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Long-Term Persistence of Spike Protein Antibody and Predictive Modeling of Antibody Dynamics After Infection With Severe Acute Respiratory Syndrome Coronavirus 2

2021; Oxford University Press; Volume: 74; Issue: 7 Linguagem: Inglês

10.1093/cid/ciab607

1537-6591

Louis Grandjean, Anja Saso, Arturo Torres Ortiz, Tanya Lam, James Hatcher, Rosie Thistlethwayte, Mark Harris, Timothy Best, Marina Johnson, Helen R. Wagstaffe, Elizabeth Ralph, Annabelle Mai, Caroline Colijn, Judith Breuer, Matthew Buckland, Kimberly Gilmour, David Goldblatt, Dorcas Mirambe-Korsah, Fernanda Fenn Torrente, Jakub Wyszynski, Victoria Gander, Amy Leonard, Louise Myers, Aimee Vallot, Camille Paillas, Rose Fitzgerald, Adam Twigg, Rabia Manaf, Lois Gibbons, Hollie Powell, Richard Nar-Dorh, A. H. Gray, Elías Carrocera Fernández, Aline Minja, Emily Beech, Waffa Girshab, Pei Shi Chia, Kate Webb, Malti Nakrani, Kim Gardiner, Valerija Karaluka, Karen Ryan, Dorothy Lee Katie Groves, Hamad Khan, Shamime Nsubuga, Olivia Rosie-Wilkinson, Julia Spires, Nuria Sanchez-Clemente, Sapriya Kaur, Natasha Carroll, Jemma Efford, Gabriel Bredin, Celma Marisa Dos Santos Domingues, Sophie Foxall, Helen Ashton, Abbey Afzal, Sally Mainland, Kate Crumpler, Lucinda Dawson, Claire M. Smith, Maria Tabbu, Laura Chiverton, Jade Sugars, Jordan Mooney, Dorothy Chikusu, Fariba Tahami, Baratth Samy, Shomona Begum, Dhimple Patel, Philippa Wiltshire, Annie Susay, Anna Ryan, Luke Lancaster, Kavita Thind, Kate Speller, Rachel Sterling, Connor Tugulu, Sandhya Ghurburrun, Steffi Gray, Joy Mugas, Moe Kishma, Kathleen Akpokomua, Sophie White, Eleana Pieri, Sabina Shamsad, Demi Alexandrou, Odera Aguele, Katherine Miles, Anamika Jain, Subishma Gautam, Oliver Simms, Rachel Goff, Zarif Shams, Tinya Chirinda, Aaliya Nur, Tarekur Rahman,

SARS-CoV-2 detection and testing

Abstract 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 on reexposure. However, the current understanding of SARS-CoV-2 humoral dynamics and longevity is conflicting. Methods The COVID-19 Staff Testing of Antibody Responses Study (Co-Stars) prospectively enrolled 3679 healthcare workers to comprehensively characterize the kinetics of SARS-CoV-2 spike protein (S), receptor-binding domain, and nucleoprotein (N) antibodies in parallel. Participants screening seropositive had serial monthly serological testing for a maximum of 7 months with the Meso Scale Discovery Assay. Survival analysis determined the proportion of seroreversion, while 2 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 after symptoms, >95% of participants had detectable S antibodies, compared with 75% with detectable N antibodies. S antibody was predicted to remain detectable in 95% of participants until 465 days (95% confidence interval, 370–575 days) 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 were correlated strongly with surrogate neutralization in vitro (R2 = 0.72). N antibodies, however, decayed rapidly with a half-life of 60 days (95% confidence interval, 52–68 days). Conclusions The Co-Stars data presented here provide evidence for long-term persistence of neutralizing S antibodies. This has important implications for the duration of functional immunity after 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 after SARS-CoV-2 infection. Clinical Trials Registration NCT04380896.