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Volume 31, Number 5—May 2025
Research

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

Eduard GrebeComments to Author , 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 Wright1, and Michael P. Busch1
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)

Main Article

Table 3

Reinfection detection data by prereinfection anti-N reactivity level in study of SARS-CoV-2 reinfections detected by nucleocapsid antibody boosting*

S/CO† No. cases Median ratio
 Sensitivity of unweighted Youden's J (1.43)
 Sensitivity of weighted Youden's J (2.33)
Neat Dilution Neat, % Dilution, % Neat, % Dilution, %
Overall 434 4.50 58.54 79.3 81.6 65.0 80.6
0–50 262 10.94 94.32 85.1 85.1 84.4 84.4
50–100 78 2.82 64.97 78.2 78.5 69.2 78.2
100–150 55 1.90 29.49 81.8 80.0 12.7 80.0
>150 39 1.35 9.20 38.5 66.7 0.0 61.5

*Reactivity was measured with and without expanded dynamic range anti-N testing reinfection cases. S/CO, signal-to-cutoff ratio. Unweighted and weighted boosting thresholds are ratios of postreinfection to prereinfection S/CO. †S/CO value is prereinfection.

Main Article

1These senior authors contributed equally to this article.

Page created: March 25, 2025
Page updated: April 22, 2025
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