SARS-CoV-2 natural antibody response persists up to 12 months in a nationwide study from the Faroe Islands

Petersen, M. S.; Hansen, C. B.; Kristiansen, M. F.; Fjallsbak, J. P.; Larsen, S.; Hansen, J. L.; Jarlhelt, I.; Perez Alos, L.; a Steig, B.; Christiansen, D. H.; Moller, L. F.; Strom, M.; Andorsdottir, G.; Gaini, S.; Weihe, P.; Garred, P.

Only a few studies have assessed the long-term duration of the humoral immune response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this nationwide longitudinal study from the Faroe Islands with close to full participation of all individuals on the Islands with PCR confirmed COVID-19 during the two waves of infections in the spring and autumn 2020 (n=172 & n=233), samples were drawn at three longitudinal time points (3, 7 and 12 months and 1, 3 and 7 months after disease onset, respectively). Serum was analyzed with a direct quantitative IgG antibody binding ELISA to detect anti-SARS-CoV-2 spike RBD antibodies and a commercially available qualitative sandwich RBD ELISA kit measuring total antibody binding. The seropositive rate in the convalescent individuals was above 95 % at all sampling time points for both assays. There was an overall decline in IgG titers over time in both waves (p < 0.001). Pairwise comparison showed that IgG declined significantly from the first sample until approximately 7 months in both waves (p < 0.001). After that, the antibody level still declined significantly (p < 0.001), but decelerated with an altered slope remaining fairly stable from 7 months to 12 months after infection. Interestingly, the IgG titers followed a U-shaped curve with higher antibody levels among the oldest (67+) and the youngest (0-17) age groups compared to intermediate groups (p < 0.001). Our results indicate that COVID-19 convalescent individuals are likely to be protected from reinfection at least 12 months after symptom onset and maybe even longer. We believe our results can add to the understanding of natural immunity and the expected durability of SARS-CoV-2 vaccine immune responses.