SARS-CoV-2 SPIKE Antibody Levels can Indicate Immuno-Resilience to Re-infection: a Real-World Study
Abstract Introduction The use of antibody titers against SARS-CoV-2, as a method of estimating subsequent infection following infection or vaccination, is unclear. Here, we investigate whether specific levels of antibodies, as markers of adaptive immunity, can serve to estimate the risk of symptomat...
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Adis, Springer Healthcare
2024-12-01
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| Series: | Infectious Diseases and Therapy |
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| Online Access: | https://doi.org/10.1007/s40121-024-01090-2 |
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| author | Yue Jin Fei Yang Christopher M. Rank Stanley Letovsky Peter Ramge Simon Jochum |
| author_facet | Yue Jin Fei Yang Christopher M. Rank Stanley Letovsky Peter Ramge Simon Jochum |
| author_sort | Yue Jin |
| collection | DOAJ |
| description | Abstract Introduction The use of antibody titers against SARS-CoV-2, as a method of estimating subsequent infection following infection or vaccination, is unclear. Here, we investigate whether specific levels of antibodies, as markers of adaptive immunity, can serve to estimate the risk of symptomatic SARS-CoV-2 (re-) infection. Methods In this real-world study, laboratory data from individuals tested for SARS-CoV-2 antibodies under routine clinical conditions were linked through tokenization to a United States medical insurance claims database to determine the risk of symptomatic/severe SARS-CoV-2 infection outcomes. Antibody titer levels were determined using the Elecsys® Anti-SARS-CoV-2 S assay. Study outcomes included the first symptomatic SARS-CoV-2 infection (per ICD-10 diagnostic codes, occurring ≥ 7 days post-antibody titer test), and severe SARS-CoV-2 infection, characterized by adverse outcomes including hospitalization, intensive care unit admission, intubation, mechanical ventilation, or death within 30 days of infection. All outcomes were assessed for 12 months following antibody measurement. Hazard ratios of subsequent symptomatic and severe infections were estimated using Cox regression with inverse probability weighting. Results Of 268,844 individuals with antibody data (April 2021–June 2022), those with levels ≥ 0.8 to < 1,000 U/mL had a 42% reduced risk of symptomatic infection within 12 months, compared with < 0.8 U/mL (HR = 0.58, 95% CI [0.55, 0.61]). The risk decreased by 53% (HR = 0.47, 95% CI [0.45, 0.49]) with ≥ 1000 to < 2500 U/mL and by 62% (HR = 0.38 [0.36, 0.39]) for ≥ 2500 U/mL. Risk of severe SARS-CoV-2 outcomes was also reduced. Subgroup analyses showed a consistent association between antibody levels and infection risk, by immune status and age. Clinically meaningful thresholds of antibody titers varied between Delta and Omicron infections. Conclusion Higher antibody titer levels indicated reduced risk of developing symptomatic or severe COVID-19. Titers of ≥ 2500 U/mL indicated a 62–87% reduced infection risk. The quantitative determination of antibody titers allowed scaling of the correlate of risk to new variants. |
| format | Article |
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| institution | Kabale University |
| issn | 2193-8229 2193-6382 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Adis, Springer Healthcare |
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| series | Infectious Diseases and Therapy |
| spelling | doaj-art-d77bca2a2b8c4b3aa8d8fc6cc81c1db82025-02-02T12:35:23ZengAdis, Springer HealthcareInfectious Diseases and Therapy2193-82292193-63822024-12-0114122924310.1007/s40121-024-01090-2SARS-CoV-2 SPIKE Antibody Levels can Indicate Immuno-Resilience to Re-infection: a Real-World StudyYue Jin0Fei Yang1Christopher M. Rank2Stanley Letovsky3Peter Ramge4Simon Jochum5Roche Information Solutions, Roche Molecular Systems IncRoche Information Solutions, F. Hoffman-La Roche LtdRoche Diagnostics GmbHLabcorpRoche Diagnostics Solutions, Roche Diagnostics International LtdRoche Diagnostics GmbHAbstract Introduction The use of antibody titers against SARS-CoV-2, as a method of estimating subsequent infection following infection or vaccination, is unclear. Here, we investigate whether specific levels of antibodies, as markers of adaptive immunity, can serve to estimate the risk of symptomatic SARS-CoV-2 (re-) infection. Methods In this real-world study, laboratory data from individuals tested for SARS-CoV-2 antibodies under routine clinical conditions were linked through tokenization to a United States medical insurance claims database to determine the risk of symptomatic/severe SARS-CoV-2 infection outcomes. Antibody titer levels were determined using the Elecsys® Anti-SARS-CoV-2 S assay. Study outcomes included the first symptomatic SARS-CoV-2 infection (per ICD-10 diagnostic codes, occurring ≥ 7 days post-antibody titer test), and severe SARS-CoV-2 infection, characterized by adverse outcomes including hospitalization, intensive care unit admission, intubation, mechanical ventilation, or death within 30 days of infection. All outcomes were assessed for 12 months following antibody measurement. Hazard ratios of subsequent symptomatic and severe infections were estimated using Cox regression with inverse probability weighting. Results Of 268,844 individuals with antibody data (April 2021–June 2022), those with levels ≥ 0.8 to < 1,000 U/mL had a 42% reduced risk of symptomatic infection within 12 months, compared with < 0.8 U/mL (HR = 0.58, 95% CI [0.55, 0.61]). The risk decreased by 53% (HR = 0.47, 95% CI [0.45, 0.49]) with ≥ 1000 to < 2500 U/mL and by 62% (HR = 0.38 [0.36, 0.39]) for ≥ 2500 U/mL. Risk of severe SARS-CoV-2 outcomes was also reduced. Subgroup analyses showed a consistent association between antibody levels and infection risk, by immune status and age. Clinically meaningful thresholds of antibody titers varied between Delta and Omicron infections. Conclusion Higher antibody titer levels indicated reduced risk of developing symptomatic or severe COVID-19. Titers of ≥ 2500 U/mL indicated a 62–87% reduced infection risk. The quantitative determination of antibody titers allowed scaling of the correlate of risk to new variants.https://doi.org/10.1007/s40121-024-01090-2COVID-19Immune responseImmunityReal-world dataRisk estimateSARS-CoV-2 |
| spellingShingle | Yue Jin Fei Yang Christopher M. Rank Stanley Letovsky Peter Ramge Simon Jochum SARS-CoV-2 SPIKE Antibody Levels can Indicate Immuno-Resilience to Re-infection: a Real-World Study Infectious Diseases and Therapy COVID-19 Immune response Immunity Real-world data Risk estimate SARS-CoV-2 |
| title | SARS-CoV-2 SPIKE Antibody Levels can Indicate Immuno-Resilience to Re-infection: a Real-World Study |
| title_full | SARS-CoV-2 SPIKE Antibody Levels can Indicate Immuno-Resilience to Re-infection: a Real-World Study |
| title_fullStr | SARS-CoV-2 SPIKE Antibody Levels can Indicate Immuno-Resilience to Re-infection: a Real-World Study |
| title_full_unstemmed | SARS-CoV-2 SPIKE Antibody Levels can Indicate Immuno-Resilience to Re-infection: a Real-World Study |
| title_short | SARS-CoV-2 SPIKE Antibody Levels can Indicate Immuno-Resilience to Re-infection: a Real-World Study |
| title_sort | sars cov 2 spike antibody levels can indicate immuno resilience to re infection a real world study |
| topic | COVID-19 Immune response Immunity Real-world data Risk estimate SARS-CoV-2 |
| url | https://doi.org/10.1007/s40121-024-01090-2 |
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