Comparative Analysis of Nucleocapsid- and Spike-Specific Isotype Humoral Immune Responses Following Natural SARS-CoV-2 Infection and Vaccination with Sinopharm, Sinovac, and AstraZeneca.

The diversity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine platforms and widespread natural exposure have created a complex landscape of humoral immunity requiring detailed characterization. Here, we compare nucleocapsid (N)- and spike (S)-specific antibody responses in sera from infected humans (IH) during the first pandemic wave (April-August 2020) and in vaccine recipients (Sinopharm, Sinovac, or AstraZeneca) using commercial ELISA kits. Among naturally IH, the IgG-positivity rate was higher for N (80.9%) than S (42.8%), with significantly elevated N-specific IgG levels compared to prepandemic controls (p-value <0.05), while IgM responses showed no significant differences. Strong positive correlations were observed between S- and N-specific antibody responses, particularly for IgG and its subclasses. Vaccinated cohorts exhibited high IgG positivity rate (83-100%) against both antigens with low IgM levels, and overall IgG and subclass responses were significantly elevated relative to pre-pandemic controls (p-value <0.05), with consistently strong inter-antigen correlations across groups. Overall, natural infection induces a coordinated humoral response biased toward the nucleocapsid antigen, supporting its utility as a marker of recent infection, whereas vaccination elicits a robust multi-subclass antibody response with platform-dependent differences in antigen recognition and subclass distribution.