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

ORCID
0000-0001-5735-3606
Affiliation
Department of Virology, Dhaka Medical College Hospital, Dhaka 1000, Bangladesh
Ghosh, Asish Kumar;
ORCID
0000-0001-6826-3438
Affiliation
TIB Molbiol GmbH, Eresburgstraße 22-23, 12103 Berlin, Germany
Landt, Olfert;
Affiliation
National Institute of Laboratory Medicine and Referral Center, Sher E-Bangla Nagar, Dhaka 1207, Bangladesh
Yeasmin, Mahmuda;
Affiliation
Department of Medicine, Dhaka Medical College Hospital, Dhaka 1000, Bangladesh
Sharif, Mohiuddin;
Affiliation
Department of Medicine, Dhaka Medical College Hospital, Dhaka 1000, Bangladesh
Ratul, Rifat Hossain;
ORCID
0000-0002-5062-9144
Affiliation
National Institute of Laboratory Medicine and Referral Center, Sher E-Bangla Nagar, Dhaka 1207, Bangladesh
Molla, Maruf Ahmed;
Affiliation
National Institute of Laboratory Medicine and Referral Center, Sher E-Bangla Nagar, Dhaka 1207, Bangladesh
Nafisa, Tasnim;
Affiliation
Department of Virology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka 1000, Bangladesh
Mosaddeque, Mymuna Binte;
Affiliation
National Institute of Laboratory Medicine and Referral Center, Sher E-Bangla Nagar, Dhaka 1207, Bangladesh
Hosen, Nur;
ORCID
0000-0001-6655-3087
Affiliation
Institute for Developing Science & Health Initiatives, Dhaka 1216, Bangladesh
Bulbul, Md. Rakibul Hassan;
Affiliation
Bangladesh Institute Tropical Infectious Disease (BITID), Fouzderhat, Chittagong 4317, Bangladesh
Mamunur, Rashid;
ORCID
0000-0002-6186-8044
Affiliation
Department of Microbiology and Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh 2202, Bangladesh
Islam, Alimul;
Affiliation
National Institute of Diseases of the Chest and Hospital, Mohakhali, Dhaka 1212, Bangladesh
Shakil, Shahjahan Siddike;
Affiliation
TIB Molbiol GmbH, Eresburgstraße 22-23, 12103 Berlin, Germany
Kaiser, Marco;
Affiliation
Department of Medicine, Dhaka Medical College Hospital, Dhaka 1000, Bangladesh
Amin, Md. Robed;
ORCID
0000-0001-5617-4139
Affiliation
SeraDiaLogistics, 81545 Munich, Germany
Lytton, Simon D.

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.

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