1580 individuals invited to undergo serologic testing: 52% accepted (n=816)
Mean age 48.0 years | 52% women | 82% White
Reported routine mask use in public: 14%
Among COVID confirmed participants
Median months passed since diagnosis: 8.7 (IQR, 1.9 to 12.9)
Tested positive for anti-RBD: 99%
Median anti-RBD level: 205 (IQR, 61 to 535) U/mL
There was no evidence of association between time after infection and antibody titer
0.8% increase per month (95% CI, –2.4% to 4.2%); P=0.62
Among COVID unconfirmed participants
Tested positive for anti-RBD: 55%
Median anti-RBD level: 131 (IQR, 35 to 402) U/mL
Among no COVID participants
Tested positive for anti-RBD: 11%
Median anti-RBD level: 82 (IQR, 19 to 172) U/mL
Among those participants who received a positive COVID-19 test, 99% had anti-RBD antibodies with persistence up to 20 months
Among those who thought that they had COVID-19, only approximately half of the cohort had detectable antibodies
Whether these antibodies are associated with protection against future SARS-CoV-2 encounters is still unclear
Authors acknowledge limitations including selection bias and the fact that antibody levels alone do not directly correlate with immunity
The authors state
Although evidence of natural immunity in unvaccinated healthy US adults up to 20 months after confirmed COVID-19 infection is encouraging, it is unclear how these antibody levels correlate with protection against future SARS-CoV-2 infections, particularly with emerging variants
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