Antibody titer levels and the effect on subsequent SARS-CoV-2 infection in a large US-based cohort
Despite a growing amount of data around the kinetics and durability of the antibody response induced by vaccination and previous infection, there is little understanding of whether or not a given quantitative level of antibodies correlates to protection against SARS-CoV-2 infection or reinfection. I...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-02-01
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| Series: | Heliyon |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844023003109 |
| _version_ | 1811161857039269888 |
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| author | Adam Sullivan David Alfego Pingsha Hu Laura Gillim Ajay Grover Chris Garcia Oren Cohen Stan Letovsky |
| author_facet | Adam Sullivan David Alfego Pingsha Hu Laura Gillim Ajay Grover Chris Garcia Oren Cohen Stan Letovsky |
| author_sort | Adam Sullivan |
| collection | DOAJ |
| description | Despite a growing amount of data around the kinetics and durability of the antibody response induced by vaccination and previous infection, there is little understanding of whether or not a given quantitative level of antibodies correlates to protection against SARS-CoV-2 infection or reinfection. In this study, we examine SARS-CoV-2 anti-spike receptor binding domain (RBD) antibody titers and subsequent SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) tests in a large cohort of US-based patients. We analyzed antibody test results in a cohort of 22,204 individuals, 6.8% (n = 1,509) of whom eventually tested positive for SARS-CoV-2 RNA, suggesting infection or reinfection. Kaplan-Meier curves were plotted to understand the effect of various levels of anti-spike RBD antibody titers (classified into discrete ranges) on subsequent RT-PCR positivity rates. Statistical analyses included fitting a Cox proportional hazards model to estimate the age-, sex- and exposure-adjusted hazard ratios for S antibody titer, using zip-code positivity rates by week as a proxy for COVID-19 exposure. It was found that the best models of the temporally associated infection risk were those based on log antibody titer level (HR = 0.836 (p < 0.05)). When titers were binned, the hazard ratio associated with antibody titer >250 Binding Antibody Units (BAU) was 0.27 (p < 0.05, 95% CI [0.18, 0.41]), while the hazard ratio associated with previous infection was 0.20 (p < 0.05, 95% CI [0.10, 0.39]). Fisher exact odds ratio (OR) for Ab titers <250 BAU showed OR = 2.84 (p < 0.05; 95% CI: [2.30, 3.53]) for predicting the outcome of a subsequent PCR test. Antibody titer levels correlate with protection against subsequent SARS-CoV-2 infection or reinfection when examining a cohort of real-world patients who had the spike RBD antibody assay performed. |
| first_indexed | 2024-04-10T06:20:48Z |
| format | Article |
| id | doaj.art-a298aee13f914149936755b69214406e |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-04-10T06:20:48Z |
| publishDate | 2023-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-a298aee13f914149936755b69214406e2023-03-02T05:00:05ZengElsevierHeliyon2405-84402023-02-0192e13103Antibody titer levels and the effect on subsequent SARS-CoV-2 infection in a large US-based cohortAdam Sullivan0David Alfego1Pingsha Hu2Laura Gillim3Ajay Grover4Chris Garcia5Oren Cohen6Stan Letovsky7Corresponding author.; LabCorp: Laboratory Corporation of America Holdings, Burlington, NC, United StatesLabCorp: Laboratory Corporation of America Holdings, Burlington, NC, United StatesLabCorp: Laboratory Corporation of America Holdings, Burlington, NC, United StatesLabCorp: Laboratory Corporation of America Holdings, Burlington, NC, United StatesLabCorp: Laboratory Corporation of America Holdings, Burlington, NC, United StatesLabCorp: Laboratory Corporation of America Holdings, Burlington, NC, United StatesLabCorp: Laboratory Corporation of America Holdings, Burlington, NC, United StatesLabCorp: Laboratory Corporation of America Holdings, Burlington, NC, United StatesDespite a growing amount of data around the kinetics and durability of the antibody response induced by vaccination and previous infection, there is little understanding of whether or not a given quantitative level of antibodies correlates to protection against SARS-CoV-2 infection or reinfection. In this study, we examine SARS-CoV-2 anti-spike receptor binding domain (RBD) antibody titers and subsequent SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) tests in a large cohort of US-based patients. We analyzed antibody test results in a cohort of 22,204 individuals, 6.8% (n = 1,509) of whom eventually tested positive for SARS-CoV-2 RNA, suggesting infection or reinfection. Kaplan-Meier curves were plotted to understand the effect of various levels of anti-spike RBD antibody titers (classified into discrete ranges) on subsequent RT-PCR positivity rates. Statistical analyses included fitting a Cox proportional hazards model to estimate the age-, sex- and exposure-adjusted hazard ratios for S antibody titer, using zip-code positivity rates by week as a proxy for COVID-19 exposure. It was found that the best models of the temporally associated infection risk were those based on log antibody titer level (HR = 0.836 (p < 0.05)). When titers were binned, the hazard ratio associated with antibody titer >250 Binding Antibody Units (BAU) was 0.27 (p < 0.05, 95% CI [0.18, 0.41]), while the hazard ratio associated with previous infection was 0.20 (p < 0.05, 95% CI [0.10, 0.39]). Fisher exact odds ratio (OR) for Ab titers <250 BAU showed OR = 2.84 (p < 0.05; 95% CI: [2.30, 3.53]) for predicting the outcome of a subsequent PCR test. Antibody titer levels correlate with protection against subsequent SARS-CoV-2 infection or reinfection when examining a cohort of real-world patients who had the spike RBD antibody assay performed.http://www.sciencedirect.com/science/article/pii/S2405844023003109COVID-19SARS-CoV-2AntibodySpikeNucleocapsidSeroprevalence |
| spellingShingle | Adam Sullivan David Alfego Pingsha Hu Laura Gillim Ajay Grover Chris Garcia Oren Cohen Stan Letovsky Antibody titer levels and the effect on subsequent SARS-CoV-2 infection in a large US-based cohort Heliyon COVID-19 SARS-CoV-2 Antibody Spike Nucleocapsid Seroprevalence |
| title | Antibody titer levels and the effect on subsequent SARS-CoV-2 infection in a large US-based cohort |
| title_full | Antibody titer levels and the effect on subsequent SARS-CoV-2 infection in a large US-based cohort |
| title_fullStr | Antibody titer levels and the effect on subsequent SARS-CoV-2 infection in a large US-based cohort |
| title_full_unstemmed | Antibody titer levels and the effect on subsequent SARS-CoV-2 infection in a large US-based cohort |
| title_short | Antibody titer levels and the effect on subsequent SARS-CoV-2 infection in a large US-based cohort |
| title_sort | antibody titer levels and the effect on subsequent sars cov 2 infection in a large us based cohort |
| topic | COVID-19 SARS-CoV-2 Antibody Spike Nucleocapsid Seroprevalence |
| url | http://www.sciencedirect.com/science/article/pii/S2405844023003109 |
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