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

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Nat Commun


. 2021 May 11;12(1):2670.
doi: 10.1038/s41467-021-22958-8.
Neutralizing antibody responses to SARS-CoV-2 in symptomatic COVID-19 is persistent and critical for survival


Stefania Dispinseri ¹ , Massimiliano Secchi ^{2 3} , Maria Franca Pirillo ⁴ , Monica Tolazzi ¹ , Martina Borghi ⁵ , Cristina Brigatti ² , Maria Laura De Angelis ⁶ , Marco Baratella ¹ , Elena Bazzigaluppi ² , Giulietta Venturi ⁵ , Francesca Sironi ¹ , Andrea Canitano ⁴ , Ilaria Marzinotto ² , Cristina Tresoldi ⁷ , Fabio Ciceri ^{8 9} , Lorenzo Piemonti ^{2 9} , Donatella Negri ⁵ , Andrea Cara ⁴ , Vito Lampasona ² , Gabriella Scarlatti ¹⁰



Affiliations

• PMID: 33976165
• DOI: 10.1038/s41467-021-22958-8

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.