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J Infect Dis Detection of Nucleocapsid Antibody to SARS-CoV-2 Is More Sensitive Than Antibody to Spike Protein in COVID-19 Patients

tetano

Editor, Senior Moderator
Peter D Burbelo[SUP] 1 [/SUP], Francis X Riedo[SUP] 2 [/SUP], Chihiro Morishima[SUP] 3 [/SUP], Stephen Rawlings[SUP] 4 [/SUP], Davey Smith[SUP] 4 [/SUP], Sanchita Das[SUP] 5 [/SUP], Jeffrey R Strich[SUP] 6 [/SUP], Daniel S Chertow[SUP] 6 [/SUP], Richard T Davey[SUP] 7 [/SUP], Jeffrey I Cohen[SUP] 8 [/SUP]



Affiliations

Abstract

Background: SARS-CoV-2, the cause of coronavirus disease 2019 (COVID-19), is associated with respiratory-related morbidity and mortality. Assays to detect virus-specific antibodies are important to understand the prevalence of infection and the course of the immune response.
Methodology: Quantitative measurements of plasma or serum antibodies by luciferase immunoprecipitation assay systems (LIPS) to the nucleocapsid and spike proteins were analyzed in 100 cross-sectional or longitudinal samples from SARS-CoV-2-infected patients. A subset of samples was tested with and without heat inactivation.
Results: Fifteen or more days after symptom onset, antibodies against SARS-CoV-2 nucleocapsid protein showed 100% sensitivity and 100% specificity, while antibodies to spike protein were detected with 91% sensitivity and 100% specificity. Neither antibody levels nor the rate of seropositivity were significantly reduced by heat inactivation of samples. Analysis of daily samples from six patients with COVID-19 showed anti-nucleocapsid and spike antibodies appearing between day 8 and day 14 after initial symptoms. Immunocompromised patients generally had a delayed antibody response to SARS-CoV-2 compared to immunocompetent patients.
Conclusions: Antibody to the nucleocapsid protein of SARS-CoV-2 is more sensitive than spike protein antibody for detecting early infection. Analyzing heat-inactivated samples by LIPS is a safe and sensitive method for detecting SARS-CoV-2 antibodies.

Keywords: COVID-19; SARS-CoV-2; coronavirus; serology.
 
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