Demographic and Clinical Factors Associated With SARS-CoV-2 Anti-Nucleocapsid Antibody Response Among Previously Infected US Adults: The C4R Study

Abstract 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 provide insights into host immunobiology of adaptive immune response to infection, which holds promise for identifying high-risk individuals for adverse COVID-19 outcomes. We investigated correlates of anti-nucleocapsid (N) antibody responses following Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection in a U.S. population-based meta-cohort of adults participating in longstanding NIH-funded cohort studies. Anti-nucleocapsid antibodies were measured from dried blood spots collected between February 2021-February 2023. Among 1419 Collaborative Cohort of Cohorts for COVID-19 Research (C4R) participants with prior SARS-CoV-2 infection, the mean age (standard deviation) was 65.8(12.1), 61% were women, and 42.8% self-reported membership in a race/ethnicity minority group. The proportion of participants reactive to nucleocapsid peaked at 69% by 4 months post-infection and waned to only 44% ≥12 months after infection. Higher anti-nucleocapsid antibody response was associated with older age, Hispanic or American Indian Alaskan Native (vs. white) race/ethnicity, lower income, lower education, former smoking and higher anti-spike antibody levels. Asian race (vs. white) and vaccination (even after infection) were associated with lower nucleocapsid reactivity. Neither vaccine manufacturer nor common cardiometabolic co-morbidities were not associated with anti-nucleocapsid response. These findings inform the underlying immunobiology of adaptive immune response to infection, as well as the potential utility of anti-nucleocapsid antibody response for clinical practice and COVID-19 serosurveillance.

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Publication Details

Journal
UNC Libraries
Published
2025-03-28
DOI
https://doi.org/10.17615/m3z5-nz83
Primary Topic
SARS-CoV-2 and COVID-19 Research
Type
article
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article

Demographic and Clinical Factors Associated 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.
UNC Libraries
SARS-CoV-2 and COVID-19 Research
article

Demographic and Clinical Factors Associated 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, Mitchell S.V. Elkind, Mary Cushman, Norrina B. Allen, Carmen R. Isasi, Alka M. Kanaya, Joel Henderson, Laura M. Raffield, Victor E. Ortega, Josef Coresh, Russell P. Tracy, Margaret F. Doyle, Barry J. Make, Elizabeth C. Oelsner, Christina Wu, Vanessa Xanthakis, Sally E. Wenzel, 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
article en

Abstract

Abstract 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 provide insights into host immunobiology of adaptive immune response to infection, which holds promise for identifying high-risk individuals for adverse COVID-19 outcomes. We investigated correlates of anti-nucleocapsid (N) antibody responses following Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection in a U.S. population-based meta-cohort of adults participating in longstanding NIH-funded cohort studies. Anti-nucleocapsid antibodies were measured from dried blood spots collected between February 2021-February 2023. Among 1419 Collaborative Cohort of Cohorts for COVID-19 Research (C4R) participants with prior SARS-CoV-2 infection, the mean age (standard deviation) was 65.8(12.1), 61% were women, and 42.8% self-reported membership in a race/ethnicity minority group. The proportion of participants reactive to nucleocapsid peaked at 69% by 4 months post-infection and waned to only 44% ≥12 months after infection. Higher anti-nucleocapsid antibody response was associated with older age, Hispanic or American Indian Alaskan Native (vs. white) race/ethnicity, lower income, lower education, former smoking and higher anti-spike antibody levels. Asian race (vs. white) and vaccination (even after infection) were associated with lower nucleocapsid reactivity. Neither vaccine manufacturer nor common cardiometabolic co-morbidities were not associated with anti-nucleocapsid response. These findings inform the underlying immunobiology of adaptive immune response to infection, as well as the potential utility of anti-nucleocapsid antibody response for clinical practice and COVID-19 serosurveillance.

UNC Libraries
University of North Carolina at Chapel Hill (US)
Openalex Percentile: Top 68%
SARS-CoV-2 and COVID-19 Research
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