Journal article
The relationship between psychological stress and SARS-CoV-2 nucleocapsid-antibody response following natural infection: Longitudinal findings from the Aegis Study
American journal of epidemiology
03/06/2026
DOI: 10.1093/aje/kwag048
PMID: 41789947
Abstract
Psychological stress can cause diminished immune response to infectious challenges. The extent this holds true during SARS-CoV-2 infection and the modifying effect of vaccination status is untested. We explored these relationships in a non-random sample standardized to the U.S. adult population. Across 2178 participants in the Aegis Study (2021-2022), we identified 507 eligible laboratory-confirmed SARS-CoV-2 infections. We estimated the natural log of nucleocapsid-binding antibody absorbance (N-antibody) at study visits up to 225 days following a positive SARS-CoV-2 test. Linear mixed effects models were fit to estimate the association of baseline perceived stress and, separately, allostatic load with N-antibody trajectories. Standardization was performed using iterative post-stratification weighting. Consistently, lower stress groups had higher N-antibody response. Low perceived stress was associated with greater antibody response up to 26 days post-positive test (P = 0.047) while low allostatic load was associated with greater antibody response up to 24 days (P = 0.049). Pre-infection vaccination modified the relationship between stress and N-antibody trajectories, where the observed relationships attenuated to the null for vaccinated individuals (P = 0.031). Overall, we found consistent evidence that high stress was associated with reduced N-antibody response following SARS-CoV-2 infection and that vaccination may narrow the antibody response across high versus low stress groups.
Details
- Title: Subtitle
- The relationship between psychological stress and SARS-CoV-2 nucleocapsid-antibody response following natural infection: Longitudinal findings from the Aegis Study
- Creators
- Erika T Beidelman - Indiana University BloomingtonAshley Judge - Indiana University BloomingtonDavid B Allison - Indiana University BloomingtonStephanie Dickinson - Indiana University BloomingtonLilian Golzarri Arroyo - Indiana University BloomingtonAnna L M Macagno - Indiana University BloomingtonMichael J Ricciardi - NoblisJon Macy - Indiana University BloomingtonStanley Perlman - University of IowaChristina Ludema - Indiana University BloomingtonKevin C Maki - Indiana University BloomingtonMolly Rosenberg - Indiana University
- Resource Type
- Journal article
- Publication Details
- American journal of epidemiology
- DOI
- 10.1093/aje/kwag048
- PMID
- 41789947
- NLM abbreviation
- Am J Epidemiol
- ISSN
- 1476-6256
- eISSN
- 1476-6256
- Publisher
- Oxford University Press
- Grant note
- multiple anonymous donations to the IU Foundation and by Eli Lilly and Company
This work was supported by multiple anonymous donations to the IU Foundation and by Eli Lilly and Company.
- Language
- English
- Electronic publication date
- 03/06/2026
- Academic Unit
- Microbiology and Immunology; Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Infectious Disease (Pediatrics)
- Record Identifier
- 9985141874202771
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