The complex relationship between clinical manifestations of SARS-CoV-2 and individual immune responses is not fully elucidated.
To examine phenotypes of symptomatology and their relationship with positive anti-SARS-CoV-2 IgG antibody responses.
An observational study was performed of adults (≥18 years) from 5 US states. Participants completed an electronic survey and underwent testing to anti-SARS-CoV-2 nucleocapsid protein IgG antibody between May-July 2020. Latent Class Analysis was used to identify characteristic symptom clusters.
Overall, 9,507 adults (mean±SD age: 39.6±15.0 years) completed the survey; 6,665 (70.1%) underwent antibody testing for anti-SARS-CoV-2 IgG. Positive SARS-CoV-2 antibodies were associated with self-reported positive SARS-CoV-2 nasal swab (bivariable logistic regression; OR [CI95]: 5.98 [4.83, 7.41]), household with ≥6 members (1.27 [1.14, 1.41]) and sick contact (3.65 [3.19, 4.17]), and older age (50-69 years: 1.55 [1.37, 1.76]); ≥70 years: 1.52 [1.16, 1.99]), but inversely associated with female sex (0.61 [0.55, 0.68]). Latent class analysis revealed 8 latent classes of symptoms. Latent classes-1 (all symptoms) and 4 (fever, cough, muscle ache, anosmia, dysgeusia, and headache) were associated with the highest proportion (62.0% and 57.4%) of positive antibodies, whereas classes-6 (fever, cough, muscle ache, headache) and 8 (anosmia, dysgeusia) had intermediate proportions (48.2% and 40.5%), and classes-3 (headache, diarrhea, stomach pain) and 7 (no symptoms) had the lowest proportion (7.8% and 8.5%) of positive antibodies.
SARS-CoV-2 infections manifest with substantial diversity of symptoms, which are associated with variable anti-SARS-CoV-2 IgG antibody responses. Prolonged fever, anosmia and receiving supplemental oxygen therapy had strongest associations with positive SARS-CoV-2 IgG.

Copyright © 2021. Published by Elsevier Inc.