Volume 27, Number 9—September 2021
Dispatch
Predictors of Nonseroconversion after SARS-CoV-2 Infection
Table
Demographic, clinical, and laboratory characteristics of serologic responders and nonresponders after SARS-CoV-2 infection*
Characteristic | SARS-CoV-2 antibody positive, n = 46 | SARS-CoV-2 antibody negative, n = 26 | p value† |
---|---|---|---|
Age, y, median (IQR) |
49 (37–63) |
35 (30–46) |
0.03 |
Sex | 0.17 | ||
M | 30 (65) | 10 (38) | |
F |
16 (35) |
16 (62) |
|
Race/ethnicity | 1.00 | ||
White | 28 (61) | 20 (77) | |
Black | 7 (15) | 3 (12) | |
Asian | 7 (15) | 3 (12) | |
Latinx |
4 (9) |
0 |
|
RT-PCR of nasal swabs | |||
DFOS, d, median (IQR) | 5 (3–11) | 5 (4–8) | 0.95 |
Ct value, median (IQR)‡ |
24.5 (22–27) |
36 (34–77) |
<0.00001 |
Symptoms§ | 45 (98) | 25 (96) | 0.21 |
Severity 0 | 1 (2) | 1 (4) | |
Severity 1 | 5 (11) | 8 (31) | |
Severity 2 | 33 (72) | 15 (58) | |
Severity 3 |
7 (15) |
2 (8) |
|
Hospitalization |
6 (13) |
2 (8) |
1.00 |
Serologic analyses | |||
DFOS of T1, d, median (IQR) |
34 (26–46) |
33 (22–43) |
0.74 |
Binding antibodies (positive¶) | |||
Spike protein (IgG)# | 46 (100) | 0 | |
Spike protein (IgA)# | 43 (93) | 0 | |
RBD (IgG)** | 44 (96) | 0 | |
RBD (IgM)** | 38 (83) | 0 | |
Nucleocapsid protein (IgG)†† |
43 (93) |
0 |
|
Neutralizing antibodies (positive¶) | 45 (98) | 0 |
*Participants were a convenience sample recruited at the University of Alabama at Birmingham (Birmingham, AL, USA) during March–May 2020. Values are no. (%) unless otherwise indicated. Ct, cycle threshold; DFOS, days following onset of symptoms; IQR, interquartile range; RBD, receptor binding domain; RT-PCR, reverse transcription PCR; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; T1, time of first serologic test. †Calculated using a likelihood ratio test for a logistic regression predicting seropositivity for the category indicated after Bonferroni correction for multiple comparisons, except for RT-PCR and serologic DFOS, for which p-values were calculated using a Welch’s 2-sample t-test. ‡Ct values were only available for a subset of seropositive (n = 34) and seronegative (n = 25) persons Appendix Table 1. §Symptom severity was self-reported, with 0 indicating no symptoms, 1 indicating mild symptoms with little impact on daily activities, 2 indicating moderate symptoms with noticeable impact on daily activities, and 3 indicating severe symptoms with a substantial reduction in quality of life (Appendix Table 1). ¶Above assay detection limits (Appendix Table 2 details midpoint and endpoint titers). #ELISA detection of IgG and IgA binding antibodies to a prefusion stabilized Wuhan-Hu-1 spike protein. **ELISA detection of IgM and IgG binding antibodies to RBD of the Wuhan-Hu-1 spike protein. ††Detection of IgG binding antibodies to the nucleocapsid protein by the Abbott Architect assay.
1These first authors contributed equally to this article.
2Current affiliation: MBMicrobio Labs, Birmingham, Alabama, USA.