{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T09:58:19Z","timestamp":1790848699173,"version":"4.1.0"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T00:00:00Z","timestamp":1721174400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["UM1AI068634"],"award-info":[{"award-number":["UM1AI068634"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["UM1AI068636"],"award-info":[{"award-number":["UM1AI068636"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["UM1AI106701"],"award-info":[{"award-number":["UM1AI106701"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["1K08AI15573"],"award-info":[{"award-number":["1K08AI15573"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["5P30AI060354"],"award-info":[{"award-number":["5P30AI060354"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["P30AI152501"],"award-info":[{"award-number":["P30AI152501"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,10,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Reliable biomarkers of coronavirus disease 2019 (COVID-19) outcomes are critically needed. We evaluated associations of spike antibody (Ab) and plasma nucleocapsid antigen (N Ag) with clinical outcomes in nonhospitalized persons with mild-to-moderate COVID-19.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Participants were nonhospitalized adults with mild-to-moderate COVID-19 enrolled in ACTIV-2 between January and July 2021 and randomized to placebo. We used quantitative assays for severe acute respiratory syndrome coronavirus 2 spike Ab and N Ag in blood and determined numbers of hospitalization\/death events within 28 days and time to symptom improvement.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 209 participants, 77 (37%) had quantifiable spike Ab and 139 (67%) quantifiable N Ag. Median age was 50 years; 111 (53%) were female, 182 (87%) White, and 105 (50%) Hispanic\/Latino. Higher risk of hospitalization\/death was seen with unquantifiable (22\/132 [16.7%]) versus quantifiable (1\/77 [1.3%]) spike Ab (risk ratio [RR], 12.83 [95% confidence interval {CI}, 1.76\u201393.34]) and quantifiable (22\/139 [15.8%]) vs unquantifiable (1\/70 [1.4%]) N Ag (RR, 11.08 [95% CI, 1.52\u201380.51]). Increasing risk of hospitalizations\/deaths was seen with increasing N Ag levels. Time to symptom improvement was longer with unquantifiable versus quantifiable spike Ab (median, 14 [interquartile range {IQR}, 8 to &amp;gt;27] vs 8 [IQR, 4\u201322] days; adjusted hazard ratio [aHR], 0.66 [95% CI, .45\u2013.96]) and with quantifiable versus unquantifiable N Ag (median, 12 [7 to &amp;gt;27] vs 10 [5\u201322] days; aHR, 0.79 [95% CI, .52\u20131.21]).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Absence of spike Ab and presence of plasma N Ag predicted hospitalization\/death and delayed symptom improvement in COVID-19 outpatients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Trials Registration<\/jats:title>\n                  <jats:p>NCT04518410<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciae324","type":"journal-article","created":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T18:40:02Z","timestamp":1721241602000},"page":"920-927","source":"Crossref","is-referenced-by-count":3,"title":["SARS-CoV-2 Plasma Antibody and Nucleocapsid Antigen Status Predict Outcomes in Outpatients With COVID-19"],"prefix":"10.1093","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9154-2769","authenticated-orcid":false,"given":"Nikolaus","family":"Jilg","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School , Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2255-9756","authenticated-orcid":false,"given":"Mark J","family":"Giganti","sequence":"additional","affiliation":[{"name":"Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health , Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4865-4348","authenticated-orcid":false,"given":"Kara W","family":"Chew","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, University of California , Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4396-2432","authenticated-orcid":false,"given":"Katy","family":"Shaw-Saliba","sequence":"additional","affiliation":[{"name":"National Institute of Allergy and Infectious Diseases , Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6307-4849","authenticated-orcid":false,"given":"Justin","family":"Ritz","sequence":"additional","affiliation":[{"name":"Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health , Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5601-9112","authenticated-orcid":false,"given":"Carlee","family":"Moser","sequence":"additional","affiliation":[{"name":"Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health , Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa H","family":"Evering","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine , New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1880-7331","authenticated-orcid":false,"given":"Eric S","family":"Daar","sequence":"additional","affiliation":[{"name":"Division of HIV Medicine, The Lundquist Institute, University of California, Los Angeles Center , Torrance, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph J","family":"Eron","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4279-4737","authenticated-orcid":false,"given":"Judith S","family":"Currier","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, University of California , Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D","family":"Hughes","sequence":"additional","affiliation":[{"name":"Center for Biostatistics in AIDS Research, Harvard T. 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Chan School of Public Health , Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9509-1045","authenticated-orcid":false,"given":"H Cliff","family":"Lane","sequence":"additional","affiliation":[{"name":"National Institute of Allergy and Infectious Diseases , Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7840-3155","authenticated-orcid":false,"given":"Robin","family":"Dewar","sequence":"additional","affiliation":[{"name":"Virus Isolation and Serology Laboratory, Frederick National Laboratory , Frederick, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3603-1733","authenticated-orcid":false,"given":"Davey M","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, University of California , San Diego, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9914-9662","authenticated-orcid":false,"given":"Jonathan Z","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School , Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,7,17]]},"reference":[{"key":"2024101519070292100_ciae324-B1","article-title":"Underlying medical conditions associated with higher risk for severe COVID-19: information for healthcare professionals","author":"Centers for Disease Control and Prevention","year":"2024"},{"key":"2024101519070292100_ciae324-B2","doi-asserted-by":"crossref","first-page":"E66","DOI":"10.5888\/pcd18.210123","article-title":"Underlying medical conditions and severe illness among 540,667 adults hospitalized with COVID-19, March 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