Abstract P1063: Association of Demographic and Clinical Factors with SARS-CoV-2 Anti-Nucleocapsid Antibody Response Among Previously Infected US Adults: The C4R Study

Background: Despite the availability of effective vaccines and a recent decrease in annual deaths, coronavirus disease-2019 (COVID-19) remains a leading cause of death. Serological studies of anti-nucleocapsid (N) antibody response to infection provide insights into host immunobiology of adaptive immune response, which holds promise for identifying high-risk individuals for adverse acute and chronic COVID-19 outcomes. Hypothesis: Among participants previously infected with SARS-CoV-2, traditional vascular disease risk factors are associated with higher anti-N antibodies while vaccination is associated with lower anti-N antibodies. Methods: Among previously infected participants, anti-N antibodies were measured from dried blood spots collected between February 2021-February 2023 among 1,419 Collaborative Cohort of Cohorts for COVID-19 Research (C4R) participants with prior SARS-CoV-2 infection. We measured anti-N IgG antibodies reported as median fluorescence intensity (MFI) units; reactivity (i.e., seropositivity) was defined based on MFI above a validated threshold. Vascular disease risk factors were assessed via pre-pandemic in-person examination, questionnaires, and medical record review. Multivariable generalized linear models regressed anti-N reactivity (modified Poisson) or LN transformed MFI (linear). Results: Among 1,419 participants with prior infection, mean age (standard deviation) was 65.8(12.1) years, 61% were women, and 42.8% were self-reported from a race/ethnicity minority group. Participant reactivity to nucleocapsid peaked at 69% by 4 months post-infection and waned to only 44% ≥12 months after infection. After multivariable adjustment, higher anti-N antibody response was associated with older age, Hispanic (vs. White) or American Indian (vs. White) race/ethnicity, lower income and education, former smoking, and higher anti-spike antibody levels. Asian race (vs. White) and vaccination ( even after infection ) were associated with lower nucleocapsid reactivity; common cardiometabolic co-morbidities were not associated with anti-N reactivity or levels (Figures 1 and 2). Conclusions: Among participants previously infected with SARS-CoV-2, select sociodemographic and behavioral risk factors were associated with higher anti-N antibody levels while vaccination was associated with lower anti-N antibody levels. The observation that vaccination, even after infection, is related to lower anti-N antibody levels merits further investigation.

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Journal
Circulation
Published
2025-03-11
DOI
https://doi.org/10.1161/cir.151.suppl_1.p1063
Primary Topic
SARS-CoV-2 and COVID-19 Research
Type
article
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article

Abstract P1063: Association of Demographic and Clinical Factors with SARS-CoV-2 Anti-Nucleocapsid Antibody Response Among Previously Infected US Adults: The C4R Study

Jean M. Rock, John S. Kim, Rachel Bievenue, Rebekah Boyle et al.
Circulation
SARS-CoV-2 and COVID-19 Research
article

Abstract P1063: Association of Demographic and Clinical Factors with SARS-CoV-2 Anti-Nucleocapsid Antibody Response Among Previously Infected US Adults: The C4R Study

Jean M. Rock, John S. Kim, Rachel Bievenue, Rebekah Boyle, Elizabeth A. Regan, Ryan T. Demmer, Sally E Morganroth, Mitchell S.V. Elkind, Mary Cushman, Norrina B. Allen, Carmen R. Isasi, Alka M. Kanaya, Joel Henderson, Laura M. Raffield, Victor E. Ortega, Russell P. Tracy, Margaret F. Doyle, Barry J. Make, Elizabeth C. Oelsner, Christina Wu, Vanessa Xanthakis, Pallavi Balte, Linda M. Styer, Prescott G. Woodruff, Taison D. Bell, Amber Pirzada, Russell Bowler, Shelley A. Cole, Namratha R. Kandula, Pamela J. Schreiner, Yifei Sun, Michaela Restivo Anderson, Virginia J. Howard, Nicholas John Mantis, David A. Schwartz, Joyce Lee, Joe Coresh
article en

Abstract

Background: Despite the availability of effective vaccines and a recent decrease in annual deaths, coronavirus disease-2019 (COVID-19) remains a leading cause of death. Serological studies of anti-nucleocapsid (N) antibody response to infection provide insights into host immunobiology of adaptive immune response, which holds promise for identifying high-risk individuals for adverse acute and chronic COVID-19 outcomes. Hypothesis: Among participants previously infected with SARS-CoV-2, traditional vascular disease risk factors are associated with higher anti-N antibodies while vaccination is associated with lower anti-N antibodies. Methods: Among previously infected participants, anti-N antibodies were measured from dried blood spots collected between February 2021-February 2023 among 1,419 Collaborative Cohort of Cohorts for COVID-19 Research (C4R) participants with prior SARS-CoV-2 infection. We measured anti-N IgG antibodies reported as median fluorescence intensity (MFI) units; reactivity (i.e., seropositivity) was defined based on MFI above a validated threshold. Vascular disease risk factors were assessed via pre-pandemic in-person examination, questionnaires, and medical record review. Multivariable generalized linear models regressed anti-N reactivity (modified Poisson) or LN transformed MFI (linear). Results: Among 1,419 participants with prior infection, mean age (standard deviation) was 65.8(12.1) years, 61% were women, and 42.8% were self-reported from a race/ethnicity minority group. Participant reactivity to nucleocapsid peaked at 69% by 4 months post-infection and waned to only 44% ≥12 months after infection. After multivariable adjustment, higher anti-N antibody response was associated with older age, Hispanic (vs. White) or American Indian (vs. White) race/ethnicity, lower income and education, former smoking, and higher anti-spike antibody levels. Asian race (vs. White) and vaccination ( even after infection ) were associated with lower nucleocapsid reactivity; common cardiometabolic co-morbidities were not associated with anti-N reactivity or levels (Figures 1 and 2). Conclusions: Among participants previously infected with SARS-CoV-2, select sociodemographic and behavioral risk factors were associated with higher anti-N antibody levels while vaccination was associated with lower anti-N antibody levels. The observation that vaccination, even after infection, is related to lower anti-N antibody levels merits further investigation.

CirculationVol. 151(Suppl_1)
University of Vermont (US), Northwestern University (US), University of North Carolina at Chapel Hill (US), Texas Biomedical Research Institute (US), New York State Department of Health (US), Albert Einstein College of Medicine (US), Mayo Clinic (US), City College of San Francisco (US), University of Pittsburgh (US), University of California, San Francisco (US), University of Virginia Health System (US), University of Minnesota System (US), National Jewish Health (US), University of Illinois Chicago (US), Boston University Academy (US), Mayo Clinic Hospital (US), New York University Langone Orthopedic Hospital (US), University of Colorado Anschutz Medical Campus (US), Columbia University (US), University of Pennsylvania (US), University of Colorado Denver (US)
Openalex Percentile: Top 89%
SARS-CoV-2 and COVID-19 Research
DOISourceOpenAlex
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