Prevalence and dynamics of SARS-CoV-2 nucleocapsid IGG in kidney transplant recipients

2021 
Background: We aimed to investigate the prevalence and dynamics of SARS-CoV-2 IgG in kidney transplant recipients in the Bronx, New York, one of the epicenters of the pandemic Methods: Between March 16 and May 5, 2021, 255 patients tested positive by SARS-CoV-2 RT-PCR. From May 3 to May 5, 2021, 1,164 patients were screened for SARS-CoV-2 IgG antibodies and 199 (17.1%) were tested positive (Figure). Results: 62 of the 199 patients were previously diagnosed COVID-19 by RT-PCR, while the remaining 137 did not have significant symptoms and had not been previously tested by RT-PCR. Overall prevalence of COVID-19 diagnosis by RT-PCR and/or SARSCoV-2 IgG in 1,348 patients tested were 29.1%. Seventy-one RT-PCR+ patients were screened for SARS-CoV-2 IgG antibody and 62 (87%) were positive at a median 106 days (81-168) A total of 50 patients of 199 who were previously tested positive for SARSCoV-2 IgG (30 diagnosed with IgG and 20 with RT-PCR) were retested at a median time of 112 days (IQR: 81-121). Twenty-six patients (52%) became seronegative at a median time of 105 days (IQR: 84-141) from their first positive IgG. Nine of 20 (45%) patients who were diagnosed by RT-PCR became seronegative at a median time of 108 days (IQR: 81-168) from their first positive IgG while 17 of 30 (57%) patients who were initially diagnosed by a positive IgG, became seronegative at a median time of 121 days (IQR: 90-145) from the date of diagnosis. Conclusions: In summary, 35% of kidney transplant recipients were asymptomatic or mildly symptomatic and developed SARS-CoV-2 IgG without requiring testing by RT-PCR. However, half of the patients who initially developed antibodies lose them over time raising the questions of lasting immunity against SARS-CoV-2 and how effective are those antibodies in preventing future infection.
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