Neutralizing antibody responses to SARS-CoV-2 in symptomatic COVID-19 is persistent and critical for survival.

Abstract

Understanding how antibody responses to SARS-CoV-2 evolve during infection may provide important insight into therapeutic approaches and vaccination for COVID-19. Here we profile the antibody responses of 162 COVID-19 symptomatic patients in the COVID-BioB cohort followed longitudinally for up to eight months from symptom onset to find SARS-CoV-2 neutralization, as well as antibodies either recognizing SARS-CoV-2 spike antigens and nucleoprotein, or specific for S2 antigen of seasonal beta-coronaviruses and hemagglutinin of the H1N1 flu virus. The presence of neutralizing antibodies within the first weeks from symptoms onset correlates with time to a negative swab result (p = 0.002), while the lack of neutralizing capacity correlates with an increased risk of a fatal outcome (p = 0.008). Neutralizing antibody titers progressively drop after 5-8 weeks but are still detectable up to 8 months in the majority of recovered patients regardless of age or co-morbidities, with IgG to spike antigens providing the best correlate of neutralization. Antibody responses to seasonal coronaviruses are temporarily boosted, and parallel those to SARS-CoV-2 without dampening the specific response or worsening disease progression. Our results thus suggest compromised immune responses to the SARS-CoV-2 spike to be a major trait of COVID-19 patients with critical conditions, and thereby inform on the planning of COVID-19 patient care and therapy prioritization.

• Authors: Stefania Dispinseri, Massimiliano Secchi, Maria Franca Pirillo, Monica Tolazzi, Martina Borghi, Cristina Brigatti, Maria Laura De Angelis, Marco Baratella, Elena Bazzigaluppi, Giulietta Venturi, Francesca Sironi, Andrea Canitano, Ilaria Marzinotto, Cristina Tresoldi, Fabio Ciceri, Lorenzo Piemonti, Donatella Negri, Andrea Cara, Vito Lampasona, Gabriella Scarlatti
• Journal: Nature communications (Nat Commun) Vol. 12 Issue 1 Pg. 2670 (05 11 2021) ISSN: 2041-1723 [Electronic] England
• PMID: 33976165 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Neutralizing
• Antibodies, Viral
• Immunoglobulin G
• Spike Glycoprotein, Coronavirus
• spike protein, SARS-CoV-2

Topics

• Aged
• Antibodies, Neutralizing (immunology)
• Antibodies, Viral (immunology)
• Antibody Formation
• Betacoronavirus (immunology)
• COVID-19 (immunology, mortality, virology)
• Female
• Humans
• Immunoglobulin G (immunology)
• Kinetics
• Longitudinal Studies
• Male
• Middle Aged
• Neutralization Tests
• SARS-CoV-2 (immunology, isolation & purification)
• Spike Glycoprotein, Coronavirus (immunology)
• Survival Rate