster vaccine is not necessarily beneficial in young Bangladeshi adults having a history of repeated SARS-CoV-2 infections.

Keywords: COVID-19 symptoms; Delta; Omicron; PCR melting curve analysis; SARS CoV-2 variants; anti-N protein; anti-S protein; hospitalization.

Grants and funding

The research received no external funding.