It has been reported that patients diagnosed with COVID-19 become critically ill primarily around the time of activation of the adaptive immune response. However the role of antibodies in the worsening of disease is not obvious. Higher titers of anti-spike immunoglobulin IgG1 associated to low fucosylation of the antibody Fc tail have been associated to excessive inflammatory response. In contrast it has been also reported in literature that NP-, S-, RBD- specific IgA, IgG, IgM are not associated with SARS-CoV-2 viral load, indicating that there is no obvious correlation between antibody response and viral antigen detection. In the present work the micro-Fourier-Transform Infrared reflectance spectroscopy (micro-FTIR) was employed to investigate blood serum samples of healthy and COVID-19 (mild or oligosynthomatic) individuals (82 healthcare workers volunteers in “Instituto de Infectologia Emilio Ribas”, São Paulo, Brazil). The molecular-level-sensitive, multiplexing quantitative and qualitative FTIR data probed on 1 mL of dryed biofluidwas compared to Signal-to-Cutoff index of chemiluminescent immunoassays CLIA and ELISA (IgG antibodies against SARS-CoV-2). Our main result indicated that 1702-1785 cm-1 spectral window (carbonyl C=O vibration) appeared to be a spectral marker of the degree of IgG glycosylation, allowing to probe distinctive subpopulations of COVID-19 patients, depending on their degree of severity. The specificity was 87.5 % while the detection rate of true positive was 100%. The computed area under the receiver operating curve was equivalent to CLIA, ELISA and other ATR-FTIR methods (> 0.85). In summary, overall discrimination of healthy and COVID-19 individuals and severity prediction as well could also be potentially implemented using micro-FTIR reflectance spectroscopy on blood serum samples. Considering the minimal and reagent-free sample preparation procedures combined to fast (few minutes) outcome of FTIR we can state that this technology is very suitable for fast screening of immune response of individuals with COVID-19. It would be an important tool in prospective studies, helping investigate the physiology of the asymptomatic, oligosymptomatic, or severe individuals and measure the extension of infection dissemination in patients.
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