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. 2021 Oct 19;59(11):e0113821.
doi: 10.1128/JCM.01138-21. Epub 2021 Aug 11.

The Fall in Antibody Response to SARS-CoV-2: a Longitudinal Study of Asymptomatic to Critically Ill Patients Up to 10 Months after Recovery

Maddalena Peghin  1 , Maria De Martino  2 , Martina Fabris  3 , Alvisa Palese  4 , Erica Visintini  4 , Elena Graziano  1   5 , Valentina Gerussi  1   5 , Giulia Bontempo  1   5 , Federica D'Aurizio  3 , Alessia Biasotto  3 , Assunta Sartor  3 , Corrado Pipan  3   5 , Stefania Marzinotto  3 , Francesco Curcio  3   5 , Emilio Bouza #  6   7   8   9 , Miriam Isola #  2   5 , Carlo Tascini  1   5
Affiliations

The Fall in Antibody Response to SARS-CoV-2: a Longitudinal Study of Asymptomatic to Critically Ill Patients Up to 10 Months after Recovery

Maddalena Peghin et al. J Clin Microbiol. .

Abstract

The aim of this study was to assess the long-term dynamics and factors associated with the serological response against the severe acute respiratory syndrome coronavirus 2 after primary infection. A prospective longitudinal study was conducted with monthly serological follow-up during the first 4 months, and then at 6, 8, and 10 months after the disease onset of all recovered adult in- and outpatients with coronavirus disease 2019 (COVID-19) attending Udine Hospital (Italy) during the first wave (from March to May 2020). A total of 546 individuals were included (289 female, mean age 53.1 years), mostly with mild COVID-19 (370, 68.3%). Patients were followed for a median of 302 days (interquartile range, 186 to 311). The overall seroconversion rate within 2 months was 32% for IgM and 90% for IgG. Seroreversion was observed in 90% of patients for IgM at 4 months and in 47% for IgG at 10 months. Older age, number of symptoms at acute onset, and severity of acute COVID-19 were all independent predictors of long-term immunity both for IgM (β, linear regression coefficient, 1.10, P = 0.001; β 5.15 P = 0.014; β 43.84 P = 0.021, respectively) and for IgG (β 1.43 P < 0.001; β 10.46 P < 0.001; β 46.79 P < 0.001, respectively), whereas the initial IgG peak was associated only with IgG duration (β 1.12, P < 0.001). IgM antibodies disappeared at 4 months, and IgG antibodies declined in about half of patients 10 months after acute COVID-19. These effects varied depending on the intensity of the initial antibody response, age, and burden of acute COVID-19.

Keywords: SARS-CoV-2 IgG; SARS-CoV-2 IgM; SARS-CoV-2 antibodies; SARS-CoV-2 serology; longitudinal study.

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Figures

FIG 1
FIG 1
Serological follow-up (up to February 2021). Flow diagram of in- and outpatients with COVID-19 included.
FIG 2
FIG 2
(A and B)Longitudinal assessment of anti-SARS-CoV-2 IgM (A) and IgG (B) in patients who recovered from COVID-19, according to the grade of severity of acute disease.
See this image and copyright information in PMC

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