Abstract

Introduction: SARS-CoV-2 antibody detection serves as an important diagnostic marker for past SARS-CoV-2 infection and is essential to determine the spread of COVID-19, monitor potential COVID-19 long-term effects, and to evaluate possible protection from reinfection. A study was conducted across three hospital sites in a large central London NHS Trust in the UK, to evaluate the prevalence and duration of SARS-CoV-2 IgG antibody positivity in healthcare workers.Methods: A matrix equivalence study consisting of 228 participants was undertaken to evaluate the Abbott Panbio™ COVID-19 IgG/IgM rapid test device. Subsequently, 2001 evaluable healthcare workers (HCW), representing a diverse population, were enrolled in a HCW study between June and August 2020. A plasma sample from each HCW was evaluated using the Abbott Panbio™ COVID-19 IgG/IgM rapid test device, with confirmation of IgG-positive results by the Abbott ArchitectTM SARS-CoV-2 IgG assay. 545 participants, of whom 399 were antibody positive at enrolment, were followed up at 3 months.Results: The Panbio™ COVID-19 IgG/IgM rapid test device demonstrated a high concordance with laboratory tests. SARS-CoV-2 antibodies were detected in 506 participants (25.3%) at enrolment, with a higher prevalence in COVID-19 frontline (28.3%) than non-frontline (19.9%) staff. At follow-up, 274/399 antibody positive participants (68.7%) retained antibodies; 4/146 participants negative at enrolment (2.7%) had seroconverted. Non-white ethnicity, older age, hypertension and COVID-19 symptoms were independent predictors of higher antibody levels (OR 1.881, 2.422–3.034, 2.128, and 1.869 respectively), based on Architect™ index quartiles; participants in the first three categories also showed a greater antibody persistence at 3 months.Conclusion: The SARS-CoV-2 anti-nucleocapsid IgG positivity rate among healthcare staff was high, declining by 31.3% during the 3-month follow-up interval. Interestingly, the IgG-positive participants with certain risk factors for severe COVID-19 illness (older age, Black or Asian Ethnicity hypertension) demonstrated greater persistence over time when compared to the IgG-positive participants without these risk factors.

Highlights

  • SARS-CoV-2 antibody detection serves as an important diagnostic marker for past SARS-CoV-2 infection and is essential to determine the spread of COVID-19, monitor potential COVID-19 long-term effects, and to evaluate possible protection from reinfection

  • Our aim was to assess the prevalence of a past immune response to the SARS-CoV-2 virus among healthcare workers (HCWs), as measured by detecting seroconversion of SARS-CoV-2-specific IgG and IgM antibodies using the PanbioTM test with confirmation using the ArchitectTM SARSCoV-2 IgG test, and to evaluate the persistence of SARS-CoV2 antibodies at a 3-month follow-up visit

  • A total of 228 participants comprised of 103 males and 125 females ranging in age from 20 to 69 years were enrolled in the matrix equivalence arm (ME) study

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Summary

Introduction

SARS-CoV-2 antibody detection serves as an important diagnostic marker for past SARS-CoV-2 infection and is essential to determine the spread of COVID-19, monitor potential COVID-19 long-term effects, and to evaluate possible protection from reinfection. As nations globally experienced immense pressure on their healthcare systems, the psychological and economic impacts of the pandemic have been challenging. This has resulted in an unprecedented worldwide effort for vaccine development alongside the establishment of robust and rapid diagnostic tests, especially as non-specific early clinical manifestations require accurate diagnosis, ensuring appropriate clinical management, surveillance, and effective control strategies [1, 2]. Lateral flow POC tests for the rapid detection of antibodies can effectively complement PCR diagnosis and antigenic tests for SARS-CoV-2 infection, as IgM and IgG seroconversion occur within 10–12 days and 12–14 days, respectively, after the onset of symptoms [6,7,8,9]. Further investigations are required to understand the dynamics of the early humoral immune response to realise the full potential of serological testing for SARS CoV-2

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