Anti-spike antibody response to natural SARS-CoV-2 infection in the general population

the COVID-19 Infection Survey team, Jia Wei, Philippa C. Matthews, Nicole Stoesser, Thomas Maddox, Luke Lorenzi, Ruth Studley, John I. Bell, John N. Newton, Jeremy Farrar, Ian Diamond, Emma Rourke, Alison Howarth, Brian D. Marsden, Sarah Hoosdally, E. Yvonne Jones, David I. Stuart, Derrick W. Crook, Tim E.A. Peto, Koen B. PouwelsA. Sarah Walker, David W. Eyre*, Julie Robotham, Paul Birrell

*Corresponding author for this work

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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.

Original languageEnglish
Article number6250
JournalNature Communications
Issue number1
Early online date29 Oct 2021
Publication statusE-pub ahead of print - 29 Oct 2021

Bibliographical note

Funding Information: We are grateful for the support of all COVID-19 Infection Survey participants. This study is funded by the Department of Health and Social Care with in-kind support from the Welsh Government, the Department of Health on behalf of the Northern Ireland Government and the Scottish Government. J.W. is supported by University of Oxford and the China Scholarship Council. A.S.W., T.E.A.P., N.S., D.E. and K.B.P. are supported by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Healthcare Associated Infections and Antimicrobial Resistance at the University of Oxford in partnership with Public Health England (PHE) (NIHR200915). A.S.W. and T.E.A.P. are also supported by the NIHR Oxford Biomedical Research Centre. K.B.P. is also supported by the Huo Family Foundation. A.S.W. is also supported by core support from the Medical Research Council UK to the MRC Clinical Trials Unit [MC_UU_12023/22] and is an NIHR Senior Investigator. P.C.M. is funded by Wellcome (intermediate fellowship, grant ref 110110/Z/15/Z) and holds an NIHR Oxford BRC Senior Fellowship award. D.W.E. is supported by a Robertson Fellowship and an NIHR Oxford BRC Senior Fellowship. NS is an Oxford Martin Fellow and holds an NIHR Oxford BRC Senior Fellowship. The views expressed are those of the authors and not necessarily those of the National Health Service, NIHR, Department of Health, or PHE.

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Publisher Copyright: © 2021, The Author(s).

Citation: Wei, J., Matthews, P.C., Stoesser, N. et al. Anti-spike antibody response to natural SARS-CoV-2 infection in the general population. Nat Commun 12, 6250 (2021).



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