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Nucleocapsid antibody positivity as a marker of past SARS-CoV-2 infection in population serosurveillance studies: impact of variant, vaccination, and choice of assay cut-off

Whitaker, H. J.; Gower, C.; Otter, A. D.; Simmons, R.; Kirsebom, F.; Letley, L.; Quinot, C.; Ireland, G.; Linley, E.; Ribeiro, S.; Ladhani, S.; Lopez-Bernal, J.; Amirthalingam, G.; Ramsay, M. E.; Brown, K. E.

2021-10-26 infectious diseases
10.1101/2021.10.25.21264964 medRxiv
Show abstract

Serological surveillance studies sometimes use presence of anti-nucleocapsid antibody as a marker of natural SARS-CoV-2 infection. We explore seroconversion rates and antibody levels following Alpha and Delta variant infections, and vaccine breakthrough infections. We find lower seroconversion rates particularly following Alpha-variant vaccine breakthrough infections. We re-evaluate assay performance with a mix of past waned infections and recent breakthrough infections, that is relevant to current serological surveillance.

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