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- Title
Anti–SARS-CoV-2 Antibody Levels Associated With COVID-19 Protection in Outpatients Tested for SARS-CoV-2, US Flu Vaccine Effectiveness Network, October 2021–June 2022.
- Authors
Sumner, Kelsey M; Yadav, Ruchi; Noble, Emma K; Sandford, Ryan; Joshi, Devyani; Tartof, Sara Y; Wernli, Karen J; Martin, Emily T; Gaglani, Manjusha; Zimmerman, Richard K; Talbot, H Keipp; Grijalva, Carlos G; Belongia, Edward A; Chung, Jessie R; Rogier, Eric; Coughlin, Melissa M; Flannery, Brendan
- Abstract
Background We assessed associations between binding antibody (bAb) concentration <5 days from symptom onset and testing positive for COVID-19 among patients in a test-negative study. Methods From October 2021 to June 2022, study sites in 7 states enrolled patients aged ≥6 months presenting with acute respiratory illness. Respiratory specimens were tested for SARS-CoV-2. In blood specimens, we measured concentrations of anti-SARS-CoV-2 antibodies against the spike protein receptor binding domain (RBD) and nucleocapsid antigens from the ancestral strain in standardized bAb units (BAU). Percentage change in odds of COVID-19 by increasing anti-RBD bAb was estimated via logistic regression as (1 – adjusted odds ratio of COVID-19) × 100, adjusting for COVID-19 mRNA vaccine doses, age, site, and high-risk exposure. Results Out of 2018 symptomatic patients, 662 (33%) tested positive for acute SARS-CoV-2 infection. Geometric mean RBD bAb levels were lower among COVID-19 cases than SARS-CoV-2 test-negative controls during the Delta-predominant period (112 vs 498 BAU/mL) and Omicron-predominant period (823 vs 1189 BAU/mL). Acute-phase ancestral spike RBD bAb levels associated with 50% lower odds of COVID-19 were 1968 BAU/mL against Delta and 3375 BAU/mL against Omicron; thresholds may differ in other laboratories. Conclusions During acute illness, antibody concentrations against ancestral spike RBD were associated with protection against COVID-19.
- Subjects
COVID-19; COVID-19 pandemic; VACCINE effectiveness; INFLUENZA vaccines; PROTEIN receptors
- Publication
Journal of Infectious Diseases, 2024, Vol 230, Issue 1, p45
- ISSN
0022-1899
- Publication type
Article
- DOI
10.1093/infdis/jiae090