Coronavirus is an enveloped RNA virus belongs to Coronaviridae family. It has four genotypes alpha, beta, gamma, delta and size ranges from 80 to 140 nm with incubation period of 1 to 14 days. The main purpose of the study was to find out the overall prevalence, antibodies level and Covid-19 variants detection in hospitalized patients of Malakand division as part of the 4^th wave. This study was conducted at Saidu Teaching Hospital Swat. This project was completed in six months, from August 2021 to January 2022. In this descriptive cross sectional study, 1500 swab samples were evaluated for Covid-19 using Genrui RT-PCR amplification kit. Among these cases, 200 positive samples having PCR CT value less than 33, were examined for antibodies titer by CLIA (Chemiluminescence immunoassay) method and 100 positive samples with PCR CT value less than 27 done for variant detection by using GSD Nova III amplification kit. According to our findings the overall prevalence in Malakand division was 31.5% (473), with highest prevalence was recorded in district Swat 22.4% (336). According to gender wise distribution the highest frequency was recorded in males 20.7% (311) and old age people 10.3% (155) respectively. The highest antibody levels were recorded in Upper Lower (Mean=12.82), Males (Mean=12.15) and people with age of 21-40 years (Mean=14.57) respectively. According to our findings all obtained samples were positive for (Delta) variant of Coronavirus during 4^th wave. This study concludes that the PCR based detection of positivity ratio is very high during the fourth wave of Covid-19. The antibodies level in patients was very low and vaccination is needed for high antibodies. The delta variants of Coronavirus is found in overall districts of Malakand division.

Index Terms-  Antibodies, Covid-19, RT-PCR, Variants