Cell Host & Microbe
Volume 29, Issue 6, 9 June 2021, Pages 917-929.e4
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Article
Kinetics and correlates of the neutralizing antibody response to SARS-CoV-2 infection in humans

https://doi.org/10.1016/j.chom.2021.04.015Get rights and content
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Highlights

  • 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

Summary

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.

Keywords

COVID-19
SARS-CoV-2 infection
antibody response
neutralizing antibodies
antibody kinetics
longitudinal cohort
correlates of neutralization
IgG
serum

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