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

Abstract

Understanding the trajectory, duration, and determinants of antibody responses after SARS-CoV-2 infection can inform subsequent protection and risk of reinfection, however large-scale representative studies are limited. Here we estimated 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, who 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.

Persistence of Anti-SARS-CoV-2 Antibodies in Long Term Care Residents Over Seven Months After Two COVID-19 Outbreaks

“…Specifically, the first survey was conducted in May 2020, a month following the facility outbreak in April 2020. Previous studies have shown that it can take 4-5 weeks to reach peak antibody responses following a primary infection ( 20 ), and this may even take months in those with severe disease ( 21 ). There are studies that describe older age as a predictor of poor seroconversion ( 22 ), perhaps due to potential comorbidities or immunosenescence.…”

Neutralizing Antibody Responses to SARS-CoV-2 in Recovered COVID-19 Patients Are Variable and Correlate With Disease Severity and Receptor-Binding Domain Recognition

“…Analysis of the humoral response across multiple cohorts of COVID-19 recovered patients showed that SARS-CoV-2 natural infection can elicit neutralizing antibodies in the majority of cases, but accumulating evidence indicates that the magnitude of the response varies greatly across individuals (7,8). This heterogeneity has been interpreted differently by public health policy across countries, resulting in different guidelines for the vaccination of COVID-19 recovered patients.…”

Persistence of Naturally Acquired and Functional SARS-CoV-2 Antibodies in Blood Donors One Year after Infection

“…To date, studies indicate that specific IgG antibodies against SARS-CoV-2 spike-protein are detectable up to 12 months after an infection [ 18 , 19 ]. A further study estimates antibody levels associated with protection against reinfection are likely to last up to two years, and antibody levels protecting against severe reinfection are present for several years [ 20 ]. Obtaining more data on infection rates and antibody dynamics, taking into account factors that may influence antibody production, could help to determine more accurate seroprevalence rates and to examine the developmental course of antibodies produced in more detail.…”