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.

Most people who are infected with SARS-CoV-2 seroconvert within a few weeks, but the determinants and duration of the antibody response are not known. Here, the authors characterise these features of the immune response using data from a large representative community sample of the UK population.

Details

Title
Anti-spike antibody response to natural SARS-CoV-2 infection in the general population
Author
Jia, Wei 1 ; Matthews, Philippa C 2 ; Stoesser, Nicole 3   VIAFID ORCID Logo  ; Maddox, Thomas 4 ; Lorenzi, Luke 4 ; Studley, Ruth 4 ; Bell, John I 5 ; Newton, John N 6 ; Farrar, Jeremy 7 ; Diamond, Ian 4 ; Rourke, Emma 4 ; Howarth, Alison 8 ; Marsden, Brian D 9 ; Hoosdally Sarah 10 ; Yvonne, Jones E 10 ; Stuart, David I 10 ; Crook, Derrick W 3 ; Peto Tim E A 3 ; Pouwels, Koen B 11   VIAFID ORCID Logo  ; Sarah, Walker A 12 ; Eyre, David W 13   VIAFID ORCID Logo  ; Thomas, Tina 4 ; Cook, Duncan 4 ; Ayoubkhani, Daniel 4 ; Black, Russell 4 ; Felton, Antonio 4 ; Crees Megan 4 ; Jones, Joel 4 ; Lloyd, Lina 4 ; Sutherland, Esther 4 ; Pritchard, Emma 10 ; Karina-Doris, Vihta 10 ; Doherty, George 10 ; Kavanagh, James 10 ; Chau, Kevin K 10 ; Hatch, Stephanie B 10 ; Ebner, Daniel 10 ; Ferreira, Lucas Martins 10 ; Christott, Thomas 10 ; Dejnirattisai Wanwisa 10 ; Juthathip, Mongkolsapaya 10 ; Cameron, Sarah 10 ; Tamblin-Hopper Phoebe 10 ; Wolna Magda 10 ; Brown, Rachael 10 ; Cornall, Richard 10 ; Screaton Gavin 10 ; Lythgoe Katrina 10 ; Bonsall, David 10 ; Golubchik Tanya 10 ; Fryer, Helen 10 ; Cox, Stuart 14 ; Paddon, Kevin 14 ; James, Tim 14 ; House, Thomas 15 ; Robotham, Julie 6 ; Birrell, Paul 6 ; Jordan, Helena 16 ; Sheppard, Tim 16 ; Athey, Graham 16 ; Moody, Dan 16 ; Curry, Leigh 16 ; Brereton, Pamela 16 ; Jarvis, Ian 17 ; Godsmark Anna 17 ; Morris, George 17 ; Mallick, Bobby 17 ; Eeles Phil 17 ; Hay, Jodie 18 ; Harper, VanSteenhouse 18 ; Lee, Jessica 19 ; White, Sean 20 ; Evans, Tim 20 ; Bloemberg Lisa 20 ; Allison, Katie 21 ; Pandya Anouska 21 ; Davis, Sophie 21 ; Conway, David I 22 ; MacLeod, Margaret 22 ; Cunningham, Chris 22 

1  University of Oxford, Nuffield Department of Medicine, Oxford, UK (GRID:grid.4991.5) (ISNI:0000 0004 1936 8948); University of Oxford, Big Data Institute, Nuffield Department of Population Health, Oxford, UK (GRID:grid.4991.5) (ISNI:0000 0004 1936 8948) 
2  University of Oxford, Nuffield Department of Medicine, Oxford, UK (GRID:grid.4991.5) (ISNI:0000 0004 1936 8948); Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Department of Infectious Diseases and Microbiology, Oxford, UK (GRID:grid.8348.7) (ISNI:0000 0001 2306 7492) 
3  University of Oxford, Nuffield Department of Medicine, Oxford, UK (GRID:grid.4991.5) (ISNI:0000 0004 1936 8948); Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Department of Infectious Diseases and Microbiology, Oxford, UK (GRID:grid.8348.7) (ISNI:0000 0001 2306 7492); The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK (GRID:grid.4991.5) (ISNI:0000 0004 1936 8948); University of Oxford, The National Institute for Health Research Oxford Biomedical Research Centre, Oxford, UK (GRID:grid.4991.5) (ISNI:0000 0004 1936 8948) 
4  Office for National Statistics, Newport, UK (GRID:grid.426100.1) (ISNI:0000 0001 2157 6840) 
5  University of Oxford, Office of the Regius Professor of Medicine, Oxford, UK (GRID:grid.4991.5) (ISNI:0000 0004 1936 8948) 
6  Public Health England, Health Improvement Directorate, London, UK (GRID:grid.271308.f) (ISNI:0000 0004 5909 016X) 
7  Wellcome Trust, London, UK (GRID:grid.52788.30) (ISNI:0000 0004 0427 7672) 
8  University of Oxford, Nuffield Department of Medicine, Oxford, UK (GRID:grid.4991.5) (ISNI:0000 0004 1936 8948); University of Oxford, The National Institute for Health Research Oxford Biomedical Research Centre, Oxford, UK (GRID:grid.4991.5) (ISNI:0000 0004 1936 8948) 
9  University of Oxford, Nuffield Department of Medicine, Oxford, UK (GRID:grid.4991.5) (ISNI:0000 0004 1936 8948); University of Oxford, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Oxford, UK (GRID:grid.4991.5) (ISNI:0000 0004 1936 8948) 
10  University of Oxford, Nuffield Department of Medicine, Oxford, UK (GRID:grid.4991.5) (ISNI:0000 0004 1936 8948) 
11  University of Oxford, Nuffield Department of Medicine, Oxford, UK (GRID:grid.4991.5) (ISNI:0000 0004 1936 8948); University of Oxford, Big Data Institute, Nuffield Department of Population Health, Oxford, UK (GRID:grid.4991.5) (ISNI:0000 0004 1936 8948); The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK (GRID:grid.4991.5) (ISNI:0000 0004 1936 8948); University of Oxford, Health Economics Research Centre, Nuffield Department of Population Health, Oxford, UK (GRID:grid.4991.5) (ISNI:0000 0004 1936 8948) 
12  University of Oxford, Nuffield Department of Medicine, Oxford, UK (GRID:grid.4991.5) (ISNI:0000 0004 1936 8948); University of Oxford, Big Data Institute, Nuffield Department of Population Health, Oxford, UK (GRID:grid.4991.5) (ISNI:0000 0004 1936 8948); The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK (GRID:grid.4991.5) (ISNI:0000 0004 1936 8948); UCL, MRC Clinical Trials Unit at UCL, London, UK (GRID:grid.83440.3b) (ISNI:0000000121901201) 
13  University of Oxford, Big Data Institute, Nuffield Department of Population Health, Oxford, UK (GRID:grid.4991.5) (ISNI:0000 0004 1936 8948); Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Department of Infectious Diseases and Microbiology, Oxford, UK (GRID:grid.8348.7) (ISNI:0000 0001 2306 7492); The National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford, Oxford, UK (GRID:grid.4991.5) (ISNI:0000 0004 1936 8948); University of Oxford, The National Institute for Health Research Oxford Biomedical Research Centre, Oxford, UK (GRID:grid.4991.5) (ISNI:0000 0004 1936 8948) 
14  Oxford University Hospitals NHS Foundation Trust, Oxford, UK (GRID:grid.410556.3) (ISNI:0000 0001 0440 1440) 
15  University of Manchester, Manchester, UK (GRID:grid.5379.8) (ISNI:0000000121662407) 
16  IQVIA, London, UK (GRID:grid.482783.2) 
17  National Biocentre, Milton Keynes, UK (GRID:grid.482783.2) 
18  Glasgow Lighthouse Laboratory, London, UK (GRID:grid.482783.2) 
19  Department of Health and Social Care, London, UK (GRID:grid.57981.32) 
20  Welsh Government, Cardiff, UK (GRID:grid.422594.c) (ISNI:0000 0004 1787 8223) 
21  Scottish Government, Edinburgh, UK (GRID:grid.421126.2) (ISNI:0000 0001 0698 0044) 
22  Public Health Scotland, Edinburgh, UK (GRID:grid.508718.3) 
Publication year
2021
Publication date
2021
Publisher
Nature Publishing Group
e-ISSN
20411723
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1038/s41467-021-26479-2
ProQuest document ID
2588169415
Copyright
© The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.