Journal Article

Decline in SARS-CoV-2 Antibodies After Mild Infection Among Frontline Health Care Personnel in a Multistate Hospital Network — 12 States, April–August 2020

Johnson, Jakea, Park, So Hee, Rice, Todd W., Nguyen, Kelly, Sehgal, Sakshi, Li, Han, Coughlin, Melissa M., Lester, Sandra N., Lindsell, Christopher J., Ategbole, Muyiwa, Edwards, Breona, Freeman, Brandi, Maruggi, Ellen, Feldstein, Leora R., Grijalva, Carlos G., Tenforde, Mark W., Ortiz, Kristina, Shapiro, Nathan I., Baughman, Adrienne, Brown, Emily, Thornburg, Natalie J., Howell, Michelle, Talbot, H. Keipp, Aston, Valerie, Epperson, Monica, Salar, Andrew, Huynh, Peter, Self, Wesley H., Dunn, Alex, Kamel, Makrina, Semenova, Vera, Stubblefield, William B., Romain, Sarah, Fletcher, Andrea, Schiffer, Jarad, Shelton, Shelby, Santana, Andres, Maniatis, Pete, Ouellette, Scott, Bookless, Holly, Qadir, Nida, Peers, Jennifer, LaRose, Mary, Mullins, Sandy, Jones, Ian D., Erickson, Heidi L., Smith, Rilee, Jia, Tao, Aboodi, Michael S., Patel, Palak, Cronin, Li, Zellner, Briana, Prekker, Matthew E., Henning, Daniel J., Peltan, Ithan D., Karow, Sarah, Ferbas, Kathie J., Steingrub, Jay S., Carlin, Claire, Hart, Kimberly W., Finck, Lani, Browning, Peter, Martin-Blais, Rachel, Khan, Akram, Bolcen, Shanna, David, Ebenezer, Klausner,

2020

Overview

Most persons infected with SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), develop virus-specific antibodies within several weeks, but antibody titers might decline over time. Understanding the timeline of antibody decline is important for interpreting SARS-CoV-2 serology results. Serum specimens were collected from a convenience sample of frontline health care personnel at 13 hospitals and tested for antibodies to SARS-CoV-2 during April 3-June 19, 2020, and again approximately 60 days later to assess this timeline. The percentage of participants who experienced seroreversion, defined as an antibody signal-to-threshold ratio >1.0 at baseline and <1.0 at the follow-up visit, was assessed. Overall, 194 (6.0%) of 3,248 participants had detectable antibodies to SARS-CoV-2 at baseline (1). Upon repeat testing approximately 60 days later (range = 50-91 days), 146 (93.6%) of 156 participants experienced a decline in antibody response indicated by a lower signal-to-threshold ratio at the follow-up visit, compared with the baseline visit, and 44 (28.2%) experienced seroreversion. Participants with higher initial antibody responses were more likely to have antibodies detected at the follow-up test than were those who had a lower initial antibody response. Whether decay in these antibodies increases risk for reinfection and disease remains unanswered. However, these results suggest that serology testing at a single time point is likely to underestimate the number of persons with previous SARS-CoV-2 infection, and a negative serologic test result might not reliably exclude prior infection.

• Publisher: U.S. Government Printing Office,U.S. Center for Disease Control,Centers for Disease Control and Prevention
• Subject: Adult / Antibodies / Antibodies, Viral - blood / Antibody response / Betacoronavirus - immunology / Coronavirus Infections - epidemiology / Coronavirus Infections - immunology / Coronaviruses / COVID-19 / Female / Full Report / Health aspects / Health care / Health services / Hispanic people / Humans / Infections / Influenza / Male / Medical personnel / Middle Aged / Pandemics / Personnel / Personnel, Hospital - statistics & numerical data / Pneumonia, Viral - epidemiology / Pneumonia, Viral - immunology / Public health / Ratios / SARS-CoV-2 / Serology / Severe acute respiratory syndrome / Severe acute respiratory syndrome coronavirus 2 / Tests / United States - epidemiology / Viral antibodies / Viral diseases / Viral infections / Viruses