{"doi":"10.1093/infdis/jiae090","title":"Anti–SARS-CoV-2 Antibody Levels Associated With COVID-19 Protection in Outpatients Tested for SARS-CoV-2, US Flu Vaccine Effectiveness Network, October 2021–June 2022","abstract":"BACKGROUND: We assessed associations between binding antibody (bAb) concentration <5 days of symptom onset and testing positive for COVID-19 among patients in a test-negative study. METHODS: From October 2021─June 2022, study sites in seven states enrolled patients aged ≥6 months presenting with acute respiratory illness. Respiratory specimens were tested for SARS-CoV-2. In blood specimens, we measured concentrations of anti-SARS-CoV-2 antibodies against the ancestral strain spike protein receptor binding domain (RBD) and nucleocapsid (N) antigens in standardized binding antibody units (BAU/mL). Percent change in odds of COVID-19 by increasing anti-RBD bAb was estimated using logistic regression as (1-adjusted odds ratio of COVID-19)x100, adjusting for COVID-19 mRNA vaccine doses, age, site, and high-risk exposure. RESULTS: Out of 2,018 symptomatic patients, 662 (33%) tested positive for acute SARS-CoV-2 infection. Geometric mean RBD bAb were lower among COVID-19 cases than SARS-CoV-2 test-negative patients during both the Delta-predominant (112 vs. 498 BAU/mL) and Omicron-predominant (823 vs. 1,189 BAU/mL) periods. Acute phase ancestral spike RBD bAb associated with 50% lower odds of COVID-19 were 1,968 BAU/mL against Delta and 3,375 BAU/mL against Omicron; thresholds may differ in other laboratories. CONCLUSION: During acute illness, antibody concentrations against ancestral spike RBD were associated with protection against COVID-19.","journal":"The Journal of Infectious Diseases","year":2024,"id":452913,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":9,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.662,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":763067,"name":"Ruchi Yadav","orcid":"0000-0002-4892-438X","position":1,"is_corresponding":false},{"id":1177584,"name":"Emma K. Noble","orcid":"0000-0002-0365-817X","position":2,"is_corresponding":false},{"id":616077,"name":"Ryan Sandford","orcid":"0000-0003-1904-9501","position":3,"is_corresponding":false},{"id":899691,"name":"Devyani Joshi","orcid":"0000-0001-5285-7725","position":4,"is_corresponding":false},{"id":660407,"name":"Sara Y. Tartof","orcid":"0000-0003-2336-8476","position":5,"is_corresponding":false},{"id":85417,"name":"Karen J. Wernli","orcid":"0000-0001-7945-0327","position":6,"is_corresponding":false},{"id":226888,"name":"Emily T. Martin","orcid":"0000-0002-5771-8895","position":7,"is_corresponding":false},{"id":264491,"name":"Manjusha Gaglani","orcid":"0000-0002-3952-9230","position":8,"is_corresponding":false},{"id":264489,"name":"Richard K. Zimmerman","orcid":"0000-0001-5941-6092","position":9,"is_corresponding":false},{"id":105916,"name":"H. Keipp Talbot","orcid":"0000-0003-0141-1760","position":10,"is_corresponding":false},{"id":105907,"name":"Carlos G. Grijalva","orcid":"0000-0002-2329-7797","position":11,"is_corresponding":false},{"id":105912,"name":"Edward A. Belongia","orcid":"0000-0001-7478-0415","position":12,"is_corresponding":false},{"id":249372,"name":"Jessie R. Chung","orcid":"0000-0001-5205-966X","position":13,"is_corresponding":false},{"id":590125,"name":"Eric Rogier","orcid":"0000-0001-7375-8304","position":14,"is_corresponding":false},{"id":243250,"name":"Melissa M. Coughlin","orcid":"0000-0003-1843-6251","position":15,"is_corresponding":false},{"id":242317,"name":"Brendan Flannery","orcid":"0000-0001-5041-308X","position":16,"is_corresponding":false},{"id":884907,"name":"Kelsey M. Sumner","orcid":"0000-0002-4479-897X","position":0,"is_corresponding":true}],"reference_count":34,"raw_metadata":null,"created_at":"2026-07-19T02:02:54.415477Z","pmid":"38390968","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}