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Antibody status and incidence of SARS-CoV-2 infection in health care workers
New England Journal of Medicine Số 6, năm 2021 (Tập 384, trang 533-540)
ISSN: 284793
ISSN: 284793
DOI: 10.1056/NEJMoa2034545
Tài liệu thuộc danh mục:
Article
English
Từ khóa: Adolescent; Adult; Aged; Aged, 80 and over; Antibodies, Viral; Coronavirus Nucleocapsid Proteins; COVID-19; COVID-19 Nucleic Acid Testing; COVID-19 Serological Testing; Female; Health Personnel; Humans; Immunoglobulin G; Incidence; Longitudinal Studies; Male; Middle Aged; Polymerase Chain Reaction; Recurrence; SARS-CoV-2; Seroconversion; Spike Glycoprotein, Coronavirus; United Kingdom; Young Adult; immunoglobulin G antibody; SARS-CoV-2 antibody; coronavirus spike glycoprotein; immunoglobulin G; virus antibody; administrative personnel; adolescent; adult; age; aged; Article; asymptomatic coronavirus disease 2019; cohort analysis; controlled study; coronavirus disease 2019; female; follow up; food service worker; gender; health care personnel; human; incidence; laboratory personnel; longitudinal study; major clinical study; male; medical student; nurse; nursing student; occupational therapist; paramedical personnel; physician; physiotherapist; polymerase chain reaction; prospective study; reinfection; risk reduction; screening; seroconversion; speech language pathologist; United Kingdom; blood; diagnosis; epidemiology; immunology; incidence; isolation and purification; middle aged; recurrent disease; very elderly; young adult
Tóm tắt tiếng anh
BACKGROUND The relationship between the presence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the risk of subsequent reinfection remains unclear. METHODS We investigated the incidence of SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR) in seropositive and seronegative health care workers attending testing of asymptomatic and symptomatic staff at Oxford University Hospitals in the United Kingdom. Baseline antibody status was determined by anti-spike (primary analysis) and anti-nucleocapsid IgG assays, and staff members were followed for up to 31 weeks. We estimated the relative incidence of PCR-positive test results and new symptomatic infection according to antibody status, adjusting for age, participant-reported gender, and changes in incidence over time. RESULTS A total of 12,541 health care workers participated and had anti-spike IgG measured; 11,364 were followed up after negative antibody results and 1265 after positive results, including 88 in whom seroconversion occurred during follow-up. A total of 223 anti-spike–seronegative health care workers had a positive PCR test (1.09 per 10,000 days at risk), 100 during screening while they were asymptomatic and 123 while symptomatic, whereas 2 anti-spike–seropositive health care workers had a positive PCR test (0.13 per 10,000 days at risk), and both workers were asymptomatic when tested (adjusted incidence rate ratio, 0.11; 95% confidence interval, 0.03 to 0.44; P=0.002). There were no symptomatic infections in workers with anti-spike antibodies. Rate ratios were similar when the anti-nucleocapsid IgG assay was used alone or in combination with the anti-spike IgG assay to determine baseline status. CONCLUSIONS The presence of anti-spike or anti-nucleocapsid IgG antibodies was associated with a substantially reduced risk of SARS-CoV-2 reinfection in the ensuing 6 months. (Funded by the U.K. Government Department of Health and Social Care and others.) Copyright © 2020 Massachusetts Medical Society.
