{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T12:30:20Z","timestamp":1775478620122,"version":"3.50.1"},"posted":{"date-parts":[[2020,4,24]]},"group-title":"Infectious Diseases (except HIV\/AIDS)","reference-count":32,"publisher":"openRxiv","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2020,4,24]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>SARS-CoV-2, the cause of coronavirus disease 2019 (COVID-19), is associated with respiratory-related morbidity and mortality. Assays to detect virus-specific antibodies are important to understand the prevalence of infection and the course of the immune response.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methodology<\/jats:title>\n                  <jats:p>Quantitative measurements of plasma or serum antibodies by luciferase immunoprecipitation assay systems (LIPS) to the nucleocapsid and spike proteins were analyzed in 100 cross-sectional or longitudinal samples from SARS-CoV-2-infected patients. A subset of samples was tested with and without heat inactivation.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Fifteen or more days after symptom onset, antibodies against SARS-CoV-2 nucleocapsid protein showed 100% sensitivity and 100% specificity, while antibodies to spike protein were detected with 91% sensitivity and 100% specificity. Neither antibody levels nor the rate of seropositivity were significantly reduced by heat inactivation of samples. Analysis of daily samples from six patients with COVID-19 showed anti-nucleocapsid and spike antibodies appearing between day 8 to day 14 after initial symptoms. Immunocompromised patients generally had a delayed antibody response to SARS-CoV-2 compared to immunocompetent patients.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Antibody to the nucleocapsid protein of SARS-CoV-2 is more sensitive than spike protein antibody for detecting early infection. Analyzing heat-inactivated samples by LIPS is a safe and sensitive method for detecting SARS-CoV-2 antibodies.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2020.04.20.20071423","type":"posted-content","created":{"date-parts":[[2020,4,24]],"date-time":"2020-04-24T11:25:12Z","timestamp":1587727512000},"source":"Crossref","is-referenced-by-count":91,"title":["Detection of Nucleocapsid Antibody to SARS-CoV-2 is More Sensitive than Antibody to Spike Protein in COVID-19 Patients"],"prefix":"10.64898","author":[{"given":"Peter D.","family":"Burbelo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francis X.","family":"Riedo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chihiro","family":"Morishima","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Rawlings","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davey","family":"Smith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanchita","family":"Das","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey R.","family":"Strich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel S.","family":"Chertow","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr.","given":"Richard T.","family":"Davey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey I.","family":"Cohen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2020120511400838000_2020.04.20.20071423v1.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30154-9"},{"key":"2020120511400838000_2020.04.20.20071423v1.2","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-020-2008-3"},{"key":"2020120511400838000_2020.04.20.20071423v1.3","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-020-2012-7"},{"key":"2020120511400838000_2020.04.20.20071423v1.4","doi-asserted-by":"publisher","DOI":"10.1080\/22221751.2020.1725399"},{"key":"2020120511400838000_2020.04.20.20071423v1.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30211-7"},{"key":"2020120511400838000_2020.04.20.20071423v1.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30183-5"},{"key":"2020120511400838000_2020.04.20.20071423v1.7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2001017"},{"key":"2020120511400838000_2020.04.20.20071423v1.8","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-018-0118-9"},{"key":"2020120511400838000_2020.04.20.20071423v1.9","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2001191"},{"key":"2020120511400838000_2020.04.20.20071423v1.10","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2001737"},{"key":"2020120511400838000_2020.04.20.20071423v1.11","unstructured":"To KK , Tsang OT , Leung WS et al. 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