SARS-CoV-2 antibodies protect against reinfection for at least 6 months in a multicentre seroepidemiological workplace cohort

Finch, Emilie and Lowe, Rachel and Fischinger, Stephanie and de St Aubin, Michael and Siddiqui, Sameed M. and Dayal, Diana and Loesche, Michael A. and Rhee, Justin and Beger, Samuel and Hu, Yiyuan and Gluck, Matthew J. and Mormann, Benjamin and Hasdianda, Mohammad A. and Musk, Elon R. and Alter, Galit and Menon, Anil S. and Nilles, Eric J. and Kucharski, Adam J. and Lei, Jiayao and Funk, Sebastian and Sun, Fiona Yueqian and Gimma, Amy and Nightingale, Emily S. and Medley, Graham and Abbott, Sam and Krauer, Fabienne and Davies, Nicholas G. and Jit, Mark and Endo, Akira and Brady, Oliver and Foss, Anna M. and Chan, Yung Wai Desmond and Jombart, Thibaut and van Zandvoort, Kevin and Eggo, Rosalind M. and Liu, Yang and Knight, Gwenan M. and Pearson, Carl A.B. and Abbas, Kaja and Atkins, Katherine E. and Clifford, Samuel and Koltai, Mihaly and Jafari, Yalda and Tully, Damien C. and Jarvis, Christopher I. and O'Reilly, Kathleen and Bosse, Nikos I. and Prem, Kiesha and Waites, William and Flasche, Stefan, the CMMID COVID-19 working group, the SpaceX COVID-19 Cohort Collaborative (2022) SARS-CoV-2 antibodies protect against reinfection for at least 6 months in a multicentre seroepidemiological workplace cohort. PLOS Biology, 20 (2). e3001531. ISSN 1544-9173 (https://doi.org/10.1371/journal.pbio.3001531)

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Abstract

Identifying the potential for Severe Acute Respiratory Syndrome : Coronavirus 2 (SARS-CoV-2) reinfection is crucial for understanding possible long-term epidemic dynamics. We analysed longitudinal PCR and serological testing data from a prospective cohort of 4,411 United States employees in 4 states between April 2020 and February 2021. We conducted a multivariable logistic regression investigating the association between baseline serological status and subsequent PCR test result in order to calculate an odds ratio for reinfection. We estimated an odds ratio for reinfection ranging from 0.14 (95% CI: 0.019 to 0.63) to 0.28 (95% CI: 0.05 to 1.1), implying that the presence of SARS-CoV-2 antibodies at baseline is associated with around 72% to 86% reduced odds of a subsequent PCR positive test based on our point estimates. This suggests that primary infection with SARS-CoV-2 provides protection against reinfection in the majority of individuals, at least over a 6-month time period. We also highlight 2 major sources of bias and uncertainty to be considered when estimating the relative risk of reinfection, confounders, and the choice of baseline time point and show how to account for both in reinfection analysis.

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