Lack of Antibodies to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in a Large Cohort of Previously Infected Persons. (5th November 2020)

• Record Type: Journal Article
• Authors: Petersen, Lyle R; Sami, Samira; Vuong, Nga; Pathela, Preeti; Weiss, Don; Morgenthau, Beth Maldin; Henseler, Rebecca A; Daskalakis, Demetre C; Atas, Jenny; Patel, Anita; Lukacs, Susan; Mackey, Lisa; Grohskopf, Lisa A; Thornburg, Natalie; Akinbami, Lara J
• Is Part Of: Clinical infectious diseases. Volume 73:Number 9(2021)
• Page Start: e3066
• Page End: e3073
• Publication Date: 2020-11-05
• Subjects: SARS-CoV-2 -- antibody -- immunology -- risk factors; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciaa1685
• Languages: English
• ISSNs: 1058-4838

Abstract

Abstract: Background: Reports suggest that some persons previously infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) lack detectable immunoglobulin G (IgG) antibodies. We aimed to determine the proportion IgG seronegative and predictors for seronegativity among persons previously infected with SARS-CoV-2. Methods: We analyzed serologic data collected from healthcare workers and first responders in New York City and the Detroit metropolitan area with a history of a positive SARS-CoV-2 reverse-transcription polymerase chain reaction (RT-PCR) test result and who were tested for IgG antibodies to SARS-CoV-2 spike protein at least 2 weeks after symptom onset. Results: Of 2547 persons with previously confirmed SARS-CoV-2 infection, 160 (6.3%) were seronegative. Of 2112 previously symptomatic persons, the proportion seronegative slightly increased from 14 to 90 days post symptom onset ( P = .06). The proportion seronegative ranged from 0% among 79 persons previously hospitalized to 11.0% among 308 persons with asymptomatic infections. In a multivariable model, persons who took immunosuppressive medications were more likely to be seronegative (31.9%; 95% confidence interval [CI], 10.7%–64.7%), while participants of non-Hispanic Black race/ethnicity (vs non-Hispanic White; 2.7%; 95% CI, 1.5%–4.8%), with severe obesity (vs under/normal weight; 3.9%; 95% CI, 1.7%–8.6%), or with more symptoms were less likely to be seronegative. Conclusions: In our population with previous RT-PCR–confirmed infection, approximately 1 in 16 persons lacked IgG antibodies. Absence of antibodies varied independently by illness severity, race/ethnicity, obesity, and immunosuppressive drug therapy. The proportion seronegative remained relatively stable among persons tested up to 90 days post symptom onset. Abstract : Our data suggest that a sizable proportion of persons do not have immunoglobulin G antibodies following severe acute respiratory syndrome coronavirus 2 infection, which independently relates to illness severity, race/ethnicity, obesity, and immunosuppressive medication. These factors should be considered when interpreting results of serologic testing.