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
. 2023 Dec 1:37:102530.
doi: 10.1016/j.pmedr.2023.102530. eCollection 2024 Jan.

Association between severe acute respiratory syndrome coronavirus 2 antibody status and reinfection: A case-control study nested in a Colorado-based prospective cohort study

Ingrid A Binswanger  1   2   3   4 , Komal J Narwaney  1 , Jennifer C Barrow  1 , Kathleen B Albers  1 , Laura Bechtel  1   5 , Claudia A Steiner  1   2   4 , Jo Ann Shoup  1 , Jason M Glanz  1   6
Affiliations

Association between severe acute respiratory syndrome coronavirus 2 antibody status and reinfection: A case-control study nested in a Colorado-based prospective cohort study

Ingrid A Binswanger et al. Prev Med Rep. .

Abstract

The association between the presence of detectable antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and SARS-CoV-2 reinfection is not well established. The objective of this study was to determine the association between antibody seronegativity and reinfection.

Methods: Participants in Colorado, USA, were recruited between June 15, 2020, and March 28, 2021, and encouraged to complete SARS-CoV-2 molecular ribonucleic acid (RNA) and serology testing for antibodies every 28 days for 10 months. Participants with reinfections (positive SARS-CoV-2 RNA test ≥ 90 days after the first positive RNA test) were matched to controls without reinfections by age, sex, date of the first positive RNA test, date of the last serology test, and serology test type. Using conditional logistic regression, case patients were compared to control patients on the last serologic test result, with adjustment for demographic and clinical confounders.

Results: The cohort (n = 4,235) included 2,033 participants with ≥ 1 positive RNA test, of whom 120 had reinfection. Among the 80 case patients who could be matched, the last serologic test was negative in 12 of the cases (15.0 %) whereas the last serologic test was negative in 77 of 1,034 (7.5 %) controls. Seronegativity (adjusted OR [aOR] 2.24; 95 % CI 1.07, 4.68), Hispanic ethnicity (aOR 1.87; 95 % 1.10, 3.18), and larger household size (aOR 1.15; 95 % 1.01, 1.30 for each additional household member) were associated with reinfection.

Conclusions: Seronegative status, Hispanic ethnicity, and increasing household size were associated with reinfection. Serologic testing could be considered to reduce vaccine hesitancy in higher risk populations.

Keywords: Antibody; COVID-19 epidemiology; COVID-19 serological testing; COVID-19 vaccine; Case-control study; Infectious disease.

PubMed Disclaimer

Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. Bechtel was employed at Kaiser Permanente Colorado at the time this study was conducted through November 2022 and is currently employed by Siemens Healthineers, USA, which had no role in the study design, analysis, manuscript preparation or review, or decision to submit for publication. All other authors declare that they do not have a conflict of interest.

Figures

Fig. 1
Fig. 1
Illustrative depiction of the design of the longitudinal, population-based cohort.
Fig. 2
Fig. 2
Illustrative depiction of the case-control design used for the study analysis.
Fig. 3
Fig. 3
Study flow diagram.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Abrams E.M., Szefler S.J. COVID-19 and the impact of social determinants of health. Lancet Respir Med. 2020;8:659–661. - PMC - PubMed
    1. Addetia A., Crawford K.H.D., Dingens A., Zhu H., Roychoudhury P., Huang M.L., Jerome K.R., Bloom J.D., Greninger A.L. Neutralizing antibodies correlate with protection from SARS-CoV-2 in humans during a fishery vessel outbreak with a high attack rate. J Clin Microbiol. 2020;58 - PMC - PubMed
    1. Al-Aly Z., Bowe B., Xie Y. Long COVID after breakthrough SARS-CoV-2 infection. Nat Med. 2022;28:461–1467. - PMC - PubMed
    1. Alejo J.L., Mitchell J., Chang A., Chiang T.P.Y., Massie A.B., Segev D.L., Makary M.A. Prevalence and durability of SARS-CoV-2 antibodies among unvaccinated US adults by history of COVID-19. JAMA. 2022;327:1085–1087. - PMC - PubMed
    1. Bailie C.R., Tseng Y.Y., Carolan L., Kirk M.D., Nicholson S., Fox A., Sullivan S.G. Trend in sensitivity of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) serology one year after mild and asymptomatic Coronavirus disease 2019 (COVID-19): unpacking potential bias in seroprevalence studies. Clin Infect Dis. 2022;75:e357–e360. - PMC - PubMed

LinkOut - more resources