Kinetics and correlates of the neutralizing antibody response to SARS-CoV-2 infection in humans

• Published in: Cell host & microbe Vol. 29; no. 6; pp. 917 - 929.e4
• Main Authors: Vanshylla, Kanika, Di Cristanziano, Veronica, Kleipass, Franziska, Dewald, Felix, Schommers, Philipp, Gieselmann, Lutz, Gruell, Henning, Schlotz, Maike, Ercanoglu, Meryem S., Stumpf, Ricarda, Mayer, Petra, Zehner, Matthias, Heger, Eva, Johannis, Wibke, Horn, Carola, Suárez, Isabelle, Jung, Norma, Salomon, Susanne, Eberhardt, Kirsten Alexandra, Gathof, Birgit, Fätkenheuer, Gerd, Pfeifer, Nico, Eggeling, Ralf, Augustin, Max, Lehmann, Clara, Klein, Florian
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 09.06.2021
• Subjects: Adolescent; Adult; Aged; Antibodies, Neutralizing - immunology; Antibodies, Viral - immunology; antibody kinetics; antibody response; Cohort Studies; correlates of neutralization; COVID-19; COVID-19 - immunology; Female; Humans; IgG; Immunoglobulin G - immunology; longitudinal cohort; Male; Middle Aged; neutralizing antibodies; SARS-CoV-2; SARS-CoV-2 infection; serum; Time Factors; Young Adult; COVID-19; antibody response; correlates of neutralization; SARS-CoV-2 infection; antibody kinetics; IgG; neutralizing antibodies; serum; longitudinal cohort
• ISSN: 1931-3128; 1934-6069; 1934-6069
• DOI: 10.1016/j.chom.2021.04.015

Understanding antibody-based SARS-CoV-2 immunity is critical for overcoming the COVID-19 pandemic and informing vaccination strategies. We evaluated SARS-CoV-2 antibody dynamics over 10 months in 963 individuals who predominantly experienced mild COVID-19. Investigating 2,146 samples, we initially detected SARS-CoV-2 antibodies in 94.4% of individuals, with 82% and 79% exhibiting serum and IgG neutralization, respectively. Approximately 3% of individuals demonstrated exceptional SARS-CoV-2 neutralization, with these “elite neutralizers” also possessing SARS-CoV-1 cross-neutralizing IgG. Multivariate statistical modeling revealed age, symptomatic infection, disease severity, and gender as key factors predicting SARS-CoV-2-neutralizing activity. A loss of reactivity to the virus spike protein was observed in 13% of individuals 10 months after infection. Neutralizing activity had half-lives of 14.7 weeks in serum versus 31.4 weeks in purified IgG, indicating a rather long-term IgG antibody response. Our results demonstrate a broad spectrum in the initial SARS-CoV-2-neutralizing antibody response, with sustained antibodies in most individuals for 10 months after mild COVID-19. [Display omitted] •Broad variation in neutralizing antibodies in SARS-CoV-2-convalescent individuals•∼3% of individuals showed a potent antibody response with SARS-CoV-1 cross-reactivity•Older age, symptoms, and severe disease predict higher SARS-CoV-2 neutralization•Serum and IgG neutralization half-lives were 14.7 and 31.4 weeks, respectively Vanshylla et al. report longitudinal antibody kinetics in a mainly mild COVID-19 convalescent cohort of 963 individuals. There is broad variation in the initial response with older age and disease severity predicting higher SARS-CoV-2 neutralizing activity. Neutralizing IgG antibodies are detectable for up to 10 months in the majority of individuals.