Longitudinal follow-up of IgG anti-nucleocapsid antibodies in SARS-CoV-2 infected patients up to eight months after infection

Elslande, Jan Van; Oyaert, Matthijs; Ailliet, Scott; Ranst, Marc Van; Lorent, Natalie; Weygaerde, Yannick Vande; André, Emmanuel; Lagrou, Katrien; Vandendriessche, Stien; Vermeersch, Pieter

doi:10.1016/j.jcv.2021.104765

Cited by 132 publications

(139 citation statements)

References 23 publications

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“…We found 24% of participants did not seroconvert after testing PCR-positive, including 34% of participants with strong evidence for a true positive PCR result (Ct≤32, ≥2 genes detected). Similar observations have been reported before, but with varying percentages of non-responders from 0%-25% [11][12][13][25][26][27][28] . Non-responders likely include both genuine non-responders and false-positive results.…”

Section: Discussionsupporting

confidence: 88%

“…5 Seroconversion to viral spike and nucleocapsid antigens usually happens within 1-3 weeks after SARS-CoV-2 infection [6][7][8] , with peak antibody levels achieved in 4-5 weeks 9,10 . However, 5-22% of individuals remain seronegative following infection [11][12][13] . Absence of seroconversion is more common following mild vs. severe disease (e.g.…”

Section: Introductionmentioning

confidence: 99%

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Anti-spike antibody response to natural SARS-CoV-2 infection in the general population

Wei

Matthews

Stoesser

et al. 2021

Preprint

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We estimated the duration and determinants of antibody response after SARS-CoV-2 infection in the general population using representative data from 7,256 United Kingdom COVID-19 infection survey participants who had positive swab SARS-CoV-2 PCR tests from 26-April-2020 to 14-June-2021. A latent class model classified 24% of participants as 'non-responders' not developing anti-spike antibodies. These seronegative non-responders were older, had higher SARS-CoV-2 cycle threshold values during infection (i.e. lower viral burden), and less frequently reported any symptoms. Among those who seroconverted, using Bayesian linear mixed models, the estimated anti-spike IgG peak level was 7.3-fold higher than the level previously associated with 50% protection against reinfection, with higher peak levels in older participants and those of non-white ethnicity. The estimated anti-spike IgG half-life was 184 days, being longer in females and those of white ethnicity. We estimated antibody levels associated with protection against reinfection likely last 1.5-2 years on average, with levels associated with protection from severe infection present for several years. These estimates could inform planning for vaccination booster strategies.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Anti-spike antibody response to natural SARS-CoV-2 infection in the general population

Wei

Matthews

Stoesser

et al. 2021

Preprint

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“…The best combination, for both sensitivity and specificity, was shown to be Spike‐f and NC‐C, which gave 99.7% sensitivity and 100.0% specificity. Considering the ongoing vaccination efforts focusing on the spike protein 19 and the potential faster decline of anti‐NC antibodies compared with anti‐Spike, 20 , 21 the combination of all three but requiring at least two was also evaluated, resulting in a specificity of 99.7% and a sensitivity of 99.4% (Table 3 ). All pairwise combinations using the five antigens in stage 3, and panels requiring two out of three antigens, were also evaluated, resulting in a wide range of sensitivities and specificities (Supplementary tables 4 and 5 ).…”

Section: Resultsmentioning

confidence: 99%

Systematic evaluation of SARS‐CoV‐2 antigens enables a highly specific and sensitive multiplex serological COVID‐19 assay

et al. 2021

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Objective. The COVID-19 pandemic poses an immense need for accurate, sensitive and high-throughput clinical tests, and serological assays are needed for both overarching epidemiological studies and evaluating vaccines. Here, we present the development and validation of a high-throughput multiplex bead-based serological assay. Methods. More than 100 representations of SARS-CoV-2 proteins were included for initial evaluation, including antigens produced in bacterial and mammalian hosts as well as synthetic peptides. The five bestperforming antigens, three representing the spike glycoprotein and two representing the nucleocapsid protein, were further

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“…Others have found no consistent IgG/IgA correlation for intensity of production [34]. Quantitation by most methods increase with the severity of infection [33,34,36,41,50,52,56,60,[70][71][72][73][74][75][76][77][78][79][80][81][82][83][84][85][86][87]. Severe disease may be associated with a delay of the humoral response [88].…”

Section: Immunogens and Humoral Immunitymentioning

confidence: 99%

“…A lack of antibody response is particularly noticeable for asymptomatic and out-patients [33,64,68,73,77,85,89,95]. Using a given threshold of anti-RBD antibody, Bartsch et al [89] define a limit above which other immune responses and effector functions are recruited.…”

Section: Immunogens and Humoral Immunitymentioning

confidence: 99%

Passive Immunity Should and Will Work for COVID-19 for Some Patients

Cimolai¹

2021

CHI

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In the absence of effective antiviral chemotherapy and still in the context of emerging vaccines for severe acute respiratory syndrome-CoV-2 infections, passive immunotherapy remains a key treatment and possible prevention strategy. What might initially be conceived as a simplified donor-recipient process, the intricacies of donor plasma, IV immunoglobulins, and monoclonal antibody modality applications are becoming more apparent. Key targets of such treatment have largely focused on virus neutralization and the specific viral components of the attachment Spike protein and its constituents (e.g., receptor binding domain, N-terminal domain). The cumulative laboratory and clinical experience suggests that beneficial protective and treatment outcomes are possible. Both a dose-and a time-dependency emerge. Lesser understood are the concepts of bioavailability and distribution. Apart from direct antigen binding from protective immunoglobulins, antibody effector functions have potential roles in outcome. In attempting to mimic the natural but variable response to infection or vaccination, a strong functional polyclonal approach attracts the potential benefits of attacking antigen diversity, high antibody avidity, antibody persistence, and protection against escape viral mutation. The availability and ease of administration for any passive immunotherapy product must be considered in the current climate of need. There is never a perfect product, but yet there is considerable room for improving patient outcomes. Given the variability of human genetics, immunity, and disease, and given the nuances of the virus and its potential for change, passive immunotherapy can be developed that will be effective for some but not all patients. An understanding of such patient variability and limitations is just as important as the understanding of the direct interactions between immunotherapy and virus.

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Longitudinal follow-up of IgG anti-nucleocapsid antibodies in SARS-CoV-2 infected patients up to eight months after infection

Cited by 132 publications

References 23 publications

Anti-spike antibody response to natural SARS-CoV-2 infection in the general population

Anti-spike antibody response to natural SARS-CoV-2 infection in the general population

Systematic evaluation of SARS‐CoV‐2 antigens enables a highly specific and sensitive multiplex serological COVID‐19 assay

Passive Immunity Should and Will Work for COVID-19 for Some Patients

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