Antibody Status and Incidence of SARS-CoV-2 Infection in Health Care Workers

作者：Sheila Lumley, Denise C. O’Donnell, Nicole E Stoesser, Philippa Clare Matthews, Alison Howarth, Stephanie B. Hatch, Brian D. Marsden, Stuart Cox, Tim James, Fiona C Warren, Liam J Peck, Thomas G. Ritter, Zoe de Toledo, Laura Warren, David Axten, Richard J. Cornall, E Yvonne Jones, David Ian Stuart, Gavin Robert Screaton, Daniel V. Ebner, Sarah Hoosdally, Meera A Chand, Derrick W. Crook, Anne-Marie O’Donnell, Christopher P. Conlon, Koen Bernardus Pouwels, Ann Sarah Walker, Tim Peto, Susan Hopkins, A Sarah Walker, Katie JM Jeffery, David W. Eyre · 发表于：New England Journal of Medicine · 年份：2020 · DOI：10.1056/nejmoa2034545 · 被引用次数：1027 · 研究领域：SARS-CoV-2 and COVID-19 Research、COVID-19 Clinical Research Studies、SARS-CoV-2 detection and testing

BACKGROUND: The relationship between the presence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the risk of subsequent reinfection remains unclear. METHODS: We investigated the incidence of SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR) in seropositive and seronegative health care workers attending testing of asymptomatic and symptomatic staff at Oxford University Hospitals in the United Kingdom. Baseline antibody status was determined by anti-spike (primary analysis) and anti-nucleocapsid IgG assays, and staff members were followed for up to 31 weeks. We estimated the relative incidence of PCR-positive test results and new symptomatic infection according to antibody status, adjusting for age, participant-reported gender, and changes in incidence over time. RESULTS: A total of 12,541 health care workers participated and had anti-spike IgG measured; 11,364 were followed up after negative antibody results and 1265 after positive results, including 88 in whom seroconversion occurred during follow-up. A total of 223 anti-spike-seronegative health care workers had a positive PCR test (1.09 per 10,000 days at risk), 100 during screening while they were asymptomatic and 123 while symptomatic, whereas 2 anti-spike-seropositive health care workers had a positive PCR test (0.13 per 10,000 days at risk), and both workers were asymptomatic when tested (adjusted incidence rate ratio, 0.11; 95% confidence interval, 0.03 to 0.44; P = 0....