TY - JOUR
T1 - Factors influencing the immune response over 15 months after SARS-CoV-2 infection
T2 - A longitudinal population-wide study in the Faroe Islands
AU - Petersen, Maria Skaalum
AU - Pérez-Alós, Laura
AU - Armenteros, Jose Juan Almagro
AU - Hansen, Cecilie Bo
AU - Páll Fjallsbak, Jógvan
AU - Larsen, Sólrun
AU - Ljósá Hansen, Jóhanna
AU - Jarlhelt, Ida
AU - Fríheim Kristiansen, Marnar
AU - Streym, Fríða Við
AU - Steig, Bjarni Á
AU - Christiansen, Debes Hammershaimb
AU - Møller, Lars Fodgaard
AU - Strøm, Marin
AU - Andorsdóttir, Guðrið
AU - Gaini, Shahin
AU - Weihe, Pál
AU - Garred, Peter
N1 - This article is protected by copyright. All rights reserved.
PY - 2023/1
Y1 - 2023/1
N2 - BACKGROUND: The durability of SARS-CoV-2 antibody response and the resulting immunity to COVID-19 is unclear.OBJECTIVES: To investigate long-term humoral immunity to SARS-CoV-2.METHODS: In this nationwide, longitudinal study, we determined antibody response in 411 patients aged 0-93 years from two waves of infections (March to December 2020) contributing 1063 blood samples. Each individual had blood drawn on 4-5 occasions 1-15 months after disease onset. We measured total anti-SARS-CoV-2 receptor-binding domain (RBD) antibody using a qualitative RBD sandwich ELISA, IgM, IgG and IgA levels using an quantitative in-house ELISA-based assay and neutralizing antibodies (NAbs) using an in-house ELISA-based pseudoneutralizing assay. IgG subclasses were analyzed in a subset of samples by ELISA-based assay. We used nonlinear models to study the durability of SARS-CoV-2 antibody responses and its influence over time.RESULTS: After 15 months, 94% still had detectable circulating antibodies, mainly the IgG isotype, and 92% had detectable NAbs. The distribution of IgG antibodies varied significantly over time, characterized by a biphasic pattern with an initial decline followed by a plateau after approximately 7 months. However, the NAbs remained relatively stable throughout the period. The strength of the antibody response was influenced by smoking and hospitalization, with lower IgG levels in smokers and higher levels in hospitalized individuals. Antibody stability over time was mainly associated with male sex and older age with higher initial levels but more marked decrease.CONCLUSIONS: The humoral immune response to SARS-CoV-2 infection varies depending on behavioral factors and disease severity, and antibody stability over 15 months was associated with sex and age.
AB - BACKGROUND: The durability of SARS-CoV-2 antibody response and the resulting immunity to COVID-19 is unclear.OBJECTIVES: To investigate long-term humoral immunity to SARS-CoV-2.METHODS: In this nationwide, longitudinal study, we determined antibody response in 411 patients aged 0-93 years from two waves of infections (March to December 2020) contributing 1063 blood samples. Each individual had blood drawn on 4-5 occasions 1-15 months after disease onset. We measured total anti-SARS-CoV-2 receptor-binding domain (RBD) antibody using a qualitative RBD sandwich ELISA, IgM, IgG and IgA levels using an quantitative in-house ELISA-based assay and neutralizing antibodies (NAbs) using an in-house ELISA-based pseudoneutralizing assay. IgG subclasses were analyzed in a subset of samples by ELISA-based assay. We used nonlinear models to study the durability of SARS-CoV-2 antibody responses and its influence over time.RESULTS: After 15 months, 94% still had detectable circulating antibodies, mainly the IgG isotype, and 92% had detectable NAbs. The distribution of IgG antibodies varied significantly over time, characterized by a biphasic pattern with an initial decline followed by a plateau after approximately 7 months. However, the NAbs remained relatively stable throughout the period. The strength of the antibody response was influenced by smoking and hospitalization, with lower IgG levels in smokers and higher levels in hospitalized individuals. Antibody stability over time was mainly associated with male sex and older age with higher initial levels but more marked decrease.CONCLUSIONS: The humoral immune response to SARS-CoV-2 infection varies depending on behavioral factors and disease severity, and antibody stability over 15 months was associated with sex and age.
KW - Antibodies, Neutralizing
KW - Antibodies, Viral
KW - COVID-19
KW - Denmark
KW - Humans
KW - Immunity
KW - Immunoglobulin G
KW - Longitudinal Studies
KW - Male
KW - SARS-CoV-2
KW - longitudinal study
KW - SARS-CoV-2 antibodies
KW - vaccination-acquired immunity
KW - Faroe Islands
KW - infection-acquired immunity
UR - http://www.scopus.com/inward/record.url?scp=85137206406&partnerID=8YFLogxK
U2 - 10.1111/joim.13560
DO - 10.1111/joim.13560
M3 - Journal article
C2 - 35996938
SN - 0954-6820
VL - 293
SP - 63
EP - 81
JO - Journal of Internal Medicine
JF - Journal of Internal Medicine
IS - 1
ER -