Post by Nadica (She/Her) on Jun 25, 2024 2:40:44 GMT
Anti-Nucleocapsid and Anti-Spike Antibody Trajectories in People with Post-Covid Condition versus Acute-Only Infections: Results from the Virus Watch Prospective Cohort Study - Preprint accepted June 19, 2024
Abstract
Background Early evidence suggests that people with Post-Covid Condition (PCC) may demonstrate aberrant immune responses post-infection; however, serological follow-up studies are currently limited. We aimed to compare SARS-CoV-2 serological responses to primary infection and vaccination in people who developed PCC versus those with an acute infection only.
Methods Participants (n=2,010) were a sub-cohort of the Virus Watch community cohort study in England who experienced mild-moderate SARS-CoV-2 infections, completed surveys on persistent symptoms, and provided monthly finger-prick blood samples for serology. We compared the likelihood of post-infection seroconversion using logistic mixed models and the trajectories of anti-nucleocapsid (anti-N) and anti-spike (anti-S) antibodies using linear mixed models.
Results Participants who developed PCC (n=394) had 1.8x the odds of post-infection seroconversion for anti-N antibodies compared to those with an acute infection only (n=1616) (adjusted odds ratio= 1.81 (95% confidence interval (CI) 1.16-2.90). Post-infection anti-N levels were persistently elevated in people with PCC (final log anti-N titres at 365 days 0.97, 95% CI 0.76-1.18) compared to those without (0.47, 95% CI 0.31-0.62). No differences were found in post-vaccination anti-S levels or trajectories before or after primary infection between participants with and without PCC; pre-vaccination anti-S responses could not be evaluated.
Conclusion People with PCC demonstrated greater and more persistent anti-N antibody responses following primary infection compared to those with an acute infection only. Vaccination response pre- or post-infection did not systematically differ between groups. These findings extend emerging evidence around inflammatory and immune activation following infection in people with PCC.
Competing Interest Statement
AH serves on the UK New and Emerging Respiratory Virus Threats Advisory Group. All other authors declare no competing interests.
Funding Statement
Virus Watch was supported by the Medical Research Council [Grant Ref: MC_PC 19070 and MR/V028375/1]. The study also received $15 000 of advertising credit from Facebook to support a pilot social media recruitment campaign on 18 August 2020. The antibody testing was also supported by funding from the Department of Health and Social Care from February 2021 to March 2022. This study was also supported by the Wellcome Trust through a Wellcome Clinical Research Career Development Fellowship to R.W.A. [206602]. G.M. was supported by RYC 2020-029886-I/ AEI/10.13039/501100011033, co-funded by European Social Fund (ESF). From 1 May 2022, Virus Watch received funding from the European Union (Project: 101046314, ENDVoC). Views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the European Union or the European Health and Digital Executive Agency (HaDEA). Neither the European Union nor the granting authority can be held responsible for them.
Author Declarations
I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.
Yes
The details of the IRB/oversight body that provided approval or exemption for the research described are given below:
Virus Watch was approved by the Hampstead NHS Health Research Authority Ethics Committee: 20/HRA/2320, and conformed to the ethical standards set out in the Declaration of Helsinki.
I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.
Yes
I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).
Yes
I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.
Yes
Abstract
Background Early evidence suggests that people with Post-Covid Condition (PCC) may demonstrate aberrant immune responses post-infection; however, serological follow-up studies are currently limited. We aimed to compare SARS-CoV-2 serological responses to primary infection and vaccination in people who developed PCC versus those with an acute infection only.
Methods Participants (n=2,010) were a sub-cohort of the Virus Watch community cohort study in England who experienced mild-moderate SARS-CoV-2 infections, completed surveys on persistent symptoms, and provided monthly finger-prick blood samples for serology. We compared the likelihood of post-infection seroconversion using logistic mixed models and the trajectories of anti-nucleocapsid (anti-N) and anti-spike (anti-S) antibodies using linear mixed models.
Results Participants who developed PCC (n=394) had 1.8x the odds of post-infection seroconversion for anti-N antibodies compared to those with an acute infection only (n=1616) (adjusted odds ratio= 1.81 (95% confidence interval (CI) 1.16-2.90). Post-infection anti-N levels were persistently elevated in people with PCC (final log anti-N titres at 365 days 0.97, 95% CI 0.76-1.18) compared to those without (0.47, 95% CI 0.31-0.62). No differences were found in post-vaccination anti-S levels or trajectories before or after primary infection between participants with and without PCC; pre-vaccination anti-S responses could not be evaluated.
Conclusion People with PCC demonstrated greater and more persistent anti-N antibody responses following primary infection compared to those with an acute infection only. Vaccination response pre- or post-infection did not systematically differ between groups. These findings extend emerging evidence around inflammatory and immune activation following infection in people with PCC.
Competing Interest Statement
AH serves on the UK New and Emerging Respiratory Virus Threats Advisory Group. All other authors declare no competing interests.
Funding Statement
Virus Watch was supported by the Medical Research Council [Grant Ref: MC_PC 19070 and MR/V028375/1]. The study also received $15 000 of advertising credit from Facebook to support a pilot social media recruitment campaign on 18 August 2020. The antibody testing was also supported by funding from the Department of Health and Social Care from February 2021 to March 2022. This study was also supported by the Wellcome Trust through a Wellcome Clinical Research Career Development Fellowship to R.W.A. [206602]. G.M. was supported by RYC 2020-029886-I/ AEI/10.13039/501100011033, co-funded by European Social Fund (ESF). From 1 May 2022, Virus Watch received funding from the European Union (Project: 101046314, ENDVoC). Views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the European Union or the European Health and Digital Executive Agency (HaDEA). Neither the European Union nor the granting authority can be held responsible for them.
Author Declarations
I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.
Yes
The details of the IRB/oversight body that provided approval or exemption for the research described are given below:
Virus Watch was approved by the Hampstead NHS Health Research Authority Ethics Committee: 20/HRA/2320, and conformed to the ethical standards set out in the Declaration of Helsinki.
I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.
Yes
I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).
Yes
I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.
Yes