Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Practice Guideline
. 2021 Jun;174(6):828-835.
doi: 10.7326/M20-7569. Epub 2021 Mar 16.

What Is the Antibody Response and Role in Conferring Natural Immunity After SARS-CoV-2 Infection? Rapid, Living Practice Points From the American College of Physicians (Version 1)

Amir Qaseem  1 , Jennifer Yost  2 , Itziar Etxeandia-Ikobaltzeta  1 , Mary Ann Forciea  3 , George M Abraham  4 , Matthew C Miller  3 , Adam J Obley  5 , Linda L Humphrey  5 ; Scientific Medical Policy Committee of the American College of Physicians; Robert M Centor, Elie A Akl, Rebecca Andrews, Thomas A Bledsoe, Ray Haeme, Devan L Kansagara
Collaborators, Affiliations
Practice Guideline

What Is the Antibody Response and Role in Conferring Natural Immunity After SARS-CoV-2 Infection? Rapid, Living Practice Points From the American College of Physicians (Version 1)

Amir Qaseem et al. Ann Intern Med. 2021 Jun.

Update in

Abstract

Description: The widespread availability of SARS-CoV-2 antibody tests raises important questions for clinicians, patients, and public health professionals related to the appropriate use and interpretation of these tests. The Scientific Medical Policy Committee (SMPC) of the American College of Physicians developed these rapid, living practice points to summarize the current and best available evidence on the antibody response to SARS-CoV-2 infection, antibody durability after initial infection with SARS-CoV-2, and antibody protection against reinfection with SARS-CoV-2.

Methods: The SMPC developed these rapid, living practice points based on a rapid and living systematic evidence review done by the Portland VA Research Foundation and funded by the Agency for Healthcare Research and Quality. Ongoing literature surveillance is planned through December 2021. When new studies are identified and a full update of the evidence review is published, the SMPC will assess the new evidence and any effect on the practice points.

Practice point 1: Do not use SARS-CoV-2 antibody tests for the diagnosis of SARS-CoV-2 infection.

Practice point 2: Antibody tests can be useful for the purpose of estimating community prevalence of SARS-CoV-2 infection.

Practice point 3: Current evidence is uncertain to predict presence, level, or durability of natural immunity conferred by SARS-CoV-2 antibodies against reinfection (after SARS-CoV-2 infection).

PubMed Disclaimer

Conflict of interest statement

Disclosures: All financial and intellectual disclosures of interest were declared, and potential conflicts were discussed and managed. Dr. Jokela participated in discussion of the practice points but was recused from authorship and voting due to a moderate-level conflict of interest (authored recent relevant publications). Dr. Marcucci participated in the discussion of the practice points but was recused from authorship and voting due to a moderate-level conflict of interest (author of relevant systematic review [forthcoming]). A record of disclosures of interest and management of conflicts is kept for each SMPC meeting and conference call and can be viewed at www.acponline.org/about-acp/who-we-are/leadership/boards-committees-councils/scientific-medical-policy-committee/disclosure-of-interests-and-conflict-of-interest-management-summary-for-scientific-medical-policy. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M20-7569.

Figures

Figure.
Figure.. Evidence description.
Evidence search and assessment done by the Portland VA Research Foundation (3, 4). Updated search for evidence updated through 15 December 2020. * Observational studies include studies estimating seroprevalence among a given population that includes a small subpopulation known to have SARS-CoV-2 and cross-sectional or cohort studies characterizing the antibody response among adults with SARS-CoV-2 infection. Immunoassay validation studies include those validating the diagnostic performance of 1 or more immunoassays (3, 4).
See this image and copyright information in PMC

References

    1. World Health Organization. What we know about the COVID-19 immune response: the latest on COVID-19 immunity & the current global situation. Accessed at www.who.int/docs/default-source/coronaviruse/risk-comms-updates/update-3... on 11 January 2021.
    1. Kellam P , Barclay W . The dynamics of humoral immune responses following SARS-CoV-2 infection and the potential for reinfection. J Gen Virol. 2020;101:791-797. [PMID: ] doi:10.1099/jgv.0.001439 - DOI - PMC - PubMed
    1. Arkhipova-Jenkins I, Helfand M, Armstrong C, et al. Antibody response after SARS-CoV-2 infection and implications for immunity: a rapid living review. Ann Intern Med. XX March 2021. [Epub ahead of print]. doi:10.7326/M20-7547 - PMC - PubMed
    1. 4. Mackey K, Arkhipova-Jenkins I, Armstrong C, et al. Antibody response following SARS-CoV-2 infection and implications for immunity: a rapid living review. (Prepared by the Portland VA Research Foundation under Contract No. 290-2017-00003-C). AHRQ Publication No. 21-EHC016. Agency for Healthcare Research and Quality. March 2021. Posted final reports are located on the Effective Health Care Program search page. doi:10.23970/AHRQEPCCOVIDIMMUNITY.
    1. World Health Organization. Advice on the use of masks in the context of COVID-19: interim guidance, 5 June 2020. World Health Organization; 2020. Accessed at https://apps.who.int/iris/handle/10665/332293 on 11 January 2021.

Publication types

Substances