Persistence of antibodies to SARS-CoV-2 in relation to symptoms in a nationwide prospective study

February 24, 2021

Gerco den Hartog, PhD, Eric R A Vos, MSc, Lotus L van den Hoogen, PhD, Michiel van Boven, PhD, Rutger M Schepp, BSc, Gaby Smits, MSc, Jeffrey van Vliet, Linde Woudstra, PhD, Alienke J Wijmenga-Monsuur, PhD, Cheyenne C E van Hagen, MSc, Elisabeth A M Sanders, MD, PhD, Hester E de Melker, PhD, Fiona R M van der Klis, PhD, Robert S van Binnendijk, PhD

Clinical Infectious Diseases

The persistence of specific antibodies against SARS-CoV-2, the causative agent of COVID-19, is not yet fully understood. Using samples from individuals with antibodies (N = 353) from a prospective national serosurveillance study (Pienter corona Study) covering all ages, the breakdown into SARS-CoV-2 Spike specific IgM, IgA, and IgG antibodies were studied. S1 for a period of 7 months after infection and the effect of COVID-19-related symptoms on antibody levels. Also, they studied the development of avidity of anti-SARS-CoV-2 Spike S1 IgG antibodies as a marker of underlying cellular immunity and the functionality of the detected antibodies. Their data confirm that antibodies decrease rapidly, in the case of IgM and IgA isotypes. In contrast, 87% of the asymptomatic / mildly symptomatic participants and 95% of the symptomatic participants remained positive for IgG seven months after the onset of COVID-19 symptoms. Furthermore, the estimated 2-fold decrease in concentration over 158 days and the increasing avidity of IgG anti-Spike antibodies indicates the presence of memory B cells and/or long-lived plasma cells. Since IgG antibodies persist much longer than IgM and IgA antibodies, their detection provides better sensitivity for a long time after infection. Therefore IgG should be the isotype of choice in studies to assess the seroprevalence more than 2 months after infection and longitudinal studies. It is not yet known what antibody levels confer protection against reinfection or COVID-19 disease. The results help interpret the duration of immunity in unvaccinated individuals and provide a framework for evaluating vaccine-induced immunity to SARS-CoV-2.

Hartog G., Vos E., Hoogen L., Boven M. Persistence of antibodies to SARS-CoV-2 in relation to symptoms in a nationwide prospective study. Clinical Infectious Diseases 2021, https://doi.org/10.1093/cid/ciab172

Related Articles

Partners