Humoral Immune Response to SARS-CoV-2 in Iceland
Open accessAbstract
BACKGROUND: Little is known about the nature and durability of the humoral immune response to infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: We measured antibodies in serum samples from 30,576 persons in Iceland, using six assays (including two pan-immunoglobulin [pan-Ig] assays), and we determined that the appropriate measure of seropositivity was a positive result with both pan-Ig assays. We tested 2102 samples collected from 1237 persons up to 4 months after diagnosis by a quantitative polymerase-chain-reaction (qPCR) assay. We measured antibodies in 4222 quarantined persons who had been exposed to SARS-CoV-2 and in 23,452 persons not known to have been exposed. RESULTS: Of the 1797 persons who had recovered from SARS-CoV-2 infection, 1107 of the 1215 who were tested (91.1%) were seropositive; antiviral antibody titers assayed by two pan-Ig assays increased during 2 months after diagnosis by qPCR and remained on a plateau for the remainder of the study. Of quarantined persons, 2.3% were seropositive; of those with unknown exposure, 0.3% were positive. We estimate that 0.9% of Icelanders were infected with SARS-CoV-2 and that the infection was fatal in 0.3%. We also estimate that 56% of all SARS-CoV-2 infections in Iceland had been diagnosed with qPCR, 14% had occurred in quarantined persons who had not been tested with qPCR (or who had not received a positive result, if tested), and 30% had occurred in persons outside quarantine and not tested with qPCR. CONCLUSIONS: Our results indicate that antiviral antibodies against SARS-CoV-2 did not decline within 4 months after diagnosis. We estimate that the risk of death from infection was 0.3% and that 44% of persons infected with SARS-CoV-2 in Iceland were not diagnosed by qPCR.
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Human recovery from SARS-CoV-2 infection seems to require both antibody and cell-mediated immune responses.
“Recovery following infection with SARS-CoV-2 in humans appears to involve both humoral and cell-mediated immunity22–24.”
From Immunological mechanisms of vaccine-induced protection against COVID-19 in humans (2021) · cites this paper as [22]
Circulating SARS-CoV-2 IgG titers are well maintained for 3-4 months.
“circulating SARS-CoV-2 IgG titers are well maintained for 3–4 months (Gudbjartsson et al., 2020; Wajnberg et al., 2020).”
From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Gudbjartsson et al., 2020
At least some individuals are low or negative to commercial IgG assays while retaining detectable SARS-CoV-2 CD4+ T cells, representing 1%-10% of PCR-confirmed SARS-CoV-2 infections.
“at least some individuals are low or negative to commercial IgG assays, while retaining detectable SARS-CoV-2 CD4+ T cells. Current estimates are these individuals represent 1%–10% of PCR-confirmed SARS-CoV-2 infections (Gudbjartsson et al., 2020; Lipsitch et al., 2020; Nelde et al., 2021; Schwarzkopf et al., 2021; Sekine et al., 2020).”
From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Gudbjartsson et al., 2020
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- Authors
- Gudbjartsson, D. F., Norddahl, G. L., Melsted, P., Gunnarsdottir, K., Holm, H., Eythorsson, E., Arnthorsson, A. O., Helgason, D., Bjarnadottir, K., Ingvarsson, R. F., Thorsteinsdottir, B., Kristjansdottir, S., Birgisdottir, K., Kristinsdottir, A. M., Sigurdsson, M. I., Arnadottir, G. A., Ivarsdottir, E. V., Andresdottir, M., Jonsson, F., Agustsdottir, A. B., Berglund, J., Eiriksdottir, B., Fridriksdottir, R., Gardarsdottir, E. E., Gottfredsson, M., Gretarsdottir, O. S., Gudmundsdottir, S., Gudmundsson, K. R., Gunnarsdottir, T. R., Gylfason, A., Helgason, A., Jensson, B. O., Jonasdottir, A., Jonsson, H., Kristjansson, T., Kristinsson, K. G., Magnusdottir, D. N., Magnusson, O. T., Olafsdottir, L. B., Rognvaldsson, S., le Roux, L., Sigmundsdottir, G., Sigurdsson, A., Sveinbjornsson, G., Sveinsdottir, K. E., Sveinsdottir, M., Thorarensen, E. A., Thorbjornsson, B., Thordardottir, M., Saemundsdottir, J., Kristjansson, S. H., Josefsdottir, K. S., Masson, G., Georgsson, G., Kristjansson, M., Moller, A., Palsson, R., Gudnason, T., Thorsteinsdottir, U., Jonsdottir, I., Sulem, P., & Stefansson, K.
- Affiliations
- From deCODE Genetics/Amgen (D.F.G., G.L.N., P.M., K.G., H.H., A.O.A., K. Bjarnadottir, B. Thorsteinsdottir, S.K., K. Birgisdottir, A.M.K., G.A.A., E.V.I., M.A., F.J., A.B.A., J.B., B.E., R.F., E.E.G., S.G., K.R.G., A.G., A.H., B.O.J., A.J., H.J., T.K., D.N.M., O.T.M., S.R., L.R., A.S., G. Sveinbjornsson, K.E.S., E.A.T., B. Thorbjornsson, J.S., G.M., G.G., U.T., I.J., P.S., K.S.), the School of Engineering and Natural Sciences (D.F.G., P.M.), the Department of Anthropology (A.H.), the BioMedical...
- ORCID
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2020-10-29
- Volume
- 383
- Issue
- 18
- Pages
- 1724-1734
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC7494247
- OpenAlex
- W3082342835
- Cited by
- 903
- References
- 16
- Citations by year
- 2026: 6 · 2025: 18 · 2024: 27 · 2023: 90 · 2022: 191 · 2021: 430 · 2020: 141
- FWCI
- 28.05
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Hirsla (Landspítali University Hospital) (submittedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 detection and testing
- Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
- Keywords
- SARS-CoV-2, humoral immune response, antibody persistence, seroprevalence, COVID-19 pandemic, quarantine, underdiagnosis, mortality risk, Iceland
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Adult, Aged, Antibodies, Viral, Female, Humans, Iceland, Male, Middle Aged, Pneumonia, Viral, Quarantine, Seroepidemiologic Studies, Polymerase Chain Reaction, Coronavirus Infections, Immunity, Humoral, Pandemics
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