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Abstract
The competence of the individual immune system is one of the factors that determines the ability to defend against SARS-CoV-2. Despite the high number of investigations that describe risk factors for greater severity and/or mortality such as age over 60 years, the presence of comorbidities or male sex, it continues to be important to identify factors that explain the wide clinical variability of this disease or as subjects exposed to the virus do not become infected. The objective was to evaluate the concentration of IgG against Tetanus and Diphtheria toxoids in patients recovered from COVID-19 and exposed first-degree relatives. A cross-sectional case-control study was carried out in which 1,131 serum samples corresponding to Cuban patients confirmed and recovered from COVID-19 and 493 exposed first-degree relatives were studied during the period from June to September 2020. The sample was divided into three age groups and two groups according to sex. The analysis was carried out in each group taking into account the degree of severity of COVID-19 reached by the patient during the infection. Concentrations of tetanus and diphtheria antitoxoids in serum were quantified using an indirect solid-phase immunoenzymatic assay. Results: 96.9% of female patients and 97.6% of male patients presented reliable long-lasting protective levels against tetanus toxin. Against diphtheria, the highest levels were reliable protection in the short term (68.2% women and 77.3% men). The cases recovered from the severe form of COVID-19 presented lower geometric mean levels of IgG against tetanus and diphtheria toxins than the control group. Conclusions: Serum ATD IgG levels of both sexes did not reach the level of reliable long-lasting protection. The CMG levels of IgG ATT and ATD varied in the different age groups depending on the status achieved by the patient during the course of the disease. These results demonstrate the need to strengthen the immune system of both people not affected by the viral infection and those affected.
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