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Study Finds Nearly Everyone Who Recovers From COVID-19 Makes Coronavirus Antibodies

Posted on by Dr. Francis Collins

Credit: NIH

There’s been a lot of excitement about the potential of antibody-based blood tests, also known as serology tests, to help contain the coronavirus disease 2019 (COVID-19) pandemic. There’s also an awareness that more research is needed to determine when—or even if—people infected with SARS-CoV-2, the novel coronavirus that causes COVID-19, produce antibodies that may protect them from re-infection.

A recent study in Nature Medicine brings much-needed clarity, along with renewed enthusiasm, to efforts to develop and implement widescale antibody testing for SARS-CoV-2 [1]. Antibodies are blood proteins produced by the immune system to fight foreign invaders like viruses, and may help to ward off future attacks by those same invaders.

In their study of blood drawn from 285 people hospitalized with severe COVID-19, researchers in China, led by Ai-Long Huang, Chongqing Medical University, found that all had developed SARS-CoV-2 specific antibodies within two to three weeks of their first symptoms. Although more follow-up work is needed to determine just how protective these antibodies are and for how long, these findings suggest that the immune systems of people who survive COVID-19 have been be primed to recognize SARS-CoV-2 and possibly thwart a second infection.

Specifically, the researchers determined that nearly all of the 285 patients studied produced a type of antibody called IgM, which is the first antibody that the body makes when fighting an infection. Though only about 40 percent produced IgM in the first week after onset of COVID-19, that number increased steadily to almost 95 percent two weeks later. All of these patients also produced a type of antibody called IgG. While IgG often appears a little later after acute infection, it has the potential to confer sustained immunity.

To confirm their results, the researchers turned to another group of 69 people diagnosed with COVID-19. The researchers collected blood samples from each person upon admission to the hospital and every three days thereafter until discharge. The team found that, with the exception of one woman and her daughter, the patients produced specific antibodies against SARS-CoV-2 within 20 days of their first symptoms of COVID-19.

Meanwhile, innovative efforts are being made on the federal level to advance COVID-19 testing. The NIH just launched the Rapid Acceleration of Diagnostics (RADx) Initiative to support a variety of research activities aimed at improving detection of the virus. As I recently highlighted on this blog, one key component of RADx is a “shark tank”-like competition to encourage science and engineering’s most inventive minds to develop rapid, easy-to-use technologies to test for the presence of SARS-CoV-2.

On the serology testing side, the NIH’s National Cancer Institute has been checking out kits that are designed to detect antibodies to SARS-CoV-2 and have found mixed results. In response, the Food and Drug Administration just issued its updated policy on antibody tests for COVID-19. This guidance sets forth precise standards for laboratories and commercial manufacturers that will help to speed the availability of high-quality antibody tests, which in turn will expand the capacity for rapid and widespread testing in the United States.

Finally, it’s important to keep in mind that there are two different types of SARS-CoV-2 tests. Those that test for the presence of viral nucleic acid or protein are used to identify people who are acutely infected and should be immediately quarantined. Tests for IgM and/or IgG antibodies to the virus, if well-validated, indicate a person has previously been infected with COVID-19 and is now potentially immune. Two very different types of tests—two very different meanings.

There’s still a way to go with both virus and antibody testing for COVID-19. But as this study and others begin to piece together the complex puzzle of antibody-mediated immunity, it will be possible to learn more about the human body’s response to SARS-CoV-2 and home in on our goal of achieving safe, effective, and sustained protection against this devastating disease.

Reference:

[1] Antibody responses to SARS-CoV-2 in patients with COVID-19. Long QX, Huang AI, et al. Nat Med. 2020 Apr 29. [Epub ahead of print]

Links:

Coronaviruses (NIH)

NIH Begins Study to Quantify Undetected Cases of Coronavirus Infection,” NIH News Release, April 10, 2020.

NIH mobilizes national innovation initiative for COVID-19 diagnostics,” NIH News Release, April 29, 2020.

Policy for Coronavirus Disease-2019 Tests During the Public Health Emergency (Revised), May 2020 (Food and Drug Administration)

134 Comments

  • Pam W. says:

    I was exposed by relatives. Started throwing up with diarrhea. Bad headacheas. Had nasal swab and was negative. They did an antibody test when they put the iv in. Was dehydrated due to the throwing up and diarrhea for 2 days. Don’t understand how I get a negative swab result but a positive antibody result? The positive antibody was for now not previous. Can someone please help me understand. Do I need to continue quarantine or am I not contagious? I never had a fever with any symptoms either.

    • bd says:

      As with any test they are not 100% accurate. You may have not had enough viral particles for a positive swab test. Also, the antibody test may not be specific and is detecting antibodies to one of the other 4 coronaviruses that can cause the common cold.

  • Jay says:

    I tested positive for covid. I waited a month and my doctor sent me to have the antibodies test. It’s came back negative. I’m confused. Did this happen to anyone else?

    • Denise K says:

      Yes. Same thing happened to me. My Dr. told me not to worry about it. The swab test was accurate and I did have Covid19. She said the antibody tests aren’t that accurate. Also, I had a mild case. It’s possible I didn’t make enough antibodies that the antibody test was able to detect.

  • C. Tribble says:

    American Scientists don’t know if Hyperimmune Globus CAN prevent or kill Covid-19 Cells! It’s as if a spray of this Virus droplets were shot from space over a certain area!

  • mukesh says:

    i lost my smell few days ago no other symptome and smell recoved after 8 to 10days and i done the antibody test igg its come positive what that mean can i infacted by covid 19

    • Kios says:

      As you have coronavirus antibodies it is unlikely you will be reinfected again in the next 9-12 months. Did they ask you to donate your plasma to treat others?

  • Priscilla Ann Curry says:

    Can l donate , I’m 70 yes old and in good health?

  • pep says:

    Thanks for sharing the valuable content with all! …

  • Nancy McLean-Cooper says:

    If an infected person is administered harvested SARS CoV-2 antibodies, does their body still produce antibodies – is there a positive feed-back mechanism?

  • Felix G says:

    My wife and I went to a model train show in West Springfield Massachusetts in late January, 2020 where there were thousands of people in close proximity. About three days later we both came down with a dry cough, headache, sore throat, head and chest congestion, shortness of breath, dizziness, fever and chills, body weakness, and I also had night sweats and my ears were blocked. This lasted for 10 days. I’ve had bronchitis many times and also had bouts with walking pneumonia and pleurisy but was never as sick as I was in January/February. The dry cough lasted a full month for both of us. In June my doctor sent me for a COVID antibody test and it was negative. Could it have been a false negative?

  • Jackie says:

    I was so sick back mid November… extremely week.. low grade fever… coughing and congestion. I had sprayed silver up my nose and my covid test came back negative.. but I’ve never had that kind of sickness.. so weak.. scary weak… so I waited and after 6 weeks.. did antibodies test .. it too came back negative. I’m so confused…

  • Susan M. says:

    In late December, early January of 2019/2020 (went home to New York for Christmas) I became ill. Diarrhea first for 24 hours. Within the next few days, headache, sinus drip, bad cough and problem with my eyes. Went to the Doctor and was told I had a fever, and a virus. Gave me z-pac, codeine cough syrup, cough pearls, and antibiotics gell for my eye infection. Recovered within about 4 or 5 days, and my husband got the same thing. Since mine went away, he just waited it out, with Tylenol and Robatussin. We have both been tested twice since then (blood tests) and both of us tested negative for covud 19 both times. I am still pretty sure that we both had Covid 19.

  • Jamie A Hale says:

    I had a terrible cough, sore throat, headache and fever back in January 2020. At that time, I was tested for the FLU and it came back negative. I wasn’t tested for COVID, because there was little known about it in the US at that time. I was so exhausted, it was literally exhausting for me to walk from my couch to my bed. This lasted for almost 2 weeks and the cough lasted for another month. Now fast forward and I just went for a Covid antibody blood test today and want to know given the amount of time (~12 months) is it possible for the test to come back positive or has too much time lapsed. Thank you.

  • Valerie WB says:

    I had a positive PCR for covid-19 12-13-21, symptoms for 10 days. Antibody testing at day 21, total AB 0.2. So repeat AB day 50, 0.9. So I began to wonder if I had a false positive PCR. Repeat PCR at day 53, positive. So I definitely had covid-19, but no AB response. My question is, would I develop AB to the vaccine?

  • Aslam says:

    I get positive on date 20 April 2021 but I don’t have symptoms I make test 22 it was positive I make 25 it was positive I make 27 its positive but still I don’t have any symptoms what should I do please any one guide me thanks

  • Jalal says:

    My sis had infected with covid-19 4 weeks ago. Today her IgM is 14.82, and IgG is 300. Where she is in the recovery cycle, please? What these figures indicates, please?

  • RTD says:

    Nice post…Thanks!!

  • R.B. says:

    Nice and very thoughtful article. While a student might not understand the importance of a blog, you have explained it so well that any person is bound to rethink her/his perspective. Love it! This is an unprecedented post. I like this subject.

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