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COVID-19 antibody testing study: a nested substudy within Alberta s Tomorrow
Project (ATP) in Alberta, Canada
#MMPMID41248356
Nejatinamini S
; Charlton C
; Harman S
; Kanji JN
; Kellner JD
; Lines K
; Murdoch K
; Powell W
; Roberts J
; Rosner W
; Shen-Tu G
; Tipples G
; Xu JY
; Vena JE
BMJ Open
2025[Nov]; 15
(11
): e101336
PMID41248356
show ga
PURPOSE: The Alberta's Tomorrow Project (ATP) prospective cohort study was
established in 2000 to investigate the causes of cancer and chronic disease. The
cohort consists of almost 55?000 participants aged 35-69 years at the time of
recruitment. From 2020 to 2022, ATP conducted a longitudinal substudy, the
COVID-19 Antibody Testing (CAT) study, nested in this existing cohort, to
understand the spread and impact of the SARS-CoV-2. In this cohort profile, we
describe the CAT study design, recruitment and initial findings. PARTICIPANTS: In
this prospective cohort substudy, ~4000 participants completed online surveys and
provided blood samples at a study centre every 4?months for 1 year, across four
cities in Alberta, Canada. The study was launched on a rolling basis beginning in
September 2020 and data collection was completed in May 2022. The surveys
collected information on health and lifestyle factors, COVID-19 (testing,
symptoms, vaccination, public health recommendations) and impacts of the pandemic
(including economic, health services, mental health). Blood samples were tested
for antinucleocapsid and antispike protein SARS-CoV-2 antibodies. FINDINGS TO
DATE: A total of 4102 participants consented and attended a study centre at
baseline, and almost 90% of these completed the study. Overall, participants were
aged 61±10 years, 60% female, 12% came from rural areas, 45% had at least a
bachelor's degree, 24% reported a household income <$C75 000 and 39% were
retired. About 15% of participants tested positive for antibodies induced by a
SARS-CoV-2 infection over the course of the study, and about 18% of those who
were infected reported long COVID (persistent symptoms for >4 weeks). By the end
of the study, 96% of participants had received at least one COVID-19 vaccine
dose. Through investigating other outcomes, it was observed that participants
under 50 years of age were more likely to be assessed to have mild or
moderate-to-severe anxiety and depressive symptoms compared with older
participants. In addition, approximately 15% of participants reported a moderate
to major impact on their ability to meet financial obligations. FUTURE PLANS:
Serology results, together with health, lifestyle and sociodemographic data, and
the continued follow-up of these participants as part of the broader ATP cohort
study (planned through 2065), will provide opportunities to investigate the
long-term sequelae of COVID-19 infection as well as the broader impacts of the
pandemic on physical, mental and emotional health. Data are available to
researchers on request through the ATP access process.
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