Dynamics of IgG seroconversion and pathophysiology of COVID-19 infections


We report dynamics of seroconversion to SARS-CoV-2 infections detected by IgG ELISA in 177 individuals diagnosed by RT-PCR. Longitudinal analysis identifies 2-8.5% of individuals who do not seroconvert even weeks after infection. They are younger than seroconverters who have increased co-morbidity and higher inflammatory markers such as C-Reactive Protein. Higher antibody responses are associated with non-white ethnicity. Antibody responses do not decline during follow up almost to 2 months. Serological assays increase understanding of disease severity. Their application in regular surveillance will clarify the duration and protective nature of humoral responses to SARS-CoV-2.

Competing Interest Statement

SK is a member of the Scientific Advisory Committee for the Foundation for Innovative New Diagnostics (FIND) a not-for-profit organisation that produces global guidance on affordable diagnostics. The views expressed here are personal opinions and do not represent the recommendations of FIND.

Clinical Trial

Cclinicaltrials.gov NCT04351646.

Funding Statement

This study was supported by a DFID/Wellcome Trust Epidemic Preparedness coronavirus grant (220764/Z/20/Z) to JRAF, SK, HMS, ERA, LEC. HMS is supported by the Wellcome Trust Institutional Strategic Support Fund (204809/Z/16/Z) awarded to St Georges University of London.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.


The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Institutional Review Board ethical approval (DARTS study – IRAS project ID: 282104; REC reference: 20/SC/0171).

All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.


I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).


I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.


Data Availability

Supplementary data for methods and results referred to in the manuscript is submitted together with the manuscript.

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