Understanding the trajectory, duration, and determinants of antibody responses after SARS-CoV-2 infection can inform subsequent protection and risk of reinfection, however large-scale representative studies are limited. Here we estimated antibody response after SARS-CoV-2 infection in the general population using representative data from 7,256 United Kingdom COVID-19 infection survey participants who had positive swab SARS-CoV-2 PCR tests from 26-April-2020 to 14-June-2021. A latent class model classified 24% of participants as ‘non-responders’ not developing anti-spike antibodies, who were older, had higher SARS-CoV-2 cycle threshold values during infection (i.e. lower viral burden), and less frequently reported any symptoms. Among those who seroconverted, using Bayesian linear mixed models, the estimated anti-spike IgG peak level was 7.3-fold higher than the level previously associated with 50% protection against reinfection, with higher peak levels in older participants and those of non-white ethnicity. The estimated anti-spike IgG half-life was 184 days, being longer in females and those of white ethnicity. We estimated antibody levels associated with protection against reinfection likely last 1.5-2 years on average, with levels associated with protection from severe infection present for several years. These estimates could inform planning for vaccination booster strategies.
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Wei, J., Matthews, P., Stoesser, N., Maddox, T., Lorenzi, L., Studley, R., Bell, J., Newton, J., Farrar, J., Diamond, I., Rourke, E., Howarth, A., Marsden, B., Hoosdally, S., Jones, E., Stuart, D., Crook, D., Peto, T., Pouwels, K., Walker, A., Eyre, D. & team, C. 2021, 'Anti-spike antibody response to natural SARS-CoV-2 infection in the general population', Nature Communications, 12, article no: 6250. https://doi.org/10.1038/s41467-021-26479-2