Seroprevalence of anti‐SARS‐CoV‐2 antibodies in COVID‐19 patients and healthy volunteers up to 6 months post disease onset

• Published in: European journal of immunology Vol. 50; no. 12; pp. 2025 - 2040
• Main Authors: Figueiredo‐Campos, Patrícia, Blankenhaus, Birte, Mota, Catarina, Gomes, Andreia, Serrano, Marta, Ariotti, Silvia, Costa, Catarina, Nunes‐Cabaço, Helena, Mendes, António M., Gaspar, Pedro, Pereira‐Santos, M. Conceição, Rodrigues, Fabiana, Condeço, Jorge, Escoval, M. Antonia, Santos, Matilde, Ramirez, Mario, Melo‐Cristino, José, Simas, J. Pedro, Vasconcelos, Eugenia, Afonso, Ângela, Veldhoen, Marc
• Format: Journal Article
• Language: English
• Published: Germany Wiley Subscription Services, Inc 01.12.2020; John Wiley and Sons Inc
• Subjects: Adult; Aged; Aged, 80 and over; Antibodies; Antibodies, Neutralizing - immunology; Antibodies, Viral - immunology; Clinical; COVID-19; COVID-19 - epidemiology; COVID-19 - immunology; Female; Fever; Healthy Volunteers; Humans; Immune response (humoral); Immunity to infection; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Male; Medical personnel; Middle Aged; neutralizing antibodies; Patients; SARS-CoV-2 - immunology; SARS‐CoV‐2; Seroepidemiologic Studies; Serology; Seroprevalence; Severe acute respiratory syndrome coronavirus 2; Spike Glycoprotein, Coronavirus - immunology; Time Factors; COVID-19; neutralizing antibodies; SARS-CoV-2; Seroprevalence
• ISSN: 0014-2980; 1521-4141; 1521-4141
• DOI: 10.1002/eji.202048970

SARS‐CoV‐2 has emerged as a human pathogen, causing clinical signs, from fever to pneumonia—COVID‐19—but may remain mild or asymptomatic. To understand the continuing spread of the virus, to detect those who are and were infected, and to follow the immune response longitudinally, reliable and robust assays for SARS‐CoV‐2 detection and immunological monitoring are needed. We quantified IgM, IgG, and IgA antibodies recognizing the SARS‐CoV‐2 receptor‐binding domain (RBD) or the Spike (S) protein over a period of 6 months following COVID‐19 onset. We report the detailed setup to monitor the humoral immune response from over 300 COVID‐19 hospital patients and healthcare workers, 2500 University staff, and 198 post‐COVID‐19 volunteers. Anti‐SARS‐CoV‐2 antibody responses follow a classic pattern with a rapid increase within the first three weeks after symptoms. Although titres reduce subsequently, the ability to detect anti‐SARS‐CoV‐2 IgG antibodies remained robust with confirmed neutralization activity for up to 6 months in a large proportion of previously virus‐positive screened subjects. Our work provides detailed information for the assays used, facilitating further and longitudinal analysis of protective immunity to SARS‐CoV‐2. Importantly, it highlights a continued level of circulating neutralising antibodies in most people with confirmed SARS‐CoV‐2. The setup of a versatile COVID19 serology ELISA system is described, allowing Yes/No screening with a two‐step method that reduces false‐positives. Accurate antibody titer screening indicates a classic pattern of antibody production, peaking at 3 weeks post‐infection and remaining detectable for at least 6 months in 90% of the subjects tested. The antibody response does not correlate with age, but with severity of disease, and show an initial higher response in men.