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Clin Infect Dis . Lack of antibodies to SARS-CoV-2 in a large cohort of previously infected persons

tetano

Editor, Senior Moderator
Clin Infect Dis


. 2020 Nov 4;ciaa1685.
doi: 10.1093/cid/ciaa1685. Online ahead of print.
Lack of antibodies to SARS-CoV-2 in a large cohort of previously infected persons


Lyle R Petersen[SUP] 1 [/SUP], Samira Sami[SUP] 2 [/SUP], Nga Vuong[SUP] 1 [/SUP], Preeti Pathela[SUP] 3 [/SUP], Don Weiss[SUP] 3 [/SUP], Beth Maldin Morgenthau[SUP] 3 [/SUP], Rebecca A Henseler[SUP] 3 [/SUP], Demetre C Daskalakis[SUP] 3 [/SUP], Jenny Atas[SUP] 4 [/SUP], Anita Patel[SUP] 2 [/SUP], Susan Lukacs[SUP] 5 6 [/SUP], Lisa Mackey[SUP] 1 [/SUP], Lisa A Grohskopf[SUP] 2 [/SUP], Natalie Thornburg[SUP] 2 [/SUP], Lara J Akinbami[SUP] 5 6 [/SUP]



Affiliations

Abstract

Background: Reports suggest that some persons previously infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) lack detectable IgG antibodies. We aimed to determine the proportion IgG seronegative and predictors for seronegativity among persons previously infected with SARS-CoV-2.
Methods: We analyzed serologic data collected from health care workers and first responders in New York City and the Detroit metropolitan area with history of a positive SARS-CoV-2 reverse transcriptase polymerase chain reaction (RT-PCR) test result and who were tested for IgG antibodies to SARS-CoV-2 spike protein at least 2 weeks after symptom onset.
Results: Of 2,547 persons with previous confirmed SARS-CoV-2 infection, 160 (6.3%) were seronegative. Of 2,112 previously symptomatic persons, the proportion seronegative slightly increased from 14 to 90 days post symptom onset (p=0.06). The proportion seronegative ranged from 0% among 79 persons previously hospitalized to 11.0% among 308 persons with asymptomatic infections. In a multivariable model, persons taking immunosuppressive medications were more likely to be seronegative (31.9%, 95% confidence interval [CI] 10.7%-64.7%), while participants of non-Hispanic Black race/ethnicity (versus non-Hispanic White) (2.7%, 95% CI 1.5%-4.8%), with severe obesity (versus under/normal weight) (3.9%, 95% CI 1.7%-8.6%), or with more symptoms were less likely to be seronegative.
Conclusions: In our population with previous RT-PCR confirmed infection, approximately one in 16 persons lacked IgG antibodies. Absence of antibodies varied independently by illness severity, race/ethnicity, obesity, and immunosuppressive drug therapy. The proportion seronegative remained relatively stable among persons tested up to 90 days post symptom onset.
 
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