Demmer Ryan T, Wu Chaoqi, Kim John S, Sun Yifei, Balte Pallavi, Cushman Mary, Boyle Rebekah, Tracy Russell P, Styer Linda M, Bell Taison D, Anderson Michaela R, Allen Norrina B, Schreiner Pamela J, Bowler Russell, Schwartz David A, Lee Joyce S, Xanthakis Vanessa, Rock Jean M, Bievenue Rachel, Pirzada Amber, Doyle Margaret, Regan Elizabeth A, Make Barry J, Kanaya Alka M, Kandula Namratha R, Wenzel Sally E, Coresh Josef, Isasi Carmen R, Raffield Laura M, Elkind Mitchell S V, Howard Virginia J, Ortega Victor E, Woodruff Prescott, Cole Shelley A, Henderson Joel M, Mantis Nicholas J, Oelsner Elizabeth C
Division of Epidemiology, Department of Quantitative Health Sciences, College of Medicine and Science, Mayo Clinic, Rochester, Minnesota, USA.
Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA.
Open Forum Infect Dis. 2025 Mar 20;12(3):ofaf123. doi: 10.1093/ofid/ofaf123. eCollection 2025 Mar.
Despite the availability of effective vaccines and a recent decrease in annual deaths, COVID-19 remains a leading cause of death. Serological studies provide insights into host immunobiology of adaptive immune response to infection, which holds promise for identifying high-risk individuals for adverse COVID-19 outcomes. We investigated correlates of anti-nucleocapsid antibody responses following SARS-CoV-2 infection in a US population-based meta-cohort of adults participating in longstanding National Institutes of Health-funded cohort studies. Anti-nucleocapsid antibodies were measured from dried blood spots collected between February 2021 and February 2023. Among 1419 Collaborative Cohort of Cohorts for COVID-19 Research participants with prior SARS-CoV-2 infection, the mean age (standard deviation) was 65.8 (12.1), 61% were women, and 42.8% self-reported membership in a race/ethnicity minority group. The proportion of participants reactive to nucleocapsid peaked at 69% by 4 months after infection and waned to only 44% ≥12 months after infection. Higher anti-nucleocapsid antibody response was associated with older age, Hispanic or American Indian Alaskan Native (vs White) race/ethnicity, lower income, lower education, former smoking, and higher anti-spike antibody levels. Asian race (vs White) and vaccination (even after infection) were associated with lower nucleocapsid reactivity. Neither vaccine manufacturer nor common cardiometabolic comorbidities were not associated with anti-nucleocapsid response. These findings inform the underlying immunobiology of adaptive immune response to infection, as well as the potential utility of anti-nucleocapsid antibody response for clinical practice and COVID-19 serosurveillance.
尽管有有效的疫苗，且年度死亡人数最近有所下降，但新冠病毒仍然是主要死因。血清学研究为宿主对感染的适应性免疫反应的免疫生物学提供了见解，这有望识别出新冠病毒不良后果的高危个体。我们在美国一项基于人群的成人荟萃队列中进行了调查，该队列参与了美国国立卫生研究院长期资助的队列研究，以探究感染新冠病毒后抗核衣壳抗体反应的相关因素。抗核衣壳抗体是从2021年2月至2023年2月收集的干血斑中测量的。在1419名曾感染过新冠病毒的新冠病毒研究协作队列参与者中，平均年龄（标准差）为65.8（12.1）岁，61%为女性，42.8%的人自我报告属于种族/族裔少数群体。对核衣壳有反应的参与者比例在感染后4个月时达到峰值，为69%，而在感染后≥12个月时降至仅44%。较高的抗核衣壳抗体反应与年龄较大、西班牙裔或美洲印第安阿拉斯加原住民（与白人相比）种族/族裔、低收入、低教育水平、既往吸烟以及较高的抗刺突抗体水平相关。亚洲种族（与白人相比）和接种疫苗（即使在感染后）与较低的核衣壳反应性相关。疫苗制造商和常见的心脏代谢合并症均与抗核衣壳反应无关。这些发现为感染的适应性免疫反应的潜在免疫生物学提供了信息，以及抗核衣壳抗体反应在临床实践和新冠病毒血清学监测中的潜在用途。
