Duration of SARS-CoV-2 sero-positivity in a large longitudinal sero-surveillance cohort: the COVID-19 Community Research Partnership
David M. Herrington, John W. Sanders, Thomas F. Wierzba, Martha A. Alexander‐Miller, Mark A. Espeland, Alain G. Bertoni, Allison Mathews, Austin Seals, Iqra Munawar, Michael S. Runyon, Lewis McCurdy, Michael Gibbs, Karen L. Kotloff, DeAnna Friedman-Klabanoff, William Weintraub, Adolfo Correa, Diane Uschner, Sharon L. Edelstein, Michele Santacatterina
Abstract
BACKGROUND: Estimating population prevalence and incidence of prior SARS-CoV-2 infection is essential to formulate public health recommendations concerning the COVID-19 pandemic. However, interpreting estimates based on sero-surveillance requires an understanding of the duration of elevated antibodies following SARS-CoV-2 infection, especially in the large number of people with pauci-symptomatic or asymptomatic disease. METHODS: We examined > 30,000 serology assays for SARS-CoV-2 specific IgG and IgM assays acquired longitudinally in 11,468 adults between April and November 2020 in the COVID-19 Community Research Partnership. RESULTS: Among participants with serologic evidence for infection but few or no symptoms or clinical disease, roughly 50% sero-reverted in 30 days of their initial positive test. Sero-reversion occurred more quickly for IgM than IgG and for antibodies targeting nucleocapsid protein compared with spike proteins, but was not associated with age, sex, race/ethnicity, or healthcare worker status. CONCLUSIONS: The short duration of antibody response suggests that the true population prevalence of prior SARS-CoV-2 infection may be significantly higher than presumed based on earlier sero-surveillance studies. The impact of the large number of minimally symptomatic COVID-19 cases with only a brief antibody response on population immunity remains to be determined.