Background
Antibodies to Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) have been shown to neutralize the virus in-vitro and prevent disease in animal challenge models upon re-exposure. However, current understanding of SARS-CoV-2 humoral dynamics and longevity is conflicting.
Methods
The Co-Stars study prospectively enrolled 3679 healthcare workers to comprehensively characterize the kinetics of SARS-CoV-2 spike (S), receptor-binding-domain (RBD) and nucleoprotein (N) antibodies in parallel. Participants screening seropositive had serial monthly serological testing for a maximum of 7 months with the Mesoscale Discovery Assay. Survival analysis determined the proportion of sero-reversion while two hierarchical Gamma models predicted the upper- and lower-bounds of long-term antibody trajectory.
Results
A total of 1163 monthly samples were provided from 349 seropositive participants. At 200 days post-symptoms, >95% of participants had detectable S-antibodies compared to 75% with detectable N-antibodies. S-antibody was predicted to remain detectable in 95% of participants until 465 days [95%CI 370-575] using a ‘continuous-decay’ model and indefinitely using a ‘decay-to-plateau’ model to account for antibody secretion by long-lived plasma cells. S-antibody titers correlated strongly with surrogate neutralization in-vitro (R 2=0.72). N-antibodies, however, decayed rapidly with a half-life of 60 days [95%CI 52-68].
Conclusions
The Co-STAR's study data presented here provides evidence for long-term persistence of neutralizing S-antibodies. This has important implications for the duration of functional immunity following SARS-CoV-2 infection. In contrast, the rapid decay of N-antibodies must be considered in future seroprevalence studies and public health decision-making. This is the first study to establish a mathematical framework capable of predicting long-term humoral dynamics following SARS-CoV-2 infection.
PWA were able to provide information about their current and preferred involvement in life activities through use of the LIV Cards. Family members did not predict activity choices and desires of PWA with full accuracy. The LIV Cards appear to be a viable tool for setting goals and discussing life priorities of PWA.
This paper presents parents' experiences of community support and their recommendations for how their communities, and the services within them, might support their families. Generated through a human-centred design methodology and using a desire-centred framework, the findings suggest that parents receiving a family service require support invoking feelings of intimacy, trust, reciprocity, inclusivity, connection and belonging. Parents' recommendations for community support include addressing material and attitudinal constraints impacting on engagement with services; creating non-judgmental services tailored to their needs but accessed as a last resort; and creating peer-based opportunities to support each other. Parents reflect that moving beyond basic survival of risk and vulnerability to a position where thriving is possible requires purposeful integration of parent's existing and desired community into service interventions. Facilitating deliberate change at the intersection of community and service support is pertinent to current and future social work policy and practice. Wider opportunities for understanding and enabling the needs and aspirations of parents, which are often overlooked because of a focus on addressing risk and vulnerability, are considered.
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