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Detection of SARS-CoV-2 Reinfections Using Nucleocapsid Antibody Boosting
Eduard Grebe

, Daniel Chacreton, Mars Stone, Bryan R. Spencer, James Haynes, Akintunde Akinseye, Marion C. Lanteri, Valerie Green, Hasan Sulaeman, Roberta Bruhn, Vivian I. Avelino-Silva, Paul Contestable, Brad J. Biggerstaff, Melissa M. Coughlin, Brian Custer, Jefferson M. Jones, David Wright
1, and Michael P. Busch
1
Author affiliation: Vitalant Research Institute, San Francisco, California, USA (E. Grebe, M. Stone, H. Sulaeman, R. Bruhn, V.I. Avelino-Silva, B. Custer, M.P. Busch); Westat, Rockville, Maryland, USA (D. Chacreton, A. Akinseye, D. Wright); University of California San Francisco, San Francisco (M. Stone, R. Bruhn, B. Custer, M.P. Busch); American Red Cross, Dedham, Massachusetts, USA (B.R. Spencer); American Red Cross, Rockville (J.M. Haynes); Creative Testing Solutions, Tempe, Arizona, USA (M.C. Lanteri, V. Green); San Francisco State University, San Francisco (H. Sulaeman); QuidelOrtho, Rochester, New York, USA (P. Contestable); Centers for Disease Control and Prevention, Fort Collins, Colorado, USA (B.J. Biggerstaff); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (M.M. Coughlin, J.M. Jones)
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Figure 1

Figure 1. Individual anti-N S/CO trajectories before and after swab-confirmed reinfection in vaccinated and unvaccinated participants in study of detection of SARS-CoV-2 reinfections using nucleocapsid antibody boosting. A) S/CO trajectories with neat-only anti-N testing of all donors with reinfections in the study. B) Trajectories of test results from 434 donors with reinfections subjected to expanded dynamic range dilutional anti-N testing; neat results only. C) Trajectories of test results from the same 434 donors with reinfections subjected to dilutional anti-N testing; dilutional (expanded dynamic range) testing results only. Images show average anti-N trajectories of donors who experienced reinfections, with and without expanded dynamic range testing, stratified by vaccination status. Time represents days before or after swab-confirmed reinfection (vertical red dashed line). N, nucleocapsid; S/CO, signal-to-cutoff ratio; UU, unvaccinated at the time of first infection and reinfection; UV, unvaccinated at first infection and vaccinated at reinfection; VV, vaccinated at first infection and reinfection.
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Page updated: April 22, 2025
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