Antibody Status and Incidence of SARS-CoV-2 Infection in Health Care Workers.
Adolescent
Adult
Aged
Aged, 80 and over
Antibodies, Viral
/ blood
COVID-19
/ diagnosis
COVID-19 Nucleic Acid Testing
COVID-19 Serological Testing
Coronavirus Nucleocapsid Proteins
/ immunology
Female
Health Personnel
Humans
Immunoglobulin G
/ blood
Incidence
Longitudinal Studies
Male
Middle Aged
Polymerase Chain Reaction
Recurrence
SARS-CoV-2
/ immunology
Seroconversion
Spike Glycoprotein, Coronavirus
/ immunology
United Kingdom
Young Adult
Journal
The New England journal of medicine
ISSN: 1533-4406
Titre abrégé: N Engl J Med
Pays: United States
ID NLM: 0255562
Informations de publication
Date de publication:
11 02 2021
11 02 2021
Historique:
pubmed:
29
12
2020
medline:
13
2
2021
entrez:
28
12
2020
Statut:
ppublish
Résumé
The relationship between the presence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the risk of subsequent reinfection remains unclear. We investigated the incidence of SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR) in seropositive and seronegative health care workers attending testing of asymptomatic and symptomatic staff at Oxford University Hospitals in the United Kingdom. Baseline antibody status was determined by anti-spike (primary analysis) and anti-nucleocapsid IgG assays, and staff members were followed for up to 31 weeks. We estimated the relative incidence of PCR-positive test results and new symptomatic infection according to antibody status, adjusting for age, participant-reported gender, and changes in incidence over time. A total of 12,541 health care workers participated and had anti-spike IgG measured; 11,364 were followed up after negative antibody results and 1265 after positive results, including 88 in whom seroconversion occurred during follow-up. A total of 223 anti-spike-seronegative health care workers had a positive PCR test (1.09 per 10,000 days at risk), 100 during screening while they were asymptomatic and 123 while symptomatic, whereas 2 anti-spike-seropositive health care workers had a positive PCR test (0.13 per 10,000 days at risk), and both workers were asymptomatic when tested (adjusted incidence rate ratio, 0.11; 95% confidence interval, 0.03 to 0.44; P = 0.002). There were no symptomatic infections in workers with anti-spike antibodies. Rate ratios were similar when the anti-nucleocapsid IgG assay was used alone or in combination with the anti-spike IgG assay to determine baseline status. The presence of anti-spike or anti-nucleocapsid IgG antibodies was associated with a substantially reduced risk of SARS-CoV-2 reinfection in the ensuing 6 months. (Funded by the U.K. Government Department of Health and Social Care and others.).
Sections du résumé
BACKGROUND
The relationship between the presence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the risk of subsequent reinfection remains unclear.
METHODS
We investigated the incidence of SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR) in seropositive and seronegative health care workers attending testing of asymptomatic and symptomatic staff at Oxford University Hospitals in the United Kingdom. Baseline antibody status was determined by anti-spike (primary analysis) and anti-nucleocapsid IgG assays, and staff members were followed for up to 31 weeks. We estimated the relative incidence of PCR-positive test results and new symptomatic infection according to antibody status, adjusting for age, participant-reported gender, and changes in incidence over time.
RESULTS
A total of 12,541 health care workers participated and had anti-spike IgG measured; 11,364 were followed up after negative antibody results and 1265 after positive results, including 88 in whom seroconversion occurred during follow-up. A total of 223 anti-spike-seronegative health care workers had a positive PCR test (1.09 per 10,000 days at risk), 100 during screening while they were asymptomatic and 123 while symptomatic, whereas 2 anti-spike-seropositive health care workers had a positive PCR test (0.13 per 10,000 days at risk), and both workers were asymptomatic when tested (adjusted incidence rate ratio, 0.11; 95% confidence interval, 0.03 to 0.44; P = 0.002). There were no symptomatic infections in workers with anti-spike antibodies. Rate ratios were similar when the anti-nucleocapsid IgG assay was used alone or in combination with the anti-spike IgG assay to determine baseline status.
CONCLUSIONS
The presence of anti-spike or anti-nucleocapsid IgG antibodies was associated with a substantially reduced risk of SARS-CoV-2 reinfection in the ensuing 6 months. (Funded by the U.K. Government Department of Health and Social Care and others.).
Identifiants
pubmed: 33369366
doi: 10.1056/NEJMoa2034545
pmc: PMC7781098
doi:
Substances chimiques
Antibodies, Viral
0
Coronavirus Nucleocapsid Proteins
0
Immunoglobulin G
0
Spike Glycoprotein, Coronavirus
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
533-540Subventions
Organisme : Medical Research Council
ID : MR/N00065X/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : G1100525
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/V001329/1
Pays : United Kingdom
Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_UU_00008/6
Pays : United Kingdom
Investigateurs
Sheila F Lumley
(SF)
Denise O'Donnell
(D)
Nicole E Stoesser
(NE)
Philippa C Matthews
(PC)
Alison Howarth
(A)
Stephanie B Hatch
(SB)
Brian D Marsden
(BD)
Stuart Cox
(S)
Tim James
(T)
Fiona Warren
(F)
Liam J Peck
(LJ)
Thomas G Ritter
(TG)
Zoe de Toledo
(Z)
Laura Warren
(L)
David Axten
(D)
Richard J Cornall
(RJ)
E Yvonne Jones
(EY)
David I Stuart
(DI)
Gavin Screaton
(G)
Daniel Ebner
(D)
Sarah Hoosdally
(S)
Meera Chand
(M)
Derrick W Crook
(DW)
Anne-Marie O'Donnell
(AM)
Christopher P Conlon
(CP)
Koen B Pouwels
(KB)
A Sarah Walker
(AS)
Tim E A Peto
(TEA)
Susan Hopkins
(S)
Timothy M Walker
(TM)
Katie Jeffery
(K)
David W Eyre
(DW)
Molly Abbott
(M)
Roxanna Abhari
(R)
Hibatullah Abuelgasim
(H)
Tariq Ahmed-Firani
(T)
Ahmed Alhussni
(A)
Isobel Argles
(I)
Rebecca Ashworth
(R)
Francesca Back
(F)
Susannah Black
(S)
Isabelle Brennan
(I)
Helen Callard
(H)
Lottie Cansdale
(L)
Triya Chakravorty
(T)
Magdalena Chmura
(M)
Zahra Choudhury
(Z)
Helen Clay
(H)
Rebecca Conway-Jones
(R)
Aisling Curtis
(A)
Joseph Cutteridge
(J)
Hannah Danbury
(H)
Hettie Davies
(H)
Lucy Denly
(L)
Julie Dequaire
(J)
Stoyan Dimitrov
(S)
Ella Dunlop
(E)
Polly Dunn
(P)
Cameron East
(C)
Ben Eastwood
(B)
Chantal Edwardes
(C)
Meirian Evans
(M)
Charlotte Fields
(C)
Sarah Flaherty
(S)
Thomas Foord
(T)
Rosie Freer
(R)
Hannah Fuchs
(H)
Alexander Grassam-Rowe
(A)
Lewis Greenan-Barrett
(L)
James Gunnell
(J)
Callum Harries
(C)
Edward Harris
(E)
Elizabeth Hatton
(E)
Conor Hennessy
(C)
Christian Holland
(C)
Ben Holloway
(B)
Gregory Howgego
(G)
Isaac Jarratt Barnham
(IJ)
Síle Johnson
(S)
Thomas Johnson
(T)
Daniela Johnstone
(D)
Julia Johnstone
(J)
Rebecca Jurdon
(R)
Gabriella Kelly
(G)
Sven Kerneis
(S)
Beinn Khulusi
(B)
Annabel Killen
(A)
Stefan Kourdov
(S)
Mary Kumarendran
(M)
Hannah Laurenson-Schafer
(H)
Ruby Lawrence
(R)
Charlotte Lee
(C)
Angus Livingstone
(A)
Rosie Lynch
(R)
Tara Madsen
(T)
Ali Manji
(A)
James Marsh
(J)
Chris Mason
(C)
Angus Mccance
(A)
Euan Mcgivern
(E)
Ailsa Mckinlay
(A)
Alexandra Mighiu
(A)
Lancelot Millar
(L)
Yethrib Mohamed
(Y)
Kenzo Motohashi
(K)
Myat San
(M)
Andrey Nezhentsev
(A)
Katherine O'Byrne
(K)
Temitope Okuwoga
(T)
Madeleine Oliver
(M)
Saxon Pattenden
(S)
Vimukthi Perera
(V)
Yva Petit
(Y)
Florence Pickles
(F)
Maria Pikoula
(M)
Govind Randhawa
(G)
Krupa Ravi
(K)
Lara Reed
(L)
Caitlin Rigler
(C)
Charlotte Robinson
(C)
Evie Rothwell
(E)
Stephanie SantosPaulo
(S)
Constantinos Savva
(C)
Alice Scharmeli
(A)
Samuel Scott
(S)
Zamin Shabir
(Z)
Ishta Sharma
(I)
Remarez Sheehan
(R)
Afrah Shibu
(A)
Arun Somanathan
(A)
Samuel Sussmes
(S)
Owen Sweeney
(O)
Emily Swift
(E)
Gayatri Tadikamalla
(G)
Morwenna Tamblyn
(M)
Adan Taylor
(A)
Rebecca Te Water Naudé
(R)
Sarah Thomas
(S)
Connor Thompson
(C)
Lottie Till
(L)
Ross Toward
(R)
Charis Virgo
(C)
Imogen Vorley
(I)
Seren Waite
(S)
Harry Ward
(H)
Jocelyn Ward
(J)
Adam Watson
(A)
Lily Watson
(L)
Matthew Wedlich
(M)
Esme Weeks
(E)
Laura Wilkins
(L)
Jack Wilson
(J)
Joseph Wilson
(J)
William Wong
(W)
Rebecca Young
(R)
Kevin K Chau
(KK)
Thomas Christott
(T)
George Doherty
(G)
Philip W Fowler
(PW)
Fredrik Karpe
(F)
James Kavanagh
(J)
Lucas Martins Ferreira
(LM)
Matt J Neville
(MJ)
Hayleah Pickford
(H)
Gillian Rodger
(G)
Donal Skelly
(D)
Jeremy Swann
(J)
Sarah Cameron
(S)
Phoebe Tamblin-Hopper
(P)
Denis Volk
(D)
Fan Yang-Turner
(F)
Ali Amini
(A)
Monique Andersson
(M)
Karen Anson
(K)
Lisa Aston
(L)
Simran Barot
(S)
Trisha Bellinger
(T)
Adrian Bialek
(A)
Noemi Bodo
(N)
Andrew Brent
(A)
Mark Campbell
(M)
Vanessa Cox
(V)
Tammy Cronin
(T)
Timothy Davies
(T)
Alessio Deales
(A)
Louise Downs
(L)
Philip Drennan
(P)
Maria Dudareva
(M)
Laura Gates
(L)
Michelle Gates
(M)
Dominique Georgiou
(D)
Bernadett Gergely
(B)
Louise Holland
(L)
Nicola Jones
(N)
Sarah Jones
(S)
Sharon Kerr
(S)
Elaine Lawson
(E)
Stacy Looms
(S)
Michael Luciw
(M)
Diva Martins
(D)
Mary Mcknight
(M)
Alexander Mentzer
(A)
Rebecca Millard
(R)
Tracey Mitchell
(T)
Lisa Morgan
(L)
Jordan Morrow
(J)
Emma Mortimore
(E)
Harriet Mullins
(H)
Heather Nevard
(H)
Kaisha Patel
(K)
Leon Peto
(L)
Jane Philips
(J)
Jessica Ponting
(J)
Roshni Ray
(R)
Maria Robles
(M)
Sonam Rughani
(S)
Nellia Sande
(N)
Angelo Scheller
(A)
Robert Shaw
(R)
Emma-Jane Simons
(EJ)
Elizabeth Sims
(E)
Kyla Smit
(K)
Lucianne Smith
(L)
Justyna Szczurkowska
(J)
Zoe Thompson
(Z)
Rachel Turford
(R)
Kim Vilca
(K)
Alexander Vogt
(A)
Annie Westlake
(A)
Vicki Wharton
(V)
Alison Whitty
(A)
Heather Woodley
(H)
Barbara Wozniak
(B)
Bernadette Young
(B)
Kathryn Cann
(K)
Mohamad Fadzillah
(M)
Nurul Huda
(N)
Anita Justice
(A)
Richard Kirton
(R)
Gerald Jesuthasan
(G)
Susan Wareing
(S)
Lisa Butcher
(L)
Gabriella D'Amato
(G)
Ruth Moroney
(R)
Gemma Pill
(G)
Lydia Rylance-Knight
(L)
Claire Sutton
(C)
Claudia Salvagno
(C)
Merline Tabirao
(M)
Sarah Wright
(S)
Informations de copyright
Copyright © 2020 Massachusetts Medical Society.
Références
Nature. 2020 Aug;584(7821):437-442
pubmed: 32555388
Lancet Infect Dis. 2021 Jan;21(1):52-58
pubmed: 33058797
Elife. 2020 Aug 21;9:
pubmed: 32820721
J Clin Microbiol. 2020 Oct 21;58(11):
pubmed: 32826322
Nat Med. 2020 Aug;26(8):1200-1204
pubmed: 32555424
Science. 2020 Dec 4;370(6521):1227-1230
pubmed: 33115920
Clin Infect Dis. 2021 Aug 2;73(3):e699-e709
pubmed: 33400782
Int J Infect Dis. 2020 Oct;99:229-230
pubmed: 32771639
Lancet Infect Dis. 2020 May;20(5):565-574
pubmed: 32213337
Precis Clin Med. 2020 Sep 04;3(4):292-293
pubmed: 35960674
Eur Respir J. 2005 Jan;25(1):12-4
pubmed: 15640317
Clin Infect Dis. 2021 Nov 2;73(9):e2946-e2951
pubmed: 32840608
J Infect Dis. 2021 Feb 13;223(3):389-398
pubmed: 33140086
N Engl J Med. 2020 Oct 29;383(18):1724-1734
pubmed: 32871063
Nat Commun. 2020 Jul 6;11(1):3436
pubmed: 32632160
Wellcome Open Res. 2020 Jun 11;5:139
pubmed: 33748431
Nat Microbiol. 2020 Dec;5(12):1598-1607
pubmed: 33106674
Lancet Infect Dis. 2020 Dec;20(12):1390-1400
pubmed: 32979318
J Infect. 2020 Nov;81(5):816-846
pubmed: 32619697
Clin Infect Dis. 2008 Aug 1;47(3):401-9
pubmed: 18558875
Clin Infect Dis. 2021 Nov 2;73(9):e2823-e2825
pubmed: 32964927
J Infect. 2020 Sep;81(3):e90-e92
pubmed: 32574567
Clin Infect Dis. 2021 Jul 15;73(2):354-356
pubmed: 32887979
Clin Biochem. 2017 Dec;50(18):1306-1311
pubmed: 28847718