Antibody Status and Incidence of SARS-CoV-2 Infection in Health Care Workers
By S. Lumley, D. O’Donnell, N. Stoesser, P. Matthews, A. Howarth, S. Hatch, Brian D. Marsden, S. Cox, Tim James, Fiona Warren and 22 more. New England Journal of Medicine, 2020
821 citations recorded by the source corpus.
Abstract Background The relationship between the presence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the risk of subsequent reinfection remains unclear. Methods We investigated the incidence of SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR) in seropositive and seronegative health care workers attending testing of asymptomatic and symptomatic staff at Oxford University Hospitals in the United Kingdom. Baseline antibody status was determined by anti-spike (primary analysis) and anti-nucleocapsid IgG assays, and staff members were followed for up to 31 weeks. We estimated the relative incidence of PCR-positive test results and new symptomatic infection according to antibody status, adjusting for age, participant-reported gender, and changes in incidence over time. Results A total of 12,541 health care workers participated and had anti-spike IgG measured; 11,364 were followed up after negative antibody results and 1265 after positive results, including 88 in whom seroconversion occurred during follow-up. A total of 223 anti-spike–seronegative health care workers had a positive PCR test (1.09 per 10,000 days at risk), 100 during screening while they were asymptomatic and 123 while symptomatic, whereas 2 anti-spike–seropositive health care workers had a positive PCR test (0.13 per 10,000 days at risk), and both workers were asymptomatic when tested (adjusted incidence rate ratio, 0.11; 95% confidence interval, 0.03 to 0.44; P=0.002). There were no symptomatic infections in workers with anti-spike antibodies. Rate ratios were similar when the anti-nucleocapsid IgG assay was used alone or in combination with the anti-spike IgG assay to determine baseline status. Conclusions The presence of anti-spike or anti-nucleocapsid IgG antibodies was associated with a substantially reduced risk of SARS-CoV-2 reinfection in the ensuing 6 months. (Funded by the U.K. Government Department of Health and Social Care and others.)
Subfields: Infectious Diseases
View Paper: https://www.semanticscholar.org/paper/bc2eb35d73fc77796b089c8f95d4a9731c7feed6
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In Infectious Diseases
Citations in the corpus
- Comprehensive mapping of mutations to the SARS-CoV-2 receptor-binding domain that affect recognition by polyclonal human serum antibodies (2021, background): “Introduction Neutralizing antibodies against the SARS-CoV-2 spike are associated with protection against infection in both humans (Addetia et al., 2020; Lumley et al., 2020) and animal models (Alsoussi et al.”
- Evidence for antibody as a protective correlate for COVID-19 vaccines (2021, neutral): “Meanwhile, a mounting body of evidence from non-human primate [3] and natural history [4] studies suggests that an antibody-based correlate of protection can be estimated for COVID-19 vaccines.”
- A human coronavirus evolves antigenically to escape antibody immunity (2020, background): “Neutralizing and anti-spike antibodies elicited by natural infection correlate with reduced SARS-CoV-2 infection of humans [1,2], and vaccines that elicit such antibodies protect humans with high efficacy [3].”
- Model-informed COVID-19 vaccine prioritization strategies by age and serostatus (2021, neutral): “Serostatus itself is an imperfect indicator of protection, and the relationship of prior infection, serostatus, and protection may change over time (10, 29,32,33).”