Impact of baseline SARS-CoV-2 antibody status on syndromic surveillance and the risk of subsequent COVID-19—a prospective multicenter cohort study

Abstract

Background In a prospective healthcare worker (HCW) cohort, we assessed the risk of SARS-CoV-2 infection according to baseline serostatus. Methods Baseline serologies were performed among HCW from 23 Swiss healthcare institutions between June and September 2020, before the second COVID-19 wave. Participants answered weekly electronic questionnaires covering information about nasopharyngeal swabs (PCR/rapid antigen tests) and symptoms compatible with coronavirus disease 2019 (COVID-19). Screening of symptomatic staff by nasopharyngeal swabs was routinely performed in participating facilities. We compared numbers of positive nasopharyngeal tests and occurrence of COVID-19 symptoms between HCW with and without anti-nucleocapsid antibodies. Results A total of 4812 HCW participated, wherein 144 (3%) were seropositive at baseline. We analyzed 107,807 questionnaires with a median follow-up of 7.9 months. Median number of answered questionnaires was similar (24 vs. 23 per person, P = 0.83) between those with and without positive baseline serology. Among 2712 HCW with ≥ 1 SARS-CoV-2 test during follow-up, 3/67 (4.5%) seropositive individuals reported a positive result (one of whom asymptomatic), compared to 547/2645 (20.7%) seronegative participants, 12 of whom asymptomatic (risk ratio [RR] 0.22; 95% confidence interval [CI] 0.07 to 0.66). Seropositive HCWs less frequently reported impaired olfaction/taste (6/144, 4.2% vs. 588/4674, 12.6%, RR 0.33, 95% CI 0.15–0.73), chills (19/144, 13.2% vs. 1040/4674, 22.3%, RR 0.59, 95% CI 0.39–0.90), and limb/muscle pain (28/144, 19.4% vs. 1335/4674, 28.6%, RR 0.68 95% CI 0.49–0.95). Impaired olfaction/taste and limb/muscle pain also discriminated best between positive and negative SARS-CoV-2 results. Conclusions Having SARS-CoV-2 anti-nucleocapsid antibodies provides almost 80% protection against SARS-CoV-2 re-infection for a period of at least 8 months.

Antibody therapy reverses biological signatures of COVID-19 progression

“…This is consistent with established findings that having SARS-CoV-2 anti-nucleocapsid Abs indicating prior infection may be associated with protection against SARS-CoV-2 re-infection and severity of symptoms. 11 …”

“…This is consistent with established findings that having SARS-CoV-2 anti-nucleocapsid Abs indicating prior infection may be associated with protection against SARS-CoV-2 re-infection and severity of symptoms. 11 Of the 202 seropositive participants at baseline, 6 (3%) were hospitalized or died: 4/97 (4%) received placebo, and 2/105 (2%) received sotrovimab. Notably, as the COMET-ICE study captured all-cause hospitalizations or death, the 2 seropositive participants in the sotrovimab arm were hospitalized with events potentially unrelated to COVID-19 (one instance of diabetic foot, and one instance of non-small cell lung cancer), while only 1 of 4 seronegative participants who received sotrovimab was admitted for potentially non-COVID-19-related hospitalization of small intestinal obstruction.…”

Symptoms Compatible With Long Coronavirus Disease (COVID) in Healthcare Workers With and Without Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection—Results of a Prospective Multicenter Cohort

“…Detection of SARS-CoV-2 was made by polymerase chain reaction (PCR) or rapid antigen test (RAT), depending on the method used in the participating institutions. Self-reported swab results were validated as described previously [ 14 ].…”

Differential Sars-Cov-2 Antigen Specificity of the Humoral Response in Inactivated Virus-Vaccinated, Convalescent, and Breakthrough Subjects

“…Interestingly, high levels of IgG against the N protein, at the time of hospital admission, has been correlated with worsen COVID-19 clinical courses [37], which could be attributed to increased IL-6 production mediated by N-specific IgG antibodies observed after COVID-19 cytokine storm [38]. On the contrary, high levels of IgG against the N protein, detected after COVID-19 recovery, have been associated with a long-term protective effect against re-infections [39]. The effect of other antibodies on the outcome of COVID-19 has not been explored to date.…”