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KMID : 1141420230280010092
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Korean Journal of Healthcare-associated Infection Control Prevention
2023 Volume.28 No. 1 p.92 ~ p.98
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The Difference in Anti-nucleocapsid Protein Antibody Responses Between Vaccinated and Unvaccinated Individuals After Asymptomatic, Mild, or Moderate COVID-19 Infection
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Kim Ji-Yeun
Cha Hye-Hee
Kwon Ji-Soo
Cha Jun-Ho
Jang Choi-Young
Lee Hyun-Jung
Lim So-Yun
Kim Sung-Han
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Abstract
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Background: Anti-nucleocapsid protein IgG antibody (N-IgG) responses are not elicited by the current COVID-19 vaccines; therefore, these responses have been used to determine previous COVID-19 infections. However, data on whether COVID-19 vaccination affects the seroconversion of the N-IgG response are limited. This study aimed to compare the seropositivity of N-IgG responses in vaccinated individuals versus unvaccinated individuals with COVID-19 confirmed by polymerase chain reaction (PCR).
Methods: The study included healthcare workers (HCWs) and immunocompromised (IC) patients with liver or kidney transplants, regardless of their COVID-19 infection status, who have received COVID-19 vaccines (ChAdOx1, BNT162b2, or mRNA-1273) between March 2021 and December 2021. We also enrolled unvaccinated patients infected with COVID-19, who were asymptomatic or had mild or moderate symptoms. Anti-spike 1 protein IgG antibody (S1- IgG) and N-IgG responses were measured in plasma obtained from the participants.
Results: None of the 100 individuals (51 HCWs and 49 IC patients) without Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) infection demonstrated a positive N-IgG response. Among the patients with PCR-confirmed SARS-CoV-2 infection, the rate of N-IgG positivity was 93.5% (29/31) in the unvaccinated patients, which was significantly higher than that in the vaccinated HCWs (75.0% [39/52], P=0.04). The positive rate of N-IgG in vaccinated IC patients was numerically lower (60.0% [9/15]) than that in vaccinated HCWs; however, this difference was not statistically significant (P=0.33).
Conclusion: COVID-19 vaccination lowered the seroconversion rate of N-IgG in patients with COVID-19. Therefore, the estimate of SARS-CoV-2 infection based on the N-IgG response may underestimate the seroprevalence of SARS-CoV-2 infection in highly vaccinated populations.
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KEYWORD
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Anti-nucleocapsid protein antibody, COVID-19 infection, Seroconversion, Vaccination
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