Nucleocapsid and spike antibody responses following virologically confirmed SARS-CoV-2 infection: an observational analysis in the Virus Watch community cohort

Annalan M D Navaratnam; Madhumita Shrotri; Vincent Nguyen; Isobel Braithwaite; Sarah Beale; Thomas E Byrne; Wing Lam Erica Fong; Ellen Fragaszy; Cyril Geismar; Susan Hoskins; Jana Kovar; Parth Patel; Alexei Yavlinsky; Anna Aryee; Alison Rodger; Andrew C Hayward; Robert W Aldridge; Virus Watch Collaborative

doi:10.1016/j.ijid.2022.07.053

Nucleocapsid and spike antibody responses following virologically confirmed SARS-CoV-2 infection: an observational analysis in the Virus Watch community cohort

Int J Infect Dis. 2022 Oct:123:104-111. doi: 10.1016/j.ijid.2022.07.053. Epub 2022 Aug 18.

Authors

Annalan M D Navaratnam¹, Madhumita Shrotri¹, Vincent Nguyen¹, Isobel Braithwaite¹, Sarah Beale², Thomas E Byrne¹, Wing Lam Erica Fong¹, Ellen Fragaszy³, Cyril Geismar¹, Susan Hoskins¹, Jana Kovar², Parth Patel¹, Alexei Yavlinsky¹, Anna Aryee¹, Alison Rodger⁴, Andrew C Hayward², Robert W Aldridge⁵; Virus Watch Collaborative

Collaborators

Virus Watch Collaborative:
Susan Michie⁶, Pia Hardelid⁷, Linda Wijlaars⁷, Eleni Nastouli⁸, Moira Spyer⁸, Ben Killingley⁹, Ingemar Cox¹⁰, Vasileios Lampos¹⁰, Rachel A McKendry¹¹, Tao Cheng¹², Yunzhe Liu¹², Jo Gibbs¹³, Richard Gilson¹³, Anne M Johnson¹³

Affiliations

¹ Institute of Health Informatics, University College London, United Kingdom.
² Institute of Epidemiology and Health Care, University College London, London, United Kingdom.
³ Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, United Kingdom.
⁴ Institute for Global Health, University College London, London, United Kingdom.
⁵ Institute of Health Informatics, University College London, United Kingdom. Electronic address: r.aldridge@ucl.ac.uk.
⁶ Centre for Behaviour Change, University College London, London, UK.
⁷ Department of Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, UK.
⁸ Department of Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, UK; Francis Crick Institute, London, UK.
⁹ Department of Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, UK; Health Protection and Influenza Research Group, Division of Epidemiology and Public Health, University of Nottingham School of Medicine, Nottingham, UK; University College London Hospital, London, UK.
¹⁰ Department of Computer Science, University College London, London, UK.
¹¹ London Centre for Nanotechnology and Division of Medicine, London, University College London, UK.
¹² SpaceTimeLab, Department of Civil, Environmental and Geomatic Engineering, University College London, London, UK.
¹³ Institute for Global Health, University College London, London, UK.

Abstract

Objectives: Seroprevalence studies can provide a measure of SARS-CoV-2 cumulative incidence, but a better understanding of spike and nucleocapsid (anti-N) antibody dynamics following infection is needed to assess the longevity of detectability.

Methods: Adults aged ≥18 years, from households enrolled in the Virus Watch prospective community cohort study in England and Wales, provided monthly capillary blood samples, which were tested for spike antibody and anti-N. Participants self-reported vaccination dates and past medical history. Previous polymerase chain reaction (PCR) swabs were obtained through Second Generation Surveillance System linkage data. The primary outcome variables were seropositivity and total anti-N and spike antibody levels after PCR-confirmed infection.

Results: A total of 13,802 eligible individuals provided 58,770 capillary blood samples. A total of 537 of these had a previous positive PCR-confirmed SARS-CoV-2 infection within 0-269 days of antibody sample date, among them 432 (80.45%) having a positive anti-N result. Median anti-N levels peaked between days 90 and 119 after PCR results and then began to decline. There is evidence of anti-N waning from 120 days onwards, with earlier waning for females and younger age categories.

Conclusion: Our findings suggest that anti-N has around 80% sensitivity for identifying previous COVID-19 infection, and the duration of detectability is affected by sex and age.

Keywords: Anti-N; Anti-S; COVID-19; Corona virus; Serosurveillance.

Publication types

Observational Study

MeSH terms

Adolescent
Adult
Antibodies, Viral
Antibody Formation
COVID-19* / diagnosis
COVID-19* / epidemiology
Cohort Studies
Female
Humans
Nucleocapsid
Prospective Studies
SARS-CoV-2
Seroepidemiologic Studies

Substances

Antibodies, Viral

Abstract

Publication types

MeSH terms

Substances

Grants and funding