Non-infectious status indicated by detectable IgG antibody to SARS-CoV-2

Br Dent J. 2020 Oct;229(8):521-524. doi: 10.1038/s41415-020-2228-9. Epub 2020 Oct 23.

Abstract

A key tenet of protection from infection for dentists is to know who is not infectious. The evidence base regarding protection from respiratory pathogens in dentistry is poor. Those with a positive SARS-CoV-2 IgG antibody are non-infectious (>99% certainty) and can be safely treated with good universal precautions, even for aerosol generating procedures. Viral infectivity with SARS-CoV-2 lasts eight days, unlike viral polymerase chain reaction (PCR) swab tests which can persist for as long as seven weeks. SARS-CoV-2 IgG antibody becomes detectable from 11 days after infection. SARS-CoV-2 IgG antibodies are usually neutralising against the virus and their direct antiviral activity was partially demonstrated in 33,000 patients with COVID-19 treated with convalescent plasma in the USA. So, a positive SARS-CoV-2 IgG antibody is a much more accurate determination of infectiousness than a repeat PCR which is only 70% sensitive. It remains to be seen whether SARS-Cov-2 vaccine responses include protective IgG titres and, once vaccines become widespread, can be used to assist decision-making on appropriate personal protective equipment (PPE) in dentistry.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Viral
  • Betacoronavirus
  • COVID-19
  • COVID-19 Serotherapy
  • COVID-19 Vaccines
  • Coronavirus Infections* / prevention & control
  • Coronavirus Infections* / therapy
  • Humans
  • Immunization, Passive
  • Immunoglobulin G
  • Pandemics*
  • Pneumonia, Viral*
  • SARS-CoV-2
  • Severe acute respiratory syndrome-related coronavirus*
  • Viral Vaccines

Substances

  • Antibodies, Viral
  • COVID-19 Vaccines
  • Immunoglobulin G
  • Viral Vaccines