Factors influencing the immune response over 15 months after SARS-CoV-2 infection: A longitudinal population-wide study in the Faroe Islands
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Background: The durability of SARS-CoV-2 antibody response and the resulting immunity to COVID-19 is unclear. Objectives: To investigate long-term humoral immunity to SARS-CoV-2. Methods: In this nationwide, longitudinal study, we determined antibody response in 411 patients aged 0–93 years from two waves of infections (March to December 2020) contributing 1063 blood samples. Each individual had blood drawn on 4–5 occasions 1–15 months after disease onset. We measured total anti-SARS-CoV-2 receptor-binding domain (RBD) antibody using a qualitative RBD sandwich ELISA, IgM, IgG and IgA levels using an quantitative in-house ELISA-based assay and neutralizing antibodies (NAbs) using an in-house ELISA-based pseudoneutralizing assay. IgG subclasses were analyzed in a subset of samples by ELISA-based assay. We used nonlinear models to study the durability of SARS-CoV-2 antibody responses and its influence over time. Results: After 15 months, 94% still had detectable circulating antibodies, mainly the IgG isotype, and 92% had detectable NAbs. The distribution of IgG antibodies varied significantly over time, characterized by a biphasic pattern with an initial decline followed by a plateau after approximately 7 months. However, the NAbs remained relatively stable throughout the period. The strength of the antibody response was influenced by smoking and hospitalization, with lower IgG levels in smokers and higher levels in hospitalized individuals. Antibody stability over time was mainly associated with male sex and older age with higher initial levels but more marked decrease. Conclusions: The humoral immune response to SARS-CoV-2 infection varies depending on behavioral factors and disease severity, and antibody stability over 15 months was associated with sex and age.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Journal of Internal Medicine |
| Vol/bind | 293 |
| Udgave nummer | 1 |
| Sider (fra-til) | 63-81 |
| ISSN | 0954-6820 |
| DOI | |
| Status | Udgivet - 2023 |
Bibliografisk note
Funding Information:
Thanks to all the participants and the technicians drawing the blood samples. Furthermore, thanks to the Department of Occupational Medicine and Public Health staff for assistance throughout the project. The authors would like to thank Mads Engelhardt Knudsen and Sif Kaas Nielsen from the Department of Clinical Immunology at Rigshospitalet for their excellent technical assistance. This work was supported by the special COVID-19 funding from the Faroese Research Council; The Carlsberg Foundation (CF20-0045); the Novo Nordisk Foundation (NNF20SA0063180 and NFF205A0063505); the corporations Nótaskip, Krúnborg, and Borgartún; and WHO Unity Studies, a global sero-epidemiological standardization initiative, with funding to WHO by the COVID-19 Solidarity Response Fund and the German Federal Ministry of Health (BMG) COVID-19 Research and Development.
Funding Information:
Thanks to all the participants and the technicians drawing the blood samples. Furthermore, thanks to the Department of Occupational Medicine and Public Health staff for assistance throughout the project. The authors would like to thank Mads Engelhardt Knudsen and Sif Kaas Nielsen from the Department of Clinical Immunology at Rigshospitalet for their excellent technical assistance. This work was supported by the special COVID‐19 funding from the Faroese Research Council; The Carlsberg Foundation (CF20‐0045); the Novo Nordisk Foundation (NNF20SA0063180 and NFF205A0063505); the corporations Nótaskip, Krúnborg, and Borgartún; and WHO Unity Studies, a global sero‐epidemiological standardization initiative, with funding to WHO by the COVID‐19 Solidarity Response Fund and the German Federal Ministry of Health (BMG) COVID‐19 Research and Development.
Publisher Copyright:
© 2022 The Association for the Publication of the Journal of Internal Medicine.
ID: 329562243