Association between self-reported signs and symptoms and SARS-CoV-2 antibody detection in UK key workers

Ranya Mulchandani, Sian Taylor-Philips, Hayley E Jones, A E Ades, Ray Borrow , Ezra Linley , Peter D Kirwan, Richard Stewart , Philippa Moore , John Boyes , Anil Hormis, Neil Todd, Antoanela Colda , Ian Reckless, Tim Brooks , Andre Charlett , Matt Hickman, Isabel I Oliver, David Wyllie*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

5 Citations (Scopus)
29 Downloads (Pure)


Background Screening for SARS-CoV-2 antibodies is under way in some key worker groups; how this adds to self-reported COVID-19 illness is unclear. In this study, we investigate the association between self-reported belief of COVID-19 illness and seropositivity. Methods Cross-sectional study of three key worker streams comprising (A) Police and Fire & Rescue (2 sites) (B) healthcare workers (1 site) and (C) healthcare workers with previously positive PCR result (5 sites). We collected self-reported signs and symptoms of COVID-19 and compared this with serology results from two SARS-CoV-2 immunoassays (Roche Elecsys® and EUROIMMUN). Results Between 01 and 26 June, we recruited 2847 individuals (Stream A: 1,247, Stream B: 1,546 and Stream C: 154). Amongst those without previous positive PCR tests, 687/2,579 (26%) reported belief they had COVID-19, having experienced compatible symptoms; however, only 208 (30.3%) of these were seropositive on both immunoassays. Both immunoassays had high sensitivities relative to previous PCR positivity (>93%); there was also limited decline in antibody titres up to 110 days post symptom onset. Symptomatic but seronegative individuals had differing symptom profiles and shorter illnesses than seropositive individuals. Conclusion Non-COVID-19 respiratory illness may have been mistaken for COVID-19 during the outbreak; laboratory testing is more specific than self-reported key worker beliefs in ascertaining past COVID-19 disease.
Original languageEnglish
Pages (from-to)151-161
Number of pages11
JournalJournal of Infection
Issue number5
Publication statusPublished - 25 Mar 2021

Structured keywords

  • Covid19


  • COVID-19
  • United Kingdom
  • antibodies
  • serology
  • symptoms


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