Correlates of Nucleocapsid Antibodies and a Combination of Spike and Nucleocapsid Antibodies Against Protection of SARS-CoV-2 Infection During the Omicron XBB.1.16/EG.5-Predominant Wave.
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Abstract
Background: We aimed to examine the association among nucleocapsid (N) antibodies, a combination of N and spike (S) antibodies, and protection against SARS-CoV-2 reinfection.
Methods: We conducted a prospective cohort study among staff at a national medical research center in Tokyo and followed them for the incidence of SARS-CoV-2 infection between June and September 2023 (Omicron XBB.1.16/EG.5 wave). At baseline, participants donated blood samples to measure N- and S-specific antibodies. Cox regression was used to estimate the hazard ratio and protection ([1 - hazard ratio] × 100) against subsequent SARS-CoV-2 infection across these antibody levels.
Results: Among participants with previous infection, higher pre-reinfection N antibodies were associated with a lower risk of reinfection, even after adjusting S antibody levels (P < .01 for trend). Estimation of the protection matrix for N and S antibodies revealed that high levels in N and S antibodies conferred robust protection (>90%) against subsequent infection. In addition, a pattern of low pre-reinfection N antibodies but high vaccine-enhanced S antibodies showed high protection (>80%).
Conclusions: Pre-reinfection N antibody levels correlated with protection against reinfection, independent of S antibodies. If the N antibodies were low, vaccine-boosted S antibodies might enhance the reinfection protection.
背景：我们的目的是研究核壳抗体（N抗体）、N抗体和尖峰抗体（S抗体）组合与SARS-CoV-2再感染保护之间的关系：我们的目的是研究核壳（N）抗体、N抗体和尖峰（S）抗体的组合与防止SARS-CoV-2再感染之间的关联：我们对东京国立医学研究中心的工作人员进行了一项前瞻性队列研究，并跟踪调查了他们在 2023 年 6 月至 9 月（Omicron XBB.1.16/EG.5 波）期间的 SARS-CoV-2 感染率。在基线期，参与者捐献血液样本以测定 N 和 S 特异性抗体。采用 Cox 回归估算了不同抗体水平的 SARS-CoV-2 感染危险比和保护率（[1-危险比] ×100）：结果：在既往感染过的参与者中，即使调整了 S 抗体水平，再感染前 N 抗体水平越高，再感染风险越低（P < .01 为趋势）。对 N 抗体和 S 抗体的保护矩阵进行估计后发现，高水平的 N 抗体和 S 抗体可对再次感染提供强有力的保护（>90%）。此外，感染前 N 抗体水平较低但疫苗增强的 S 抗体水平较高的模式显示出较高的保护率（>80%）：结论：再感染前的 N 抗体水平与再感染保护率相关，与 S 抗体无关。结论：再感染前的 N 抗体水平与再感染保护率相关，与 S 抗体无关。如果 N 抗体水平低，疫苗增强的 S 抗体可能会提高再感染保护率。
期刊介绍：
Open Forum Infectious Diseases provides a global forum for the publication of clinical, translational, and basic research findings in a fully open access, online journal environment. The journal reflects the broad diversity of the field of infectious diseases, and focuses on the intersection of biomedical science and clinical practice, with a particular emphasis on knowledge that holds the potential to improve patient care in populations around the world. Fully peer-reviewed, OFID supports the international community of infectious diseases experts by providing a venue for articles that further the understanding of all aspects of infectious diseases.
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