IgG Seroconversion and Pathophysiology in Severe Acute Respiratory Syndrome Coronavirus 2 Infection

Staines, Henry M.; Kirwan, Daniela E.; Clark, David J.; Adams, Emily R.; Augustin, Yolanda; Byrne, Rachel L.; Cocozza, Michael; Cubas-Atienzar, Ana I.; Cuevas, Luis E.; Cusinato, Martina; Davies, Benedict M.O.; Davis, Mark; Davis, Paul; Duvoix, Annelyse; Eckersley, Nicholas M.; Forton, Daniel; Fraser, Alice J.; Garrod, Gala; Hadcocks, Linda; Hu, Qinxue; Johnson, Michael; Kay, Grant A.; Klekotko, Kesja; Lewis, Zawditu; Macallan, Derek C.; Mensah-Kane, Josephine; Menzies, Stefanie; Monahan, Irene; Moore, Catherine M.; Nebe-von-Caron, Gerhard; Owen, Sophie I.; Sainter, Chris; Sall, Amadou A.; Schouten, James; Williams, Christopher T.; Wilkins, John; Woolston, Kevin; Fitchett, Joseph R.A.; Krishna, Sanjeev; Planche, Tim

We investigated the dynamics of seroconversion in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. During March 29–May 22, 2020, we collected serum samples and associated clinical data from 177 persons in London, UK, who had SARS-CoV-2 infection. We measured IgG against SARS-CoV-2 and compared antibody levels with patient outcomes, demographic information, and laboratory characteristics. We found that 2.0%–8.5% of persons did not seroconvert 3–6 weeks after infection. Persons who seroconverted were older, were more likely to have concurrent conditions, and had higher levels of inflammatory markers. Non-White persons had higher antibody concentrations than those who identified as White; these concentrations did not decline during follow-up. Serologic assay results correlated with disease outcome, race, and other risk factors for severe SARS-CoV-2 infection. Serologic assays can be used in surveillance to clarify the duration and protective nature of humoral responses to SARS-CoV-2 infection.