SARS-CoV-2 seroprevalence and antibody trajectories after easing of COVID-19 restrictions: a longitudinal study in China

Abstract

BackgroundWe aimed to evaluate the seroprevalence of SARS-CoV-2 and investigate the trajectories of protective immunity and associated risk factors in eastern China between March and November 2023 after the easing of COVID-19 restrictions.Materials and methodsWe conducted repeated population-based seroepidemiologic studies using a multistage, population-stratified, cluster random sampling method. We measured neutralizing antibodies (nAbs) using a fluorescence immunoassay. We calculated both overall and stratified seroprevalence. The latent class growth mixed model (LCGMM) was used to analyze the dynamic trajectories of antibodies, and a multinomial logistic regression model was used to identify factors associated with different antibody trajectory patterns.ResultsA total of 6,147 participants were included at baseline, with a median age of 53.61 years. Both observed and adjusted seroprevalence remained high and stable throughout the study period. The LCGMM identified four distinct antibody trajectories: 75.22% of participants had a high and stable antibody trajectory, while nearly 8% of them exhibited an increase, decline, or low-stable antibody trajectory. Younger participants, women, those fully vaccinated, and individuals with a history of previous infection were more likely to have high and stable antibody trajectories.ConclusionThe majority of the population maintained sustained protective immunity after the outbreak, following the easing of COVID-19 restrictions across the country.