Anti-spike antibody response to natural SARS-CoV-2 infection in the general population
Jia Wei, Philippa C. Matthews, Nicole Stoesser, Thomas W. Maddox, Luke Lorenzi, Ruth Studley, John I. Bell, John Newton, Jeremy Farrar, Ian Diamond, Emma Rourke, Alison Howarth, Brian D. Marsden, Sarah Hoosdally, E. Yvonne Jones, David I. Stuart, Derrick W. Crook, Tim Peto, Koen B. Pouwels, A. Sarah Walker, David W. Eyre, the COVID-19 Infection Survey team, Tina Thomas, Duncan Cook, Daniel Ayoubkhani, Russell Black, Antonio Felton, Megan Crees, Joel W. Jones, Lina Lloyd, Esther Sutherland, Emma Pritchard, Karina-Doris Vihta, George Doherty, James Kavanagh, Kevin Chau, Stephanie B. Hatch, Daniel Ebner, Lucas Martins Ferreira, Thomas Christott, Wanwisa Dejnirattisai, Juthathip Mongkolsapaya, Sarah Cameron, Phoebe Tamblin-Hopper, Magda Wolna, Rachael Brown, Richard J. Cornall, Gavin Screaton, Katrina Lythgoe, David Bonsall, Tanya Golubchik, Helen Fryer, Stuart Cox, Kevin Paddon, Tim James, Thomas House, Julie V. Robotham, Paul Birrell, Helena Jordan, Tim Sheppard, Graham Athey, Dan Moody, Leigh Curry, Pamela Brereton, Ian Jarvis, Anna Godsmark, George Morris, Bobby Mallick, Phil Eeles, Jodie Hay, Harper VanSteenhouse, Jessica Lee, Sean White, Tim Evans, Lisa Bloemberg, Katie Allison, Anouska Pandya, Sophie Davis, David I. Conway, Margaret MacLeod, Chris Cunningham
Abstract
Understanding the trajectory, duration, and determinants of antibody responses after SARS-CoV-2 infection can inform subsequent protection and risk of reinfection, however large-scale representative studies are limited. Here we estimated antibody response after SARS-CoV-2 infection in the general population using representative data from 7,256 United Kingdom COVID-19 infection survey participants who had positive swab SARS-CoV-2 PCR tests from 26-April-2020 to 14-June-2021. A latent class model classified 24% of participants as 'non-responders' not developing anti-spike antibodies, who were older, had higher SARS-CoV-2 cycle threshold values during infection (i.e. lower viral burden), and less frequently reported any symptoms. Among those who seroconverted, using Bayesian linear mixed models, the estimated anti-spike IgG peak level was 7.3-fold higher than the level previously associated with 50% protection against reinfection, with higher peak levels in older participants and those of non-white ethnicity. The estimated anti-spike IgG half-life was 184 days, being longer in females and those of white ethnicity. We estimated antibody levels associated with protection against reinfection likely last 1.5-2 years on average, with levels associated with protection from severe infection present for several years. These estimates could inform planning for vaccination booster strategies.