Top

Published in:

Open Access 01-12-2021 | Myalgie | Research article

Impact of baseline SARS-CoV-2 antibody status on syndromic surveillance and the risk of subsequent COVID-19—a prospective multicenter cohort study

Authors: Philipp Kohler, Sabine Güsewell, Marco Seneghini, Thomas Egger, Onicio Leal, Angela Brucher, Eva Lemmenmeier, J. Carsten Möller, Philip Rieder, Markus Ruetti, Reto Stocker, Danielle Vuichard-Gysin, Benedikt Wiggli, Ulrike Besold, Stefan P. Kuster, Allison McGeer, Lorenz Risch, Andrée Friedl, Matthias Schlegel, Pietro Vernazza, Christian R. Kahlert

Published in: BMC Medicine | Issue 1/2021

Abstract

Background

In a prospective healthcare worker (HCW) cohort, we assessed the risk of SARS-CoV-2 infection according to baseline serostatus.

Methods

Baseline serologies were performed among HCW from 23 Swiss healthcare institutions between June and September 2020, before the second COVID-19 wave. Participants answered weekly electronic questionnaires covering information about nasopharyngeal swabs (PCR/rapid antigen tests) and symptoms compatible with coronavirus disease 2019 (COVID-19). Screening of symptomatic staff by nasopharyngeal swabs was routinely performed in participating facilities. We compared numbers of positive nasopharyngeal tests and occurrence of COVID-19 symptoms between HCW with and without anti-nucleocapsid antibodies.

Results

A total of 4812 HCW participated, wherein 144 (3%) were seropositive at baseline. We analyzed 107,807 questionnaires with a median follow-up of 7.9 months. Median number of answered questionnaires was similar (24 vs. 23 per person, P = 0.83) between those with and without positive baseline serology. Among 2712 HCW with ≥ 1 SARS-CoV-2 test during follow-up, 3/67 (4.5%) seropositive individuals reported a positive result (one of whom asymptomatic), compared to 547/2645 (20.7%) seronegative participants, 12 of whom asymptomatic (risk ratio [RR] 0.22; 95% confidence interval [CI] 0.07 to 0.66). Seropositive HCWs less frequently reported impaired olfaction/taste (6/144, 4.2% vs. 588/4674, 12.6%, RR 0.33, 95% CI 0.15–0.73), chills (19/144, 13.2% vs. 1040/4674, 22.3%, RR 0.59, 95% CI 0.39–0.90), and limb/muscle pain (28/144, 19.4% vs. 1335/4674, 28.6%, RR 0.68 95% CI 0.49–0.95). Impaired olfaction/taste and limb/muscle pain also discriminated best between positive and negative SARS-CoV-2 results.

Conclusions

Having SARS-CoV-2 anti-nucleocapsid antibodies provides almost 80% protection against SARS-CoV-2 re-infection for a period of at least 8 months.

Available only for authorised users

Dan J, Mehta S. SARS-CoV-2 immunity and reinfection. Clinical Infectious Diseases; 2021. p. ciaa1936). [cited 2021 Jan 13];Available from. https://doi.org/10.1093/cid/ciaa1936.CrossRef

Cromer D, Juno JA, Khoury D, Reynaldi A, Wheatley AK, Kent SJ, et al. Prospects for durable immune control of SARS-CoV-2 and prevention of reinfection. Nat Rev Immunol. 2021;29(6):1–10. https://doi.org/10.1038/s41577-021-00550-x.CrossRef

Addetia A, Crawford KHD, Dingens A, Zhu H, Roychoudhury P, Huang M-L, et al. Neutralizing antibodies correlate with protection from SARS-CoV-2 in humans during a fishery vessel outbreak with a high attack rate. J Clin Microbiol. 2020;58(11):e02107–20 [cited 2021 Jan 8]. Available from: https://jcm.asm.org/content/58/11/e02107-20.CrossRef

Lumley SF, O’Donnell D, Stoesser NE, Matthews PC, Howarth A, Hatch SB, et al. Antibody status and incidence of SARS-CoV-2 infection in health care workers. New England J Med. 2020;0(0):null.

He Z, Ren L, Yang J, Guo L, Feng L, Ma C, et al. Seroprevalence and humoral immune durability of anti-SARS-CoV-2 antibodies in Wuhan, China: a longitudinal, population-level, cross-sectional study. Lancet. 2021;397(10279):1075–84. https://doi.org/10.1016/S0140-6736(21)00238-5.CrossRefPubMedPubMedCentral

Kahlert CR, Persi R, Güsewell S, Egger T, Leal-Neto OB, Sumer J, et al. Non-occupational and occupational factors associated with specific SARS-CoV-2 antibodies among hospital workers – a multicentre cross-sectional study. Clin Microbiol Infect. 2021;27(9):S1198743X21002366.CrossRef

Mahase E. Covid-19: Two antibody tests are “highly specific” but vary in sensitivity, evaluations find. BMJ. 2020;369:m2066 [cited 2020 Jun 15]. Available from: https://www.bmj.com/content/369/bmj.m2066.CrossRef

Harvey RA, Rassen JA, Kabelac CA, Turenne W, Leonard S, Klesh R, et al. Association of SARS-CoV-2 seropositive antibody test with risk of future infection. JAMA Intern Med. 2021;181(5):672–9 [cited 2021 Mar 31]; Available from: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2776810.CrossRef

Abu-Raddad LJ, Chemaitelly H, Coyle P, Malek JA, Ahmed AA, Mohamoud YA, et al. SARS-CoV-2 antibody-positivity protects against reinfection for at least seven months with 95% efficacy. EClinicalMedicine. 2021;35:100861 [cited 2021 Aug 25];35. Available from: https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00141-3/abstract.CrossRef

10.

Hansen CH, Michlmayr D, Gubbels SM, Mølbak K, Ethelberg S. Assessment of protection against reinfection with SARS-CoV-2 among 4 million PCR-tested individuals in Denmark in 2020: a population-level observational study. Lancet. 2021;397(10280):1204–12. https://doi.org/10.1016/S0140-6736(21)00575-4.CrossRefPubMedPubMedCentral

11.

Leidi A, Koegler F, Dumont R, Dubos R, Zaballa M-E, Piumatti G, et al. Risk of reinfection after seroconversion to SARS-CoV-2: a population-based propensity-score matched cohort study. Clin Infect Dis. 2021:ciab495) [cited 2021 May 28]. Available from. https://doi.org/10.1093/cid/ciab495.

12.

Hall VJ, Foulkes S, Charlett A, Atti A, Monk EJM, Simmons R, et al. SARS-CoV-2 infection rates of antibody-positive compared with antibody-negative health-care workers in England: a large, multicentre, prospective cohort study (SIREN). Lancet. 2021;397(10283):1459–69. https://doi.org/10.1016/S0140-6736(21)00675-9.CrossRefPubMedPubMedCentral

13.

Rennert L, McMahan C. Risk of SARS-CoV-2 reinfection in a university student population. Clin Infect Dis. 2021;16:ciab454.CrossRef

14.

Letizia AG, Ge Y, Vangeti S, Goforth C, Weir DL, Kuzmina NA, et al. SARS-CoV-2 seropositivity and subsequent infection risk in healthy young adults: a prospective cohort study. Lancet Respir Med. 2021;9(7):712–20. https://doi.org/10.1016/S2213-2600(21)00158-2.CrossRefPubMedPubMedCentral

15.

Khoury DS, Cromer D, Reynaldi A, Schlub TE, Wheatley AK, Juno JA, et al. Neutralizing antibody levels are highly predictive of immune protection from symptomatic SARS-CoV-2 infection. Nat Med. 2021;17(7):1205–11. https://doi.org/10.1038/s41591-021-01377-8.CrossRef

16.

Menni C, Valdes AM, Freidin MB, Sudre CH, Nguyen LH, Drew DA, et al. Real-time tracking of self-reported symptoms to predict potential COVID-19. Nat Med. 2020;26(7):1037–40 [cited 2020 Jun 24]; Available from: http://www.nature.com/articles/s41591-020-0916-2.CrossRef

17.

Nepal G, Rehrig JH, Shrestha GS, Shing YK, Yadav JK, Ojha R, et al. Neurological manifestations of COVID-19: a systematic review. Crit Care. 2020;24(1):421. https://doi.org/10.1186/s13054-020-03121-z.CrossRefPubMedPubMedCentral

18.

Klopfenstein T, Kadiane-Oussou NJ, Toko L, Royer P-Y, Lepiller Q, Gendrin V, et al. Features of anosmia in COVID-19. Med Mal Infect. 2020;50(5):436–9. https://doi.org/10.1016/j.medmal.2020.04.006.CrossRefPubMedPubMedCentral

19.

To KK-W, Hung IF-N, Ip JD, Chu AW-H, Chan W-M, Tam AR, et al. COVID-19 re-infection by a phylogenetically distinct SARS-coronavirus-2 strain confirmed by whole genome sequencing. Clin Infect Dis. 2020;25:ciaa1275. https://doi.org/10.1093/cid/ciaa1275.CrossRef

20.

Harrington D, Kele B, Pereira S, Couto-Parada X, Riddell A, Forbes S, et al. Confirmed reinfection with SARS-CoV-2 variant VOC-202012/01. Clin Infect Dis. 2021:ciab014) [cited 2021 Jan 13]. Available from. https://doi.org/10.1093/cid/ciab014.

21.

Federal Office of Public Health. Virus variants overview. Last accessed April 1st 2021. Available from: https://www.covid19.admin.ch/en/epidemiologic/virus-variants

22.

Planas D, Veyer D, Baidaliuk A, Staropoli I, Guivel-Benhassine F, Rajah MM, et al. Reduced sensitivity of SARS-CoV-2 variant Delta to antibody neutralization. Nature. 2021;596(7871):276–80. https://doi.org/10.1038/s41586-021-03777-9.CrossRefPubMed

23.

Polack FP, Thomas SJ, Kitchin N, Absalon J, Gurtman A, Lockhart S, et al. Safety and efficacy of the BNT162b2 mRNA COVID-19 vaccine. New England J Med. 2020;383(27):2603–15. https://doi.org/10.1056/NEJMoa2034577.CrossRef

24.

Harris RJ, Whitaker HJ, Andrews NJ, Aiano F, Amin-Chowdhury Z, Flood J, et al. Serological surveillance of SARS-CoV-2: Six-month trends and antibody response in a cohort of public health workers. J Infect. 2021;82(5):162–9. https://doi.org/10.1016/j.jinf.2021.03.015.CrossRefPubMedPubMedCentral

25.

Van Elslande J, Decru B, Jonckheere S, Van Wijngaerden E, Houben E, Vandecandelaere P, et al. Antibody response against SARS-CoV-2 spike protein and nucleoprotein evaluated by four automated immunoassays and three ELISAs. Clin Microbiol Infect. 2020;26(11):1557 e1-1557.e7.PubMedPubMedCentral

26.

Dan JM, Mateus J, Kato Y, Hastie KM, Yu ED, Faliti CE, et al. Immunological memory to SARS-CoV-2 assessed for up to 8 months after infection. Science. 2021;371(6529):eabf4063. https://doi.org/10.1126/science.abf4063.CrossRef

27.

Breathnach AS, Duncan CJA, Bouzidi KE, Hanrath AT, Payne BAI, Randell PA, et al. Prior COVID-19 protects against reinfection, even in the absence of detectable antibodies. J Infect. 2021;0(0):237–79 [cited 2021 May 30]. Available from: https://www.journalofinfection.com/article/S0163-4453(21)00266-8/abstract.CrossRef

28.

Wang Z, Yang X, Zhong J, Zhou Y, Tang Z, Zhou H, et al. Exposure to SARS-CoV-2 generates T-cell memory in the absence of a detectable viral infection. Nat Commun. 2021;12(1):1724. https://doi.org/10.1038/s41467-021-22036-z.CrossRefPubMedPubMedCentral

Title: Impact of baseline SARS-CoV-2 antibody status on syndromic surveillance and the risk of subsequent COVID-19—a prospective multicenter cohort study
Authors: Philipp Kohler
Sabine Güsewell
Marco Seneghini
Thomas Egger
Onicio Leal
Angela Brucher
Eva Lemmenmeier
J. Carsten Möller
Philip Rieder
Markus Ruetti
Reto Stocker
Danielle Vuichard-Gysin
Benedikt Wiggli
Ulrike Besold
Stefan P. Kuster
Allison McGeer
Lorenz Risch
Andrée Friedl
Matthias Schlegel
Pietro Vernazza
Christian R. Kahlert
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Myalgie
Myalgia
SARS-CoV-2
COVID-19
Polymerase Chain Reaction
Published in: BMC Medicine / Issue 1/2021
Electronic ISSN: 1741-7015
DOI: https://doi.org/10.1186/s12916-021-02144-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Impact of baseline SARS-CoV-2 antibody status on syndromic surveillance and the risk of subsequent COVID-19—a prospective multicenter cohort study

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2021

Characteristics and mortality rates among patients requiring intermediate care: a national cohort study using linked databases

Association between thyroid dysfunction and type 2 diabetes: a meta-analysis of prospective observational studies

The positive externalities of migrant-based TB control strategy in a Chinese urban population with internal migration: a transmission-dynamic modeling study

Serum anti-DIDO1, anti-CPSF2, and anti-FOXJ2 antibodies as predictive risk markers for acute ischemic stroke

Physician-directed genetic screening to evaluate personal risk for medically actionable disorders: a large multi-center cohort study

Correction to: Idiopathic pulmonary fibrosis in BRIC countries: the cases of Brazil, Russia, India, and China