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. 2021 Apr 23;223(8):1334-1338.
doi: 10.1093/infdis/jiaa796.

SARS-CoV-2 Seroprevalence Survey Estimates Are Affected by Anti-Nucleocapsid Antibody Decline

Shelly Bolotin  1   2   3 , Vanessa Tran  1   3 , Selma Osman  1 , Kevin A Brown  1   2 , Sarah A Buchan  1   2 , Eugene Joh  1 , Shelley L Deeks  1   2 , Vanessa G Allen  1   3
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SARS-CoV-2 Seroprevalence Survey Estimates Are Affected by Anti-Nucleocapsid Antibody Decline

Shelly Bolotin et al. J Infect Dis. .

Abstract

We analyzed 21 676 residual specimens from Ontario, Canada collected March-August 2020 to investigate the effect of antibody decline on SARS-CoV-2 seroprevalence estimates. Testing specimens orthogonally using Abbott (anti-nucleocapsid) and Ortho (anti-spike) assays, seroprevalence estimates were 0.4%-1.4%, despite ongoing disease activity. The geometric mean concentration (GMC) of antibody-positive specimens decreased over time (P = .015), and GMC of antibody-negative specimens increased over time (P = .0018). Association between the 2 tests decreased each month (P < .001), suggesting anti-nucleocapsid antibody decline. Lowering Abbott antibody index cutoff from 1.4 to 0.7 resulted in a 16% increase in positive specimens.

Keywords: COVID-19; SARS-CoV-2; serology; seroprevalence.

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