![]() ![]() Further, the hospitalized group had higher seroprevalence rates for cytomegalovirus and herpes simplex virus 1. We stratified the COVID-19 patient samples by disease severity and found that patients who had required hospitalization exhibited stronger and broader antibody responses to SARS-CoV-2 but weaker overall responses to past infections compared with those who did not need hospitalization. We used the most discriminatory SARS-CoV-2 peptides to produce a Luminex-based serological assay, which performed similarly to gold-standard enzyme-linked immunosorbent assays. We developed a machine learning model that predicted SARS-CoV-2 exposure history with 99% sensitivity and 98% specificity from VirScan data. Several of these cross-reacting antibodies are present in pre–COVID-19 era samples. We identified epitopes ranging from “private” (recognized by antibodies in only a small number of individuals) to “public” (recognized by antibodies in many individuals) and detected SARS-CoV-2–specific epitopes as well as those that cross-react with common-cold coronaviruses. We screened sera from 232 COVID-19 patients and 190 pre–COVID-19 era controls against the original VirScan and supplemental coronavirus libraries, assaying more than 10 8 antibody repertoire–peptide interactions. Elledge +34 authors +32 authors +27 authors fewer Authors Info & Affiliations Chu, MGH COVID-19 Collection & Processing Team, Alexandra-Chloé Villani, Kyle Kays, Marcia B. Clarke, Patrizio Caturegli, Oliver Laeyendecker, Alicja Piechocka-Trocha, Jonathan Z. Monaco, Meghan Travers, Shaghayegh Habibi, William A. Li, , Yuezhou Chen, Jennifer Logue, Adam Zuiani, Denise McCulloch, Felipe J. Timms, , I-Hsiu Lee, Yumei Leng, Matthew L. Ellen Shrock, Eric Fujimura, , Tomasz Kula, Richard T. ![]()
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