@article{Mullins2023,
abstract = {The COVID-19 pandemic continues to affect individuals across the globe, with some individuals experiencing more severe disease than others. The relatively high frequency of re-infections and breakthrough infections observed with SARS-CoV-2 highlights the importance of extending our understanding of immunity to COVID-19. Here, we aim to shed light on the importance of antibody titres and epitope utilization in protection from re-infection. Health care workers are highly exposed to SARS-CoV-2 and are therefore also more likely to become re-infected. We utilized quantitative, multi-antigen, multi-epitope SARS-CoV-2 protein microarrays to measure IgG and IgA titres against various domains of the nucleocapsid and spike proteins. Potential re-infections in a large, diverse health care worker cohort (N = 300) during the second wave of the pandemic were identified by assessing the IgG anti-N titres before and after the second wave. We assessed epitope coverage and antibody titres between the ‘single infection' and ‘re-infection' groups. Clear differences were observed in the breadth of the anti-N response before the second wave, with the epitope coverage for both IgG (p = 0.019) and IgA (p = 0.015) being significantly increased in those who did not become re-infected compared to those who did. Additionally, the IgG anti-N (p = 0.004) and anti-S titres (p = 0.018) were significantly higher in those not re-infected. These results highlight the importance of the breadth of elicited antibody epitope coverage following natural infection in protection from re-infection and disease in the COVID-19 pandemic.},
author = {Mullins, Michelle O and Smith, Muneerah and Maboreke, Hazel and Nel, Andrew J M and Ntusi, Ntobeko A B and Burgers, Wendy A and Blackburn, Jonathan M},
doi = {10.3390/V15020584},
file = {:C$\backslash$:/Users/01462563/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Mullins et al. - 2023 - Epitope coverage of anti-SARS-CoV-2 nucleocapsid IgA and IgG antibodies correlates with protection against re-in.pdf:pdf},
issn = {1999-4915},
journal = {Viruses},
keywords = {COVID-19* / epidemiology,Epitopes,Humans,Immunoglobulin A,Immunoglobulin G,Jonathan M Blackburn,MEDLINE,Michelle O Mullins,Muneerah Smith,NCBI,NIH,NLM,National Center for Biotechnology Information,National Institutes of Health,National Library of Medicine,Nucleocapsid,OA,OA{\_}PMC,PMC9967965,Pandemics,PubMed Abstract,Reinfection,SARS-CoV-2*,doi:10.3390/v15020584,fund{\_}not{\_}ack,original,pmid:36851798},
mendeley-tags = {OA,OA{\_}PMC,fund{\_}not{\_}ack,original},
month = {feb},
number = {2},
pages = {584},
pmid = {36851798},
publisher = {Viruses},
title = {{Epitope coverage of anti-SARS-CoV-2 nucleocapsid IgA and IgG antibodies correlates with protection against re-infection by new variants in subsequent waves of the COVID-19 pandemic}},
url = {https://pubmed.ncbi.nlm.nih.gov/36851798/},
volume = {15},
year = {2023}
}

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We utilized quantitative, multi-antigen, multi-epitope SARS-CoV-2 protein microarrays to measure IgG and IgA titres against various domains of the nucleocapsid and spike proteins. Potential re-infections in a large, diverse health care worker cohort (N = 300) during the second wave of the pandemic were identified by assessing the IgG anti-N titres before and after the second wave. We assessed epitope coverage and antibody titres between the ‘single infection' and ‘re-infection' groups. Clear differences were observed in the breadth of the anti-N response before the second wave, with the epitope coverage for both IgG (p = 0.019) and IgA (p = 0.015) being significantly increased in those who did not become re-infected compared to those who did. Additionally, the IgG anti-N (p = 0.004) and anti-S titres (p = 0.018) were significantly higher in those not re-infected. 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