From deCODE Genetics/Amgen (D.F.G., G.L.N., P.M., K.G., H.H., A.O.A., K. Bjarnadottir, B. Thorsteinsdottir, S.K., K. Birgisdottir, A.M.K., G.A.A., E.V.I., M.A., F.J., A.B.A., J.B., B.E., R.F., E.E.G., S.G., K.R.G., A.G., A.H., B.O.J., A.J., H.J., T.K., D.N.M., O.T.M., S.R., L.R., A.S., G. Sveinbjornsson, K.E.S., E.A.T., B. Thorbjornsson, J.S., G.M., G.G., U.T., I.J., P.S., K.S.), the School of Engineering and Natural Sciences (D.F.G., P.M.), the Department of Anthropology (A.H.), the BioMedical Center (K.G.K.), and the Faculty of Medicine, School of Health Sciences (M.I.S., M.G., K.G.K., R.P., U.T., I.J., K.S.), University of Iceland, Internal Medicine and Rehabilitation Services (E.E., D.H., R.F.I., M.G., L.B.O., M.K., R.P.), the Division of Anesthesia and Intensive Care Medicine (M.I.S.), and the Department of Clinical Microbiology (O.S.G., T.R.G., K.G.K., M.S.), Landspitali-the National University Hospital, and the Directorate of Health (G. Sigmundsdottir, M.T., K.S.J., A.M., T.G.), Reykjavik, and the Health Care Institution of South Iceland, Selfoss (S.H.K.) - all in Iceland.
N Engl J Med. 2020 Oct 29;383(18):1724-1734. doi: 10.1056/NEJMoa2026116. Epub 2020 Sep 1.
Little is known about the nature and durability of the humoral immune response to infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
We measured antibodies in serum samples from 30,576 persons in Iceland, using six assays (including two pan-immunoglobulin [pan-Ig] assays), and we determined that the appropriate measure of seropositivity was a positive result with both pan-Ig assays. We tested 2102 samples collected from 1237 persons up to 4 months after diagnosis by a quantitative polymerase-chain-reaction (qPCR) assay. We measured antibodies in 4222 quarantined persons who had been exposed to SARS-CoV-2 and in 23,452 persons not known to have been exposed.
Of the 1797 persons who had recovered from SARS-CoV-2 infection, 1107 of the 1215 who were tested (91.1%) were seropositive; antiviral antibody titers assayed by two pan-Ig assays increased during 2 months after diagnosis by qPCR and remained on a plateau for the remainder of the study. Of quarantined persons, 2.3% were seropositive; of those with unknown exposure, 0.3% were positive. We estimate that 0.9% of Icelanders were infected with SARS-CoV-2 and that the infection was fatal in 0.3%. We also estimate that 56% of all SARS-CoV-2 infections in Iceland had been diagnosed with qPCR, 14% had occurred in quarantined persons who had not been tested with qPCR (or who had not received a positive result, if tested), and 30% had occurred in persons outside quarantine and not tested with qPCR.
Our results indicate that antiviral antibodies against SARS-CoV-2 did not decline within 4 months after diagnosis. We estimate that the risk of death from infection was 0.3% and that 44% of persons infected with SARS-CoV-2 in Iceland were not diagnosed by qPCR.
目前对于感染严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）后体液免疫反应的性质和持久性知之甚少。
我们使用六种检测方法（包括两种免疫球蛋白 pan-Ig 检测），对来自冰岛的 30576 人血清样本中的抗体进行了测量，并确定血清阳性的适当衡量标准是两种 pan-Ig 检测均呈阳性。我们检测了 1237 名经定量聚合酶链反应（qPCR）检测确诊感染 SARS-CoV-2 后 4 个月内的 2102 个样本。我们还测量了接触过 SARS-CoV-2 的 4222 名隔离人员和 23452 名未接触过 SARS-CoV-2 的人员的抗体。
在 1797 名已从 SARS-CoV-2 感染中康复的患者中，1215 名接受检测的患者中有 1107 名（91.1%）为血清阳性；通过 qPCR 诊断后 2 个月内，两种 pan-Ig 检测的抗病毒抗体滴度升高，在研究剩余时间内保持稳定。在隔离人员中，2.3%为血清阳性；在未知接触者中，0.3%为阳性。我们估计，0.9%的冰岛人感染了 SARS-CoV-2，感染死亡率为 0.3%。我们还估计，冰岛 SARS-CoV-2 感染的 56%是通过 qPCR 诊断的，14%发生在未通过 qPCR 检测（或未获得阳性结果，如果检测过）的隔离人员中，30%发生在未隔离且未通过 qPCR 检测的人员中。
我们的结果表明，SARS-CoV-2 的抗病毒抗体在诊断后 4 个月内并未下降。我们估计，感染死亡率为 0.3%，冰岛 SARS-CoV-2 感染者中有 44%未通过 qPCR 诊断。
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