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

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.

[1]  D. Barouch Covid-19 Vaccines — Immunity, Variants, Boosters , 2022, The New England journal of medicine.

[2]  A. Islam,et al.  Transmission Dynamics and Genomic Epidemiology of Emerging Variants of SARS-CoV-2 in Bangladesh , 2022, Tropical medicine and infectious disease.

[3]  A. Galvani,et al.  The durability of natural infection and vaccine-induced immunity against future infection by SARS-CoV-2 , 2022, Proceedings of the National Academy of Sciences of the United States of America.

[4]  M. Kalam,et al.  Transmission Pathways and Genomic Epidemiology of Emerging Variants of SARS-CoV-2 in the Environment , 2022, COVID.

[5]  E. Lam,et al.  Detection of SARS-CoV-2 VOC-Omicron using commercial sample-to-answer real-time RT-PCR platforms and melting curve-based SNP assays , 2022, Journal of Clinical Virology Plus.

[6]  K. Ferreira-Paim,et al.  Clinical-Epidemiology Aspect of Inpatients With Moderate or Severe COVID-19 in a Brazilian Macroregion: Disease and Countermeasures , 2022, Frontiers in Cellular and Infection Microbiology.

[7]  C. Alves,et al.  Assessment of mutations on RBD in the Spike protein of SARS-CoV-2 Alpha, Delta and Omicron variants , 2022, Scientific Reports.

[8]  Naveen Dhawan,et al.  Characteristics of COVID-19 Breakthrough Infections among Vaccinated Individuals and Associated Risk Factors: A Systematic Review , 2022, Tropical medicine and infectious disease.

[9]  S. A. Abdool Karim,et al.  Clinical severity of COVID-19 in patients admitted to hospital during the omicron wave in South Africa: a retrospective observational study , 2022, The Lancet Global Health.

[10]  Asma Al Balushi,et al.  COVID-19-Associated Mucormycosis: An Opportunistic Fungal Infection. A Case Series and Review , 2022, International Journal of Infectious Diseases.

[11]  E. Klein,et al.  The displacement of the SARS-CoV-2 variant Delta with Omicron: An investigation of hospital admissions and upper respiratory viral loads , 2022, eBioMedicine.

[12]  H. Jinno,et al.  Discrimination of SARS-CoV-2 Omicron Sublineages BA.1 and BA.2 Using a High-Resolution Melting-Based Assay: a Pilot Study , 2022, bioRxiv.

[13]  H. Ullum,et al.  Risk of hospitalisation associated with infection with SARS-CoV-2 omicron variant versus delta variant in Denmark: an observational cohort study , 2022, The Lancet Infectious Diseases.

[14]  C. Steves,et al.  Symptom prevalence, duration, and risk of hospital admission in individuals infected with SARS-CoV-2 during periods of omicron and delta variant dominance: a prospective observational study from the ZOE COVID Study , 2022, The Lancet.

[15]  J. L. Bernal,et al.  COVID-19 vaccine effectiveness against the omicron (BA.2) variant in England , 2022, The Lancet Infectious Diseases.

[16]  Nicholas R. Thompson,et al.  Genome Sequences of 25 SARS-CoV-2 Sublineage B.1.1.529 Omicron Strains in Bangladesh , 2022, Microbiology Resource Announcements.

[17]  L. Madoff,et al.  Characterization of immune responses in fully vaccinated individuals following breakthrough infection with the SARS-CoV-2 delta variant , 2022, Science Translational Medicine.

[18]  Md. Rabiul Islam The SARS‐CoV‐2 Omicron (B.1.1.529) variant and the re‐emergence of COVID‐19 in Europe: An alarm for Bangladesh , 2022, Health science reports.

[19]  F. Kirchhoff,et al.  Omicron: What Makes the Latest SARS-CoV-2 Variant of Concern So Concerning? , 2022, Journal of virology.

[20]  R. Poduri,et al.  Omicron, a new SARS-CoV-2 variant: assessing the impact on severity and vaccines efficacy , 2022, Human Vaccines & Immunotherapeutics.

[21]  Md. Rabiul Islam,et al.  New Coronavirus Variants are Creating More Challenges to Global Healthcare System: A Brief Report on the Current Knowledge , 2022, Clinical pathology.

[22]  A. Walls,et al.  Structural basis of SARS-CoV-2 Omicron immune evasion and receptor engagement , 2021, bioRxiv.

[23]  M. Bhuiyan,et al.  Detection of highly muted coronavirus variant Omicron (B.1.1.529) is triggering the alarm for South Asian countries: Associated risk factors and preventive actions , 2021, Journal of medical virology.

[24]  Y. Liu,et al.  The Disease Severity and Clinical Outcomes of the SARS-CoV-2 Variants of Concern , 2021, Frontiers in Public Health.

[25]  A. Ghosh,et al.  Molecular and Serological Characterization of the SARS-CoV-2 Delta Variant in Bangladesh in 2021 , 2021, Viruses.

[26]  Jahida Gulshan,et al.  Systematic Assessment of COVID-19 Pandemic in Bangladesh: Effectiveness of Preparedness in the First Wave , 2021, Frontiers in Public Health.

[27]  G. Wiesmüller,et al.  Limited protection against SARS-CoV-2 infection and virus transmission after mRNA vaccination , 2021, Journal of Infection.

[28]  K. Jöckel,et al.  The performance of the SARS-CoV-2 RT-PCR test as a tool for detecting SARS-CoV-2 infection in the population , 2021, Journal of Infection.

[29]  S. Antinori,et al.  COVID-19–Associated Pulmonary Aspergillosis, March–August 2020 , 2021, Emerging infectious diseases.

[30]  K. Crandall,et al.  Genome-wide analysis of SARS-CoV-2 virus strains circulating worldwide implicates heterogeneity , 2020, Scientific Reports.

[31]  M. Hallek,et al.  COVID‐19 associated pulmonary aspergillosis , 2020, Mycoses.