Duration of SARS-CoV-2 sero-positivity in a large longitudinal sero-surveillance cohort: the COVID-19 Community Research Partnership

Abstract

Background Estimating population prevalence and incidence of prior SARS-CoV-2 infection is essential to formulate public health recommendations concerning the COVID-19 pandemic. However, interpreting estimates based on sero-surveillance requires an understanding of the duration of elevated antibodies following SARS-CoV-2 infection, especially in the large number of people with pauci-symptomatic or asymptomatic disease. Methods We examined > 30,000 serology assays for SARS-CoV-2 specific IgG and IgM assays acquired longitudinally in 11,468 adults between April and November 2020 in the COVID-19 Community Research Partnership. Results Among participants with serologic evidence for infection but few or no symptoms or clinical disease, roughly 50% sero-reverted in 30 days of their initial positive test. Sero-reversion occurred more quickly for IgM than IgG and for antibodies targeting nucleocapsid protein compared with spike proteins, but was not associated with age, sex, race/ethnicity, or healthcare worker status. Conclusions The short duration of antibody response suggests that the true population prevalence of prior SARS-CoV-2 infection may be significantly higher than presumed based on earlier sero-surveillance studies. The impact of the large number of minimally symptomatic COVID-19 cases with only a brief antibody response on population immunity remains to be determined.

Analysis of Fatality Impact and Seroprevalence Surveys in a Community Sustaining a SARS-CoV-2 Superspreading Event

“…Furthermore, repeated seroprevalence surveys showed that seroprevalence changed only modestly in the fall of 2020 and beyond as compared with our previously published results on seroprevalence in April 2020 12 . However, we documented substantial rates of seroreversion, which is in agreement with some other studies [29][30][31][32][33][34][35][36] . Some studies have found even higher rates of seroreversion, e.g.…”

“…Some studies have found even higher rates of seroreversion, e.g. one investigation found a median time to seroreversion for IgG being only 55 days 30 , but this may include false-positives at initial screening. Nevertheless, it is very likely that seroreversion causes the number of infected individuals to be substantially under-estimated and thus the IFR to be over-estimated 29,30 .…”

“…one investigation found a median time to seroreversion for IgG being only 55 days 30 , but this may include false-positives at initial screening. Nevertheless, it is very likely that seroreversion causes the number of infected individuals to be substantially under-estimated and thus the IFR to be over-estimated 29,30 . This may apply even to our early April 2020 survey that happened within two months of the superspreader event.…”

Waning of Anti-spike Antibodies in AZD1222 (ChAdOx1) Vaccinated Healthcare Providers: A Prospective Longitudinal Study

“…Twelve participants had documented prior history of COVID-19. Prior studies have indicated a large number of unreported asymptomatic infections during the COVID-19 pandemic [ 22 ].…”

The Impact of SARS-CoV-2 Primary Vaccination in a Cohort of Patients Hospitalized for Acute COVID-19 during Delta Variant Predominance

“…Prior infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) generates humoral and cellular correlates of immunity [ 1 , 2 , 3 , 4 ] and some protection of uncertain duration from re-infection [ 5 , 6 , 7 ]. However, the permissive accumulation of infections in populations is a poor strategy for controlling the pandemic given the considerable morbidity and mortality of coronavirus disease 2019 (COVID-19).…”