• J. Intern. Med. · Jan 2023

    Factors influencing the immune response over 15 months after SARS-CoV-2 infection: A longitudinal population-wide study in the Faroe Islands.

    • Maria Skaalum Petersen, Laura Pérez-Alós, Jose Juan A Armenteros, Cecilie B Hansen, FjallsbakJógvan PállJPFaroese Food and Veterinary Authority, Tórshavn, Faroe Islands., Sólrun Larsen, Jóhanna L Hansen, Ida Jarlhelt, Marnar F Kristiansen, Við StreymFríðaFDepartment of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faroe Islands., Á SteigBjarniBCOVID-19 Task Force, Ministry of Health, Tórshavn, Faroe Islands.Medical Department, National Hospital of the Faroe Islands, Tórshavn, Faroe Islands., Debes H Christiansen, Lars F Møller, Marin Strøm, Guðrið Andorsdóttir, Shahin Gaini, Pál Weihe, and Peter Garred.
    • Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faroe Islands.
    • J. Intern. Med. 2023 Jan 1; 293 (1): 638163-81.

    BackgroundThe durability of SARS-CoV-2 antibody response and the resulting immunity to COVID-19 is unclear.ObjectivesTo investigate long-term humoral immunity to SARS-CoV-2.MethodsIn this nationwide, longitudinal study, we determined antibody response in 411 patients aged 0-93 years from two waves of infections (March to December 2020) contributing 1063 blood samples. Each individual had blood drawn on 4-5 occasions 1-15 months after disease onset. We measured total anti-SARS-CoV-2 receptor-binding domain (RBD) antibody using a qualitative RBD sandwich ELISA, IgM, IgG and IgA levels using an quantitative in-house ELISA-based assay  and neutralizing antibodies (NAbs) using an in-house ELISA-based pseudoneutralizing assay. IgG subclasses were analyzed in a subset of samples by ELISA-based assay. We used nonlinear models to study the durability of SARS-CoV-2 antibody responses and its influence over time.ResultsAfter 15 months, 94% still had detectable circulating antibodies, mainly the IgG isotype, and 92% had detectable NAbs. The distribution of IgG antibodies varied significantly over time, characterized by a biphasic pattern with an initial decline followed by a plateau after approximately 7 months. However, the NAbs remained relatively stable throughout the period. The strength of the antibody response was influenced by smoking and hospitalization, with lower IgG levels in smokers and higher levels in hospitalized individuals. Antibody stability over time was mainly associated with male sex and older age with higher initial levels but more marked decrease.ConclusionsThe humoral immune response to SARS-CoV-2 infection varies depending on behavioral factors and disease severity, and antibody stability over 15 months was associated with sex and age.© 2022 The Association for the Publication of the Journal of Internal Medicine.

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