'No Guarantee of Anti-N Antibodies' From COVID Infection

Tim Locke

November 09, 2021

Around 1 in 5 infected with SARS-CoV-2 don't develop anti-N antibodies, according to King's College London research.

The ZOE COVID Study of 8193 previously infected people found 81% tested positive for anti-N antibodies, arising from natural infection rather than vaccination, between April and August 2021.

The likelihood of having these antibodies was higher if people had more symptoms, and displayed 'classic' symptoms, such as fever, persistent cough, and anosmia.

Rates were also higher when case rates in the population were higher when testing positive.

Those less likely to have anti-N antibodies included those with comorbidities and smokers.

Enduring Protection

The data were published in a news release and have not been peer reviewed.

Lead scientist, Professor Tim Spector, said in a statement: "While antibodies seem to endure following natural infection, 1 in 5 people won't get any clear protective benefit from their infection, especially if they had mild or asymptomatic infection, or if they have comorbidities or unhealthy habits like smoking.

"It's interesting to observe that, unlike vaccination, it's not just older, frailer, or overweight adults who gain least protection from a previous infection, but rather anyone with poorer overall health.

"This supports our previous findings that have shown longer term protection gained from the COVID-19 vaccines is more effective than natural antibodies gained from infection.”

Another ZOE scientist, Dr Claire Steves, added: "What is interesting here is that not everyone who had natural infection had antibodies which sustain over time.  This underlines the importance of getting vaccinated even if you have had exposure to the virus."

Questions

Commenting via the Science Media Centre, Dr Simon Clarke, associate professor in cellular microbiology, University of Reading, said: "The observation that not everyone who has had a confirmed case of COVID-19 has antibodies to the virus would be extremely interesting if the authors had checked to see whether antibodies to the virus' other structural proteins were missing too.  But judging from this press release, which does not appear linked to a peer-reviewed paper, they seem not to have done so.  It remains possible that people had antibodies reactive to other coronavirus proteins that conferred some protection against infection or disease and this is an obvious research question to ask.

"Instead ZOE appear to have looked solely at antibodies to the N-protein, which is found predominantly within the core of the virus and is not exposed on its surface like the spike protein is.  Therefore it's difficult to envisage exactly how antibodies reactive to N-protein would work to block the virus interacting with our cells, or to tag it for destruction by our white blood cells.  These questions are much easier to answer with something on the virus surface.

"Because we don't really have a great understanding of how effective anti-N-protein antibodies are in protecting against Covid-19, it can't be said that lacking them renders someone vulnerable to infection or disease, and simple measures of antibodies in someone's blood are rarely a good measure of protection.  It might be the case that someone with low anti-N-protein antibodies has a stonking amount of anti-spike protein antibodies and some killer T-cells which confers strong protection.

"While this reported lack of antibodies in some people is an interesting phenomenon which should be investigated more closely, its finding remain conjecture.  There seems to be a lot more work to do and I look forward to reading a peer-reviewed study, which would address possible alternative outcomes and explanations, in due course."

Paul Hunter, professor in medicine, UEA, said: "The fact that people do not necessarily generate antibodies following COVID infection or indeed following vaccination is well known."

He added: "One of the key implications of this is that those studies that have looked at the prevalence of antibody in a population as an estimate of past infection, such as the UK REACT-2 and ONS infection Ab survey, will likely have substantially under-estimated the proportion of people who have already had COVID and recovered."

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.

processing....