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den Hartog G, Vos ERA, van den Hoogen LL, et al. Persistence of Antibodies to Severe Acute Respiratory Syndrome Coronavirus 2 in Relation to Symptoms in a Nationwide Prospective Study. Clin Infect Dis. 2021;73(12):2155-2162doi: 10.1093/cid/ciab172.
den Hartog, G., Vos, E. R. A., van den Hoogen, L. L., van Boven, M., Schepp, R. M., Smits, G., van Vliet, J., Woudstra, L., Wijmenga-Monsuur, A. J., van Hagen, C. C. E., Sanders, E. A. M., de Melker, H. E., van der Klis, F. R. M., & van Binnendijk, R. S. (2021). Persistence of Antibodies to Severe Acute Respiratory Syndrome Coronavirus 2 in Relation to Symptoms in a Nationwide Prospective Study. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 73(12), 2155-2162. https://doi.org/10.1093/cid/ciab172
den Hartog, Gerco, et al. "Persistence of Antibodies to Severe Acute Respiratory Syndrome Coronavirus 2 in Relation to Symptoms in a Nationwide Prospective Study." Clinical infectious diseases : an official publication of the Infectious Diseases Society of America vol. 73,12 (2021): 2155-2162. doi: https://doi.org/10.1093/cid/ciab172
den Hartog G, Vos ERA, van den Hoogen LL, van Boven M, Schepp RM, Smits G, van Vliet J, Woudstra L, Wijmenga-Monsuur AJ, van Hagen CCE, Sanders EAM, de Melker HE, van der Klis FRM, van Binnendijk RS. Persistence of Antibodies to Severe Acute Respiratory Syndrome Coronavirus 2 in Relation to Symptoms in a Nationwide Prospective Study. Clin Infect Dis. 2021 Dec 16;73(12):2155-2162. doi: 10.1093/cid/ciab172. PMID: 33624751; PMCID: PMC7929058.
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Clin Infect Dis. 2021 Dec 16;73(12):2155-2162. doi: 10.1093/cid/ciab172.

Persistence of Antibodies to Severe Acute Respiratory Syndrome Coronavirus 2 in Relation to Symptoms in a Nationwide Prospective Study.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

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

Affiliations

  1. Centre for Immunology of Infectious Diseases and Vaccines, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
  2. Centre for Infectious Diseases, Epidemiology and Surveillance, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
  3. Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.

PMID: 33624751 PMCID: PMC7929058 DOI: 10.1093/cid/ciab172

Abstract

BACKGROUND: Assessing the duration of immunity following infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a first priority to gauge the degree of protection following infection. Such knowledge is lacking, especially in the general population. Here, we studied changes in immunoglobulin isotype seropositivity and immunoglobulin G (IgG) binding strength of SARS-CoV-2-specific serum antibodies up to 7 months following onset of symptoms in a nationwide sample.

METHODS: Participants from a prospective representative serological study in the Netherlands were included based on IgG seroconversion to the spike S1 protein of SARS-CoV-2 (N = 353), with up to 3 consecutive serum samples per seroconverted participant (N = 738). Immunoglobulin M (IgM), immunoglobulin A (IgA), and IgG antibody concentrations to S1, and increase in IgG avidity in relation to time since onset of disease symptoms, were determined.

RESULTS: While SARS-CoV-2-specific IgM and IgA antibodies declined rapidly after the first month after disease onset, specific IgG was still present in 92% (95% confidence interval [CI], 89%-95%) of the participants after 7 months. The estimated 2-fold decrease of IgG antibodies was 158 days (95% CI, 136-189 days). Concentrations were sustained better in persons reporting significant symptoms compared to asymptomatic persons or those with mild upper respiratory complaints only. Similarly, avidity of IgG antibodies for symptomatic persons showed a steeper increase over time compared with persons with mild or no symptoms (P = .022).

CONCLUSIONS: SARS-CoV-2-specific IgG antibodies persist and show increasing avidity over time, indicative of underlying immune maturation. These data support development of immune memory against SARS-CoV-2, providing insight into protection of the general unvaccinated part of the population.

CLINICAL TRIALS REGISTRATION: NL8473 (the Dutch trial registry).

© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.

Keywords: COVID-19; avidity/maturation; decay; immunoglobulin G; symptoms

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