Laboratory evaluation of SARS-CoV-2 antibodies: detectable IgG up to 20 weeks post infection

Background The SARS-CoV-2 pandemic necessitated rapid and global responses across all areas of healthcare, including an unprecedented interest in serological immunoassays to detect antibodies to the virus. The dynamics of the immune response to SARS-CoV-2 is still not well understood and requires further investigation into the longevity of humoral immune response that is evoked due to SARS-CoV-2 infection. Methods We measured SARS-CoV-2 antibody levels in plasma samples from 880 people in Northern Ireland using Roche Elecsys Anti-SARS-CoV-2 IgG/IgA/IgM, Abbott SARS-CoV-2 IgG and EuroImmun IgG SARS-CoV-2 ELISA immunoassays to analyse immune dynamics over time. We undertook a laboratory evaluation for the UK-RTC AbC-19 rapid lateral flow immunoassay (LFIA), for the target condition of SARS-CoV-2 Spike protein IgG antibodies using a reference standard system to establish a characterised panel of 330 positive and 488 negative SARS-CoV-2 IgG samples. Results We detected persistence of SARS-CoV-2 IgG up to 140 days (20 weeks) post infection, across all three laboratory-controlled immunoassays. On the known positive cohort, the UK-RTC AbC-19 lateral flow immunoassay showed a sensitivity of 97.58% (95.28%-98.95%) and on known negatives, showed specificity of 99.59% (98.53 %-99.95%). Conclusions Through comprehensive analysis of a cohort of pre-pandemic and pandemic individuals, we show detectable levels of IgG antibodies, lasting up to 140 days, providing insight to antibody levels at later time points post infection. We show good laboratory validation performance metrics for the AbC-19 rapid test for SARS-CoV-2 Spike protein IgG antibody detection in a laboratory based setting. ### Competing Interest Statement At the time of this study TM and JML acted as advisors to CIGA HealthCare, an industrial partner in the UK Rapid Test Consortium. No personal financial reward or renumeration was received for this advisory role. At the time of submission of this manuscript TM and JML no longer held these advisory positions. All other authors have no potential conflict of interest to report. ### Funding Statement Costs for assays and laboratory expenses only will be paid by UK-RTC as is normal practice. The authors have not been paid or financially benefitted from this study. The advisory roles within CIGA Healthcare were unpaid temporary roles. This manuscript and associated data within this paper has only been used to build confidence into the overall device design and performance assessment of the UK RTC AbC-19 devices and such work was never commissioned for any government contractual consideration. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This study was approved by Ulster University Institutional Ethics committee (REC/20/0043), South Birmingham REC (The PANDEMIC Study IRAS Project ID: 286041Ref 20/WM/0184). All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.