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Detailed Multiplex Analysis of SARS-CoV-2 Specific Antibodies in COVID-19 Disease

Detailed Multiplex Analysis of SARS-CoV-2 Specific Antibodies in COVID-19 Disease

Title: Detailed Multiplex Analysis of SARS-CoV-2 Specific Antibodies in COVID-19 Disease
Author: Brynjólfsson, Siggeir Fannar
Sigurgrímsdóttir, Hildur
Einarsdóttir, Elín D.
Björnsdóttir, Guðrún Ása
Ármannsdóttir, Brynja
Baldvinsdóttir, Guðrún E.
Bjarnason, Agnar   orcid.org/0000-0002-2892-3304
Guðlaugsson, Ólafur
Guðmundsson, Sveinn Viðar
Sigurðardóttir, Sigurveig T.
... 3 more authors Show all authors
Date: 2021-06-10
Language: English
Scope: 695230
University/Institute: Landspitali - The National University Hospital of Iceland
Department: Faculty of Medicine
Clinical Laboratory Services, Diagnostics and Blood Bank
Internal Medicine and Emergency Services
Other departments
Series: Frontiers in Immunology; 12()
ISSN: 1664-3224
DOI: https://doi.org/10.3389/fimmu.2021.695230
Subject: COVID-19; Mótefni; antibodies; COVID-19; IgA; IgG; IgM; multiplex; SARS-CoV-2; Immunoglobulin G/metabolism; Protein Domains/immunology; Spike Glycoprotein, Coronavirus/immunology; Antibodies, Viral/metabolism; Humans; Middle Aged; COVID-19/immunology; Male; Immunoglobulin A/metabolism; Immunoglobulin M/metabolism; SARS-CoV-2/immunology; Antibody Formation; Adult; Female; Aged; Immunology and Allergy; Immunology
URI: https://hdl.handle.net/20.500.11815/2850

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Brynjólfsson , S F , Sigurgrímsdóttir , H , Einarsdóttir , E D , Björnsdóttir , G Á , Ármannsdóttir , B , Baldvinsdóttir , G E , Bjarnason , A , Guðlaugsson , Ó , Guðmundsson , S V , Sigurðardóttir , S T , Löve , A , Kristinsson , K G & Lúðvíksson , B R 2021 , ' Detailed Multiplex Analysis of SARS-CoV-2 Specific Antibodies in COVID-19 Disease ' , Frontiers in Immunology , vol. 12 , 695230 , pp. 695230 . https://doi.org/10.3389/fimmu.2021.695230


A detailed understanding of the antibody response against SARS-CoV-2 is of high importance, especially with the emergence of novel vaccines. A multiplex-based assay, analyzing IgG, IgM, and IgA antibodies against the receptor binding domain (RBD), spike 1 (S1), and nucleocapsid proteins of the SARS-CoV-2 virus was set up. The multiplex-based analysis was calibrated against the Elecsys® Anti-SARS-CoV-2 assay on a Roche Cobas® instrument, using positive and negative samples. The calibration of the multiplex based assay yielded a sensitivity of 100% and a specificity of 97.7%. SARS-CoV-2 specific antibody levels were analyzed by multiplex in 251 samples from 221 patients. A significant increase in all antibody types (IgM, IgG, and IgA) against RBD was observed between the first and the third weeks of disease. Additionally, the S1 IgG antibody response increased significantly between weeks 1, 2, and 3 of disease. Class switching appeared to occur earlier for IgA than for IgG. Patients requiring hospital admission and intensive care had higher levels of SARS-CoV-2 specific IgA levels than outpatients. These findings describe the initial antibody response during the first weeks of disease and demonstrate the importance of analyzing different antibody isotypes against multiple antigens and include IgA when examining the immunological response to COVID-19.


This work was supported in part by The Student Innovation Fund. The funding body had no role in the design of the study, collection, analysis, interpretation of data or writing of the manuscript. Funding Information: We would like to thank Runólfur Pálsson and Elías Eyþórsson for their assistance with the patient demographics. The Department of Clinical Microbiology for their assistance and last but not least the patients. Publisher Copyright: © Copyright © 2021 Brynjolfsson, Sigurgrimsdottir, Einarsdottir, Bjornsdottir, Armannsdottir, Baldvinsdottir, Bjarnason, Gudlaugsson, Gudmundsson, Sigurdardottir, Love, Kristinsson and Ludviksson.

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