Codina, HelenaVieitez, IreneGutierrez-Valencia, AliciaSkouridou, VassoMartínez, CristinaPatiño, LucíaBotero-Gallego, MariluzTrujillo-Rodríguez, MaríaSerna-Gallego, AnaMuñoz-Muela, EsperanzaBobillo, María MPérez, AlexandreCabrera-Alvar, Jorge JulioCrespo, ManuelO'Sullivan, Ciara KRuiz-Mateos, EzequielPoveda, Eva2025-01-072025-01-072021-10-292076-2607https://hdl.handle.net/10668/24602Viral and host immune kinetics during acute COVID-19 and after remission of acute symptoms need better characterization. SARS-CoV-2 RNA, anti-SARS-CoV-2 IgA, IgM, and IgG antibodies, and proinflammatory cytokines were measured in sequential samples from hospitalized COVID-19 patients during acute infection and six months following diagnosis. Twenty four laboratory confirmed COVID-19 patients with mild/moderate and severe COVID-19 were included. Most were males (83%) with a median age of 61 years. Twenty one percent were admitted to the intensive care unit (ICU) and eight of them (33.3%) met the criteria for severe COVID-19 disease. A delay in SARS-CoV-2 levels' decline during the first six days of follow up, and viral load persistence until month 3 were related to severe COVID-19, but not viral load levels at the diagnosis. Higher levels of anti-SARS-CoV-2 IgA, IgM, IgG and the cytokines IL-6, IL-8 and MIP-1β at the diagnosis time were related to the severe COVID-19 outcome. Higher levels of MIP-1β, IL-1β, MIP-1α and IFN-γ were observed at month 1 and 3 during mild/moderate disease, compared to severe COVID-19. IgG persisted at low levels after six months of diagnosis. In conclusion, higher concentrations of IgA, IgM, and IgG, and IL-6, IL-8 and MIP-1β are identified as early predictors of COVID-19 severity, whereas no significant association is found between baseline SARS-COV-2 viral load and COVID-19 severity.enAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/SARS-CoV-2anti-SARS-CoV-2 antibodiescytokinessevere COVID-19viral loadresearch article34835384open access10.3390/microorganisms9112259PMC8624589https://www.mdpi.com/2076-2607/9/11/2259/pdf?version=1635582507https://pmc.ncbi.nlm.nih.gov/articles/PMC8624589/pdf