Association between self-reported signs and symptoms and SARS-CoV-2 antibody detection in UK key workers

Ranya Mulchandani, Sian Taylor-Philips, Hayley E. Jones, A. E. Ades, Raymond Borrow, Ezra Linley, Peter Kirwan, Richard Stewart, Philippa Moore, John Boyes, Anil Hormis, Neil Todd, Antoanela Colda, Ian Reckless, Tim Brooks, Andre Charlett, Matthew Hickman, Isabel Oliver, David Wyllie*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)
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Background: Screening for SARS-CoV-2 antibodies is under way in some key worker groups; how this adds to self-reported COVID-19 illness is unclear. In this study, we investigate the association between self-reported belief of COVID-19 illness and seropositivity. 

Methods: Cross-sectional study of three key worker streams comprising (A) Police and Fire & Rescue (2 sites) (B) healthcare workers (1 site) and (C) healthcare workers with previously positive PCR result (5 sites). We collected self-reported signs and symptoms of COVID-19 and compared this with serology results from two SARS-CoV-2 immunoassays (Roche Elecsys® and EUROIMMUN). 

Results: Between 01 and 26 June, we recruited 2847 individuals (Stream A: 1,247, Stream B: 1,546 and Stream C: 154). Amongst those without previous positive PCR tests, 687/2,579 (26%) reported belief they had COVID-19, having experienced compatible symptoms; however, only 208 (30.3%) of these were seropositive on both immunoassays. Both immunoassays had high sensitivities relative to previous PCR positivity (>93%); there was also limited decline in antibody titres up to 110 days post symptom onset. Symptomatic but seronegative individuals had differing symptom profiles and shorter illnesses than seropositive individuals. 

Conclusion: Non-COVID-19 respiratory illness may have been mistaken for COVID-19 during the outbreak; laboratory testing is more specific than self-reported key worker beliefs in ascertaining past COVID-19 disease.

Original languageEnglish
Pages (from-to)151-161
Number of pages11
JournalJournal of Infection
Issue number5
Early online date26 Mar 2021
Publication statusPublished - May 2021

Bibliographical note

Funding Information: The study was funded by Public Health England and supported by the NIHR Clinical Research Network (CRN) Portfolio.

Open Access: This is an open access article under the CC BY-NC-ND license (

Publisher Copyright: Crown Copyright © 2021 Published by Elsevier Ltd on behalf of The British Infection Association.

Citation: Mulchandani, Ranya, et al. "Association between self-reported signs and symptoms and SARS-CoV-2 antibody detection in UK key workers." Journal of Infection (2021).



  • Antibodies
  • Covid-19
  • Symptoms
  • United kingdom
  • serology


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