Rolando Herrero, Romain Fantin, Viviana Loría, Amada Aparicio, D Rebecca Prevots, Michael Zúñiga, Roy Wong, Melvin Morera, Julia Butt, Marco Binder, Arturo Abdelnour, Alejandro Calderón, Roberto Castro, Bernal Cortes, Rebeca Ocampo, Juan Carlos Vanegas, Mitchell H Gail, Ruth M Pfeiffer, Julia Flock, Kim Remans, Lukas Eberhardt, Soheil Rastgou, Vladimir Magalhaes, Carolina Porras, Allan Hildesheim, Tim Waterboer
{"title":"Time course and determinants of the antibody response to SARS-CoV-2 in Costa Rica: the RESPIRA study.","authors":"Rolando Herrero, Romain Fantin, Viviana Loría, Amada Aparicio, D Rebecca Prevots, Michael Zúñiga, Roy Wong, Melvin Morera, Julia Butt, Marco Binder, Arturo Abdelnour, Alejandro Calderón, Roberto Castro, Bernal Cortes, Rebeca Ocampo, Juan Carlos Vanegas, Mitchell H Gail, Ruth M Pfeiffer, Julia Flock, Kim Remans, Lukas Eberhardt, Soheil Rastgou, Vladimir Magalhaes, Carolina Porras, Allan Hildesheim, Tim Waterboer","doi":"10.1186/s12879-025-10742-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Antibodies to SARS-CoV-2 are essential for protection or reduction in severity of subsequent disease. We studied antibody responses to spike protein receptor-binding domain (S1-RBD) and nucleocapsid (N) in a population-based sample of COVID-19 cases in Costa Rica.</p><p><strong>Methods: </strong>As part of the RESPIRA study, we selected an age-stratified random sample of PCR-confirmed COVID-19 cases diagnosed from March 2020 to July 2021. Antibodies were determined with multiplex serology in 794 unvaccinated subjects diagnosed 3 days to 17 months before recruitment to investigate immune response to natural infection. In addition, neutralizing antibodies were determined in 136 randomly selected participants. We estimated antibody positivity and GMTs by time since diagnosis and explored determinants using multivariate regression.</p><p><strong>Results: </strong>Most participants tested 15-29 days after PCR diagnosis were seropositive for N (90%) and S1-RBD antibodies (96%) and had the highest GMTs for both antibodies. Only 42% of subjects tested one year after infection were seropositive for N antibodies, compared to 97% for S1-RBD. GMTs for neutralizing antibodies peaked 15-89 days after infection and declined but remained positive for 95% of subjects thereafter. In multivariate models, antibodies were significantly higher among men and increased with age and severity of the clinical presentation. The correlation of multiplex and neutralizing antibodies was high (0.72 [95% CI = 0.63-0.79]) and stronger among women.</p><p><strong>Conclusions: </strong>A robust immune response against N and S1-RBD is elicited by COVID-19 a few days after infection. While S1-RBD antibodies are present after > 1 year, N antibodies decline significantly. Antibody levels are higher in men and increase with age and severity of disease. The different immune response patterns by sex warrant further investigation.</p><p><strong>Trial registration: </strong>RESPIRA Study ClinicalTrials.gov ID: NCT04537338 (3 September 2020).</p>","PeriodicalId":8981,"journal":{"name":"BMC Infectious Diseases","volume":"25 1","pages":"376"},"PeriodicalIF":3.4000,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11917050/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Infectious Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12879-025-10742-8","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Antibodies to SARS-CoV-2 are essential for protection or reduction in severity of subsequent disease. We studied antibody responses to spike protein receptor-binding domain (S1-RBD) and nucleocapsid (N) in a population-based sample of COVID-19 cases in Costa Rica.
Methods: As part of the RESPIRA study, we selected an age-stratified random sample of PCR-confirmed COVID-19 cases diagnosed from March 2020 to July 2021. Antibodies were determined with multiplex serology in 794 unvaccinated subjects diagnosed 3 days to 17 months before recruitment to investigate immune response to natural infection. In addition, neutralizing antibodies were determined in 136 randomly selected participants. We estimated antibody positivity and GMTs by time since diagnosis and explored determinants using multivariate regression.
Results: Most participants tested 15-29 days after PCR diagnosis were seropositive for N (90%) and S1-RBD antibodies (96%) and had the highest GMTs for both antibodies. Only 42% of subjects tested one year after infection were seropositive for N antibodies, compared to 97% for S1-RBD. GMTs for neutralizing antibodies peaked 15-89 days after infection and declined but remained positive for 95% of subjects thereafter. In multivariate models, antibodies were significantly higher among men and increased with age and severity of the clinical presentation. The correlation of multiplex and neutralizing antibodies was high (0.72 [95% CI = 0.63-0.79]) and stronger among women.
Conclusions: A robust immune response against N and S1-RBD is elicited by COVID-19 a few days after infection. While S1-RBD antibodies are present after > 1 year, N antibodies decline significantly. Antibody levels are higher in men and increase with age and severity of disease. The different immune response patterns by sex warrant further investigation.
Trial registration: RESPIRA Study ClinicalTrials.gov ID: NCT04537338 (3 September 2020).
期刊介绍：
BMC Infectious Diseases is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of infectious and sexually transmitted diseases in humans, as well as related molecular genetics, pathophysiology, and epidemiology.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
