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Determinants of pre-vaccination antibody responses to SARS-CoV-2: a population-based longitudinal study (COVIDENCE UK)

Mohammad Talaei Orcid Logo, Sian Faustini Orcid Logo, Hayley Holt, David A. Jolliffe Orcid Logo, Giulia Vivaldi Orcid Logo, Matthew Greenig, Natalia Perdek, Sheena Maltby, Carola M. Bigogno, Jane Symons Orcid Logo, Gwyneth Davies Orcid Logo, Ronan Lyons, Christopher J. Griffiths, Frank Kee Orcid Logo, Aziz Sheikh Orcid Logo, Alex G. Richter Orcid Logo, Seif O. Shaheen Orcid Logo, Adrian R. Martineau Orcid Logo

BMC Medicine, Volume: 20, Issue: 1

Swansea University Authors: Gwyneth Davies Orcid Logo, Ronan Lyons

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DOI (Published version): 10.1186/s12916-022-02286-4

Abstract

BackgroundProspective population-based studies investigating multiple determinants of pre-vaccination antibody responses to SARS-CoV-2 are lacking.MethodsWe did a prospective population-based study in SARS-CoV-2 vaccine-naive UK adults recruited between May 1 and November 2, 2020, without a positive...

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Published in: BMC Medicine
ISSN: 1741-7015
Published: Springer Science and Business Media LLC 2022
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URI: https://cronfa.swan.ac.uk/Record/cronfa70387
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2025-10-27T14:35:32.3743645</datestamp><bib-version>v2</bib-version><id>70387</id><entry>2025-09-18</entry><title>Determinants of pre-vaccination antibody responses to SARS-CoV-2: a population-based longitudinal study (COVIDENCE UK)</title><swanseaauthors><author><sid>92d69cf8519a334ced3f55142c811d95</sid><ORCID>0000-0003-1218-1008</ORCID><firstname>Gwyneth</firstname><surname>Davies</surname><name>Gwyneth Davies</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>83efcf2a9dfcf8b55586999d3d152ac6</sid><firstname>Ronan</firstname><surname>Lyons</surname><name>Ronan Lyons</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2025-09-18</date><deptcode>MEDS</deptcode><abstract>BackgroundProspective population-based studies investigating multiple determinants of pre-vaccination antibody responses to SARS-CoV-2 are lacking.MethodsWe did a prospective population-based study in SARS-CoV-2 vaccine-naive UK adults recruited between May 1 and November 2, 2020, without a positive swab test result for SARS-CoV-2 prior to enrolment. Information on 88 potential sociodemographic, behavioural, nutritional, clinical and pharmacological risk factors was obtained through online questionnaires, and combined IgG/IgA/IgM responses to SARS-CoV-2 spike glycoprotein were determined in dried blood spots obtained between November 6, 2020, and April 18, 2021. We used logistic and linear regression to estimate adjusted odds ratios (aORs) and adjusted geometric mean ratios (aGMRs) for potential determinants of SARS-CoV-2 seropositivity (all participants) and antibody titres (seropositive participants only), respectively.ResultsOf 11,130 participants, 1696 (15.2%) were seropositive. Factors independently associated with higher risk of SARS-CoV-2 seropositivity included frontline health/care occupation (aOR 1.86, 95% CI 1.48&#x2013;2.33), international travel (1.20, 1.07&#x2013;1.35), number of visits to shops and other indoor public places (&#x2265;&#x2009;5 vs. 0/week: 1.29, 1.06&#x2013;1.57, P-trend&#x2009;=&#x2009;0.01), body mass index (BMI) &#x2265;&#x2009;25 vs.&#x2009;&lt;&#x2009;25&#x2009;kg/m2 (1.24, 1.11&#x2013;1.39), South Asian vs. White ethnicity (1.65, 1.10&#x2013;2.49) and alcohol consumption &#x2265;15 vs. 0&#x2009;units/week (1.23, 1.04&#x2013;1.46). Light physical exercise associated with lower risk (0.80, 0.70&#x2013;0.93, for &#x2265;&#x2009;10 vs. 0&#x2013;4&#x2009;h/week). Among seropositive participants, higher titres of anti-Spike antibodies associated with factors including BMI &#x2265;&#x2009;30 vs.&#x2009;&lt;&#x2009;25&#x2009;kg/m2 (aGMR 1.10, 1.02&#x2013;1.19), South Asian vs. White ethnicity (1.22, 1.04&#x2013;1.44), frontline health/care occupation (1.24, 95% CI 1.11&#x2013;1.39), international travel (1.11, 1.05&#x2013;1.16) and number of visits to shops and other indoor public places (&#x2265;&#x2009;5 vs. 0/week: 1.12, 1.02&#x2013;1.23, P-trend&#x2009;=&#x2009;0.01); these associations were not substantially attenuated by adjustment for COVID-19 disease severity.ConclusionsHigher alcohol consumption and lower light physical exercise represent new modifiable risk factors for SARS-CoV-2 infection. Recognised associations between South Asian ethnic origin and obesity and higher risk of SARS-CoV-2 seropositivity were independent of other sociodemographic, behavioural, nutritional, clinical, and pharmacological factors investigated. Among seropositive participants, higher titres of anti-Spike antibodies in people of South Asian ancestry and in obese people were not explained by greater COVID-19 disease severity in these groups.</abstract><type>Journal Article</type><journal>BMC Medicine</journal><volume>20</volume><journalNumber>1</journalNumber><paginationStart/><paginationEnd/><publisher>Springer Science and Business Media LLC</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>1741-7015</issnElectronic><keywords>SARS-CoV-2; Serology; Ethnicity; Diet; Micronutrients; Lifestyle; Exercise; Obesity; Alcohol; Occupation</keywords><publishedDay>22</publishedDay><publishedMonth>2</publishedMonth><publishedYear>2022</publishedYear><publishedDate>2022-02-22</publishedDate><doi>10.1186/s12916-022-02286-4</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><funders>This study was supported by a grant from Barts Charity to ARM and CJG (MGU0466). The work was carried out with the support of BREATHE - The Health Data Research Hub for Respiratory Health (MC_PC_19004) in partnership with SAIL Databank. BREATHE is funded through the UK Research and Innovation Industrial Strategy Challenge Fund and delivered through Health Data Research UK. MT was supported by a grant from the Rosetrees Trust and The Bloom Foundation (M771) until May 2021 and has been supported by the Barts Charity since then (MGU0570). DAJ is supported by a Barts Charity Lectureship (ref MGU045). The views expressed are those of the authors and not necessarily those of Barts Charity, BREATHE, or Health Data Research UK.</funders><projectreference/><lastEdited>2025-10-27T14:35:32.3743645</lastEdited><Created>2025-09-18T11:20:31.6192164</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Health Data Science</level></path><authors><author><firstname>Mohammad</firstname><surname>Talaei</surname><orcid>0000-0002-6901-3665</orcid><order>1</order></author><author><firstname>Sian</firstname><surname>Faustini</surname><orcid>0000-0002-9300-5569</orcid><order>2</order></author><author><firstname>Hayley</firstname><surname>Holt</surname><order>3</order></author><author><firstname>David A.</firstname><surname>Jolliffe</surname><orcid>0000-0003-3592-1945</orcid><order>4</order></author><author><firstname>Giulia</firstname><surname>Vivaldi</surname><orcid>0000-0003-0816-9276</orcid><order>5</order></author><author><firstname>Matthew</firstname><surname>Greenig</surname><order>6</order></author><author><firstname>Natalia</firstname><surname>Perdek</surname><order>7</order></author><author><firstname>Sheena</firstname><surname>Maltby</surname><order>8</order></author><author><firstname>Carola M.</firstname><surname>Bigogno</surname><order>9</order></author><author><firstname>Jane</firstname><surname>Symons</surname><orcid>0000-0003-2535-4545</orcid><order>10</order></author><author><firstname>Gwyneth</firstname><surname>Davies</surname><orcid>0000-0003-1218-1008</orcid><order>11</order></author><author><firstname>Ronan</firstname><surname>Lyons</surname><order>12</order></author><author><firstname>Christopher J.</firstname><surname>Griffiths</surname><order>13</order></author><author><firstname>Frank</firstname><surname>Kee</surname><orcid>0000-0002-0606-8167</orcid><order>14</order></author><author><firstname>Aziz</firstname><surname>Sheikh</surname><orcid>0000-0001-7022-3056</orcid><order>15</order></author><author><firstname>Alex G.</firstname><surname>Richter</surname><orcid>0000-0003-2885-1299</orcid><order>16</order></author><author><firstname>Seif O.</firstname><surname>Shaheen</surname><orcid>0000-0002-7273-8691</orcid><order>17</order></author><author><firstname>Adrian R.</firstname><surname>Martineau</surname><orcid>0000-0001-5387-1721</orcid><order>18</order></author></authors><documents><document><filename>70387__35485__2ac4b4f88e8c48cbb06e1a958b40c49f.pdf</filename><originalFilename>70387.VoR.pdf</originalFilename><uploaded>2025-10-27T14:29:12.1766164</uploaded><type>Output</type><contentLength>1218155</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>&#xA9; The Author(s) 2022. 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spelling 2025-10-27T14:35:32.3743645 v2 70387 2025-09-18 Determinants of pre-vaccination antibody responses to SARS-CoV-2: a population-based longitudinal study (COVIDENCE UK) 92d69cf8519a334ced3f55142c811d95 0000-0003-1218-1008 Gwyneth Davies Gwyneth Davies true false 83efcf2a9dfcf8b55586999d3d152ac6 Ronan Lyons Ronan Lyons true false 2025-09-18 MEDS BackgroundProspective population-based studies investigating multiple determinants of pre-vaccination antibody responses to SARS-CoV-2 are lacking.MethodsWe did a prospective population-based study in SARS-CoV-2 vaccine-naive UK adults recruited between May 1 and November 2, 2020, without a positive swab test result for SARS-CoV-2 prior to enrolment. Information on 88 potential sociodemographic, behavioural, nutritional, clinical and pharmacological risk factors was obtained through online questionnaires, and combined IgG/IgA/IgM responses to SARS-CoV-2 spike glycoprotein were determined in dried blood spots obtained between November 6, 2020, and April 18, 2021. We used logistic and linear regression to estimate adjusted odds ratios (aORs) and adjusted geometric mean ratios (aGMRs) for potential determinants of SARS-CoV-2 seropositivity (all participants) and antibody titres (seropositive participants only), respectively.ResultsOf 11,130 participants, 1696 (15.2%) were seropositive. Factors independently associated with higher risk of SARS-CoV-2 seropositivity included frontline health/care occupation (aOR 1.86, 95% CI 1.48–2.33), international travel (1.20, 1.07–1.35), number of visits to shops and other indoor public places (≥ 5 vs. 0/week: 1.29, 1.06–1.57, P-trend = 0.01), body mass index (BMI) ≥ 25 vs. < 25 kg/m2 (1.24, 1.11–1.39), South Asian vs. White ethnicity (1.65, 1.10–2.49) and alcohol consumption ≥15 vs. 0 units/week (1.23, 1.04–1.46). Light physical exercise associated with lower risk (0.80, 0.70–0.93, for ≥ 10 vs. 0–4 h/week). Among seropositive participants, higher titres of anti-Spike antibodies associated with factors including BMI ≥ 30 vs. < 25 kg/m2 (aGMR 1.10, 1.02–1.19), South Asian vs. White ethnicity (1.22, 1.04–1.44), frontline health/care occupation (1.24, 95% CI 1.11–1.39), international travel (1.11, 1.05–1.16) and number of visits to shops and other indoor public places (≥ 5 vs. 0/week: 1.12, 1.02–1.23, P-trend = 0.01); these associations were not substantially attenuated by adjustment for COVID-19 disease severity.ConclusionsHigher alcohol consumption and lower light physical exercise represent new modifiable risk factors for SARS-CoV-2 infection. Recognised associations between South Asian ethnic origin and obesity and higher risk of SARS-CoV-2 seropositivity were independent of other sociodemographic, behavioural, nutritional, clinical, and pharmacological factors investigated. Among seropositive participants, higher titres of anti-Spike antibodies in people of South Asian ancestry and in obese people were not explained by greater COVID-19 disease severity in these groups. Journal Article BMC Medicine 20 1 Springer Science and Business Media LLC 1741-7015 SARS-CoV-2; Serology; Ethnicity; Diet; Micronutrients; Lifestyle; Exercise; Obesity; Alcohol; Occupation 22 2 2022 2022-02-22 10.1186/s12916-022-02286-4 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Another institution paid the OA fee This study was supported by a grant from Barts Charity to ARM and CJG (MGU0466). The work was carried out with the support of BREATHE - The Health Data Research Hub for Respiratory Health (MC_PC_19004) in partnership with SAIL Databank. BREATHE is funded through the UK Research and Innovation Industrial Strategy Challenge Fund and delivered through Health Data Research UK. MT was supported by a grant from the Rosetrees Trust and The Bloom Foundation (M771) until May 2021 and has been supported by the Barts Charity since then (MGU0570). DAJ is supported by a Barts Charity Lectureship (ref MGU045). The views expressed are those of the authors and not necessarily those of Barts Charity, BREATHE, or Health Data Research UK. 2025-10-27T14:35:32.3743645 2025-09-18T11:20:31.6192164 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Mohammad Talaei 0000-0002-6901-3665 1 Sian Faustini 0000-0002-9300-5569 2 Hayley Holt 3 David A. Jolliffe 0000-0003-3592-1945 4 Giulia Vivaldi 0000-0003-0816-9276 5 Matthew Greenig 6 Natalia Perdek 7 Sheena Maltby 8 Carola M. Bigogno 9 Jane Symons 0000-0003-2535-4545 10 Gwyneth Davies 0000-0003-1218-1008 11 Ronan Lyons 12 Christopher J. Griffiths 13 Frank Kee 0000-0002-0606-8167 14 Aziz Sheikh 0000-0001-7022-3056 15 Alex G. Richter 0000-0003-2885-1299 16 Seif O. Shaheen 0000-0002-7273-8691 17 Adrian R. Martineau 0000-0001-5387-1721 18 70387__35485__2ac4b4f88e8c48cbb06e1a958b40c49f.pdf 70387.VoR.pdf 2025-10-27T14:29:12.1766164 Output 1218155 application/pdf Version of Record true © The Author(s) 2022. This article is licensed under a Creative Commons Attribution 4.0 International License. true eng http://creativecommons.org/licenses/by/4.0/
title Determinants of pre-vaccination antibody responses to SARS-CoV-2: a population-based longitudinal study (COVIDENCE UK)
spellingShingle Determinants of pre-vaccination antibody responses to SARS-CoV-2: a population-based longitudinal study (COVIDENCE UK)
Gwyneth Davies
Ronan Lyons
title_short Determinants of pre-vaccination antibody responses to SARS-CoV-2: a population-based longitudinal study (COVIDENCE UK)
title_full Determinants of pre-vaccination antibody responses to SARS-CoV-2: a population-based longitudinal study (COVIDENCE UK)
title_fullStr Determinants of pre-vaccination antibody responses to SARS-CoV-2: a population-based longitudinal study (COVIDENCE UK)
title_full_unstemmed Determinants of pre-vaccination antibody responses to SARS-CoV-2: a population-based longitudinal study (COVIDENCE UK)
title_sort Determinants of pre-vaccination antibody responses to SARS-CoV-2: a population-based longitudinal study (COVIDENCE UK)
author_id_str_mv 92d69cf8519a334ced3f55142c811d95
83efcf2a9dfcf8b55586999d3d152ac6
author_id_fullname_str_mv 92d69cf8519a334ced3f55142c811d95_***_Gwyneth Davies
83efcf2a9dfcf8b55586999d3d152ac6_***_Ronan Lyons
author Gwyneth Davies
Ronan Lyons
author2 Mohammad Talaei
Sian Faustini
Hayley Holt
David A. Jolliffe
Giulia Vivaldi
Matthew Greenig
Natalia Perdek
Sheena Maltby
Carola M. Bigogno
Jane Symons
Gwyneth Davies
Ronan Lyons
Christopher J. Griffiths
Frank Kee
Aziz Sheikh
Alex G. Richter
Seif O. Shaheen
Adrian R. Martineau
format Journal article
container_title BMC Medicine
container_volume 20
container_issue 1
publishDate 2022
institution Swansea University
issn 1741-7015
doi_str_mv 10.1186/s12916-022-02286-4
publisher Springer Science and Business Media LLC
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
document_store_str 1
active_str 0
description BackgroundProspective population-based studies investigating multiple determinants of pre-vaccination antibody responses to SARS-CoV-2 are lacking.MethodsWe did a prospective population-based study in SARS-CoV-2 vaccine-naive UK adults recruited between May 1 and November 2, 2020, without a positive swab test result for SARS-CoV-2 prior to enrolment. Information on 88 potential sociodemographic, behavioural, nutritional, clinical and pharmacological risk factors was obtained through online questionnaires, and combined IgG/IgA/IgM responses to SARS-CoV-2 spike glycoprotein were determined in dried blood spots obtained between November 6, 2020, and April 18, 2021. We used logistic and linear regression to estimate adjusted odds ratios (aORs) and adjusted geometric mean ratios (aGMRs) for potential determinants of SARS-CoV-2 seropositivity (all participants) and antibody titres (seropositive participants only), respectively.ResultsOf 11,130 participants, 1696 (15.2%) were seropositive. Factors independently associated with higher risk of SARS-CoV-2 seropositivity included frontline health/care occupation (aOR 1.86, 95% CI 1.48–2.33), international travel (1.20, 1.07–1.35), number of visits to shops and other indoor public places (≥ 5 vs. 0/week: 1.29, 1.06–1.57, P-trend = 0.01), body mass index (BMI) ≥ 25 vs. < 25 kg/m2 (1.24, 1.11–1.39), South Asian vs. White ethnicity (1.65, 1.10–2.49) and alcohol consumption ≥15 vs. 0 units/week (1.23, 1.04–1.46). Light physical exercise associated with lower risk (0.80, 0.70–0.93, for ≥ 10 vs. 0–4 h/week). Among seropositive participants, higher titres of anti-Spike antibodies associated with factors including BMI ≥ 30 vs. < 25 kg/m2 (aGMR 1.10, 1.02–1.19), South Asian vs. White ethnicity (1.22, 1.04–1.44), frontline health/care occupation (1.24, 95% CI 1.11–1.39), international travel (1.11, 1.05–1.16) and number of visits to shops and other indoor public places (≥ 5 vs. 0/week: 1.12, 1.02–1.23, P-trend = 0.01); these associations were not substantially attenuated by adjustment for COVID-19 disease severity.ConclusionsHigher alcohol consumption and lower light physical exercise represent new modifiable risk factors for SARS-CoV-2 infection. Recognised associations between South Asian ethnic origin and obesity and higher risk of SARS-CoV-2 seropositivity were independent of other sociodemographic, behavioural, nutritional, clinical, and pharmacological factors investigated. Among seropositive participants, higher titres of anti-Spike antibodies in people of South Asian ancestry and in obese people were not explained by greater COVID-19 disease severity in these groups.
published_date 2022-02-22T14:18:32Z
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