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Background <p>High spike-based vaccine coverage led to a high seroprevalence of anti-spike (S) antibodies against SARS-CoV-2 in Japanese adults in 2024. Nevertheless, the COVID-19 epidemic continues, and individuals with hybrid immunity are becoming more common in these populations.</p> Methods <p>We conducted a prospective cohort study to measure serum anti-SARS-CoV-2 antibody levels in 4496 Japanese adults as part of the national seroepidemiological survey. This study evaluated the correlation between first-visit anti-SARS-CoV-2 antibody levels and their effectiveness in providing protection until the second visit during the Omicron BA.5 epidemic.</p> Results <p>Reduced symptomatic infection risk was found to be associated with anti-S antibody, anti-nucleocapsid (N) antibody, and BA.5 neutralizing antibody levels. However, the reduced asymptomatic infection risk associated with anti-S antibody or BA.5 neutralizing antibody levels was limited. In contrast, higher anti-N antibody levels were strongly linked to a reduced asymptomatic infection risk. Furthermore, higher anti-N antibody levels were also associated with a reduced risk of re-infection in individuals with hybrid immunity.</p> Conclusion <p>These observations highlight the potential of anti-N antibody level as a correlate of protection against SARS-CoV-2 asymptomatic infection and re-infection. The findings indicate that individuals with hybrid immunity have a distinct protective immunity against both symptomatic and asymptomatic infection beyond serum anti-S and neutralizing antibodies against circulating viral strains, which correlate with serum anti-N antibodies.</p>

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Serum anti-nucleocapsid antibody correlates of protection from SARS-CoV-2 re-infection regardless of symptoms or immune history

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月15日

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  • Sho Miyamoto,
  • Koki Numakura,
  • Ryo Kinoshita,
  • Takeshi Arashiro,
  • Hiromizu Takahashi,
  • Hiromi Hibino,
  • Minako Hayakawa,
  • Takayuki Kanno,
  • Akiko Sataka,
  • Rena Sakamoto,
  • Akira Ainai,
  • Satoru Arai,
  • Motoi Suzuki,
  • Daisuke Yoneoka,
  • Takaji Wakita,
  • Tadaki Suzuki

摘要

Background

High spike-based vaccine coverage led to a high seroprevalence of anti-spike (S) antibodies against SARS-CoV-2 in Japanese adults in 2024. Nevertheless, the COVID-19 epidemic continues, and individuals with hybrid immunity are becoming more common in these populations.

Methods

We conducted a prospective cohort study to measure serum anti-SARS-CoV-2 antibody levels in 4496 Japanese adults as part of the national seroepidemiological survey. This study evaluated the correlation between first-visit anti-SARS-CoV-2 antibody levels and their effectiveness in providing protection until the second visit during the Omicron BA.5 epidemic.

Results

Reduced symptomatic infection risk was found to be associated with anti-S antibody, anti-nucleocapsid (N) antibody, and BA.5 neutralizing antibody levels. However, the reduced asymptomatic infection risk associated with anti-S antibody or BA.5 neutralizing antibody levels was limited. In contrast, higher anti-N antibody levels were strongly linked to a reduced asymptomatic infection risk. Furthermore, higher anti-N antibody levels were also associated with a reduced risk of re-infection in individuals with hybrid immunity.

Conclusion

These observations highlight the potential of anti-N antibody level as a correlate of protection against SARS-CoV-2 asymptomatic infection and re-infection. The findings indicate that individuals with hybrid immunity have a distinct protective immunity against both symptomatic and asymptomatic infection beyond serum anti-S and neutralizing antibodies against circulating viral strains, which correlate with serum anti-N antibodies.