A Novel Anti-nucleocapsid Antibody Avidity Method for Identifying SARS-CoV-2 Reinfections

Liam Golding; Allison W Watts; Jacob Shew; Marina Viñeta Paramo; Louise C Mâsse; David M Goldfarb; Bahaa Abu-Raya; Pascal M Lavoie

doi:10.1093/infdis/jiae072

A Novel Anti-nucleocapsid Antibody Avidity Method for Identifying SARS-CoV-2 Reinfections

J Infect Dis. 2024 Mar 5:jiae072. doi: 10.1093/infdis/jiae072. Online ahead of print.

Authors

Liam Golding^{1

2}, Allison W Watts¹, Jacob Shew^{1

2}, Marina Viñeta Paramo^{1

2

3}, Louise C Mâsse^{1

4}, David M Goldfarb^{1

5}, Bahaa Abu-Raya^{1

2}, Pascal M Lavoie^{1

2

3}

Affiliations

¹ British Columbia Children's Hospital Research Institute, University of British Columbia, Vancouver, British Columbia, Canada.
² Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
³ Women+ and Children's Health, Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, British Columbia, Canada.
⁴ School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
⁵ Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada.

PMID: 38442331
DOI: 10.1093/infdis/jiae072

Abstract

Detecting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfections is challenging with current serology assays and is further complicated by the marked decrease in routine viral testing practices as viral transmission increased during Omicron. Here, we provide proof-of-principle that high-avidity anti-nucleocapsid (N) antibodies detects reinfections after a single infection with higher specificity (85%; 95% confidence interval [95% CI], 80%-90%) compared to anti-N antibody levels (72%; 95% CI, 66%-79%) in a vaccinated cohort. This method could be used to retroactively investigate the epidemiology and incremental long-term health consequences of SARS-CoV-2 reinfections.

Keywords: COVID-19; SARS-CoV-2; avidity; nucleocapsid; reinfection; serology.

Abstract

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