Development of a SARS-CoV-2 total antibody assay and the dynamics of antibody response over time in hospitalized and nonhospitalized patients with COVID-19

Erik H. Vogelzang, Floris C. Loeff, Ninotska I.L. Derksen, Simone Kruithof, Pleuni Ooijevaar-De Heer, Gerard van Mierlo, Federica Linty, Juk Yee Mok, Wim van Esch, Sanne de Bruin, Alexander P.J. Vlaar, Bart Seppen, Maureen Leeuw, Anne J.G. van Oudheusden, Anton G.M. Buiting, Kin Ki Jim, Hans Vrielink, Francis Swaneveld, Gestur Vidarsson, C. Ellen van der SchootPeter C. Wever, Wentao Li, Frank van Kuppeveld, Jean Luc Murk, Berend Jan Bosch, Gerrit Jan Wolbink, Theo Rispens*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Severe acute respiratory syndrome coronavirus (SARS-CoV)-2 infections often cause only mild disease that may evoke relatively low Ab titers compared with patients admitted to hospitals. Generally, total Ab bridging assays combine good sensitivity with high specificity. Therefore, we developed sensitive total Ab bridging assays for detection of SARS-CoV-2 Abs to the receptor-binding domain (RBD) and nucleocapsid protein in addition to conventional isotype-specific assays. Ab kinetics was assessed in PCRconfirmed, hospitalized coronavirus disease 2019 (COVID-19) patients (n = 41) and three populations of patients with COVID- 19 symptoms not requiring hospital admission: PCR-confirmed convalescent plasmapheresis donors (n = 182), PCR-confirmed hospital care workers (n = 47), and a group of longitudinally sampled symptomatic individuals highly suspect of COVID-19 (n = 14). In nonhospitalized patients, the Ab response to RBD is weaker but follows similar kinetics, as has been observed in hospitalized patients. Across populations, the RBD bridging assay identified most patients correctly as seropositive. In 11/14 of the COVID-19-suspect cases, seroconversion in the RBD bridging assay could be demonstrated before day 12; nucleocapsid protein Abs emerged less consistently. Furthermore, we demonstrated the feasibility of finger-prick sampling for Ab detection against SARS-CoV-2 using these assays. In conclusion, the developed bridging assays reliably detect SARS-CoV-2 Abs in hospitalized and nonhospitalized patients and are therefore well suited to conduct seroprevalence studies.

Original languageEnglish
Pages (from-to)3491-3499
Number of pages9
JournalJournal of Immunology
Issue number12
Publication statusPublished - 15 Dec 2020

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