Longevity of anti-spike and anti-nucleocapsid antibodies after COVID-19 in solid organ transplant recipients compared to immunocompetent controls

• DOI: 10.1111/ajt.16909
• Publication Date: 2021-12-03T16:43:54Z
• Authors: John M. Søfteland; Magnus Gisslén; Jan-Åke Liljeqvist; Vanda Friman; Emily de Coursey; Kristjan Karason; Jan Ekelund; Marie Felldin; Jesper Magnusson; Seema Baid-Agrawal; Carin Wallquist; Andreas Schult; Hanna Jacobsson; Anders Bergdahl; Mats Bemark; Lars-Magnus Ander...; Inger Holm Gunnar...; Jan Stenström; Susannah Leach
• Keywords: 03 medical and health sciences; 0302 clinical medicine; SARS-CoV-2; COVID-19; Humans; Longitudinal Studies; Organ Transplantation; Brief Communication; Antibodies, Viral; Transplant Recipients; 3. Good health

Solid organ transplant recipients (SOTRs) are on lifelong immunosuppression, which may interfere with adaptive immunity to COVID-19. The data on dynamics and duration of antibody response in SOTRs are limited. This longitudinal study examined the longevity of both anti-spike (S)- and anti-nucleocapsid (N)-specific IgG antibodies after COVID-19 in SOTRs compared to matched immunocompetent persons. SOTRs (n = 65) were matched with controls (n = 65) for COVID-19 disease severity, age, and sex in order of priority. Serum-IgG antibodies against N and S antigens of SARS-CoV-2 were analyzed. At 1 and 9 months after COVID-19, anti-S-IgG detectability decreased from 91% to 82% in SOTRs versus 100% to 95% in controls, whereas the anti-N-IgG decreased from 63% to 29% in SOTRs versus 89% to 46% in controls. A matched paired analysis showed SOTRs having significantly lower levels of anti-N-IgG at all time points (1 month p = .007, 3 months p < .001, 6 months p = .019, and 9 months p = .021) but not anti-S-IgG at any time points. A mixed-model analysis confirmed these findings except for anti-S-IgG at 1 month (p = .005) and identified severity score as the most important predictor of antibody response. SOTRs mount comparable S-specific, but not N-specific, antibody responses to SARS-CoV-2 infection compared to immunocompetent controls.