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Clin Immunol
. 2022 Feb 23;236:108959.
doi: 10.1016/j.clim.2022.108959. Online ahead of print.
Effect of monoclonal antibody therapy on the endogenous SARS-CoV-2 antibody response
Paul S Kim 1 , Derek E Dimcheff 1 , Andrew Siler 2 , Richard J Schildhouse 1 , Stephen W Chensue 3
Affiliations
- PMID: 35218964
- PMCID: PMC8866167
- DOI: 10.1016/j.clim.2022.108959
Abstract
Monoclonal antibody treatment of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has been widely implemented. Effects of treatment on the endogenous primary humoral response to the virus are unknown. A retrospective cohort study performed at a Veterans Health Administration medical center compared serologic responses of treated and untreated COVID-19 patients at high risk for severe outcomes. Three anti-viral spike protein IgG monoclonal treatments were used during the study period, 1) bamlanivimab, 2) casirivimab with imdevimab, and 3) bamlanivimab with etesevimab. Data were analyzed at acute (0-9 days), seroconversion (10-19 days), and maximum antibody (20-39 days) stages. SARS-Cov-2 infection induced a dynamic primary humoral response with anti-spike IgM and anti-nucleocapsid IgG seroconversion occurring after 9 days with maximum serologic indices achieved by 20-39 days. All monoclonal antibody treatments suppressed the endogenous anti-spike IgM response by 85-90% with minor effect on the anti-nucleocapsid response. Thus, passive immunization therapy may cause immunologic interference.
Keywords: COVID-19; Humoral immunity; Monoclonal antibody; Passive immunization; SARS-CoV-2.