Lancet correspondence - Neutralisation sensitivity of the SARS-CoV-2 XBB.1 lineage

[sharon sanders]

Neutralisation sensitivity of the SARS-CoV-2 XBB.1 lineage

• Prerna Arora
• Anne Cossmann
• Sebastian R Schulz
• Gema Morillas Ramos
• Metodi V Stankov
• Hans-Martin Jäck
• et al.
• Show all authors

Published:January 05, 2023DOI:https://doi.org/10.1016/S1473-3099(22)00831-3


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Finally, we assessed the sensitivity of XBB.1_pp to neutralisation by antibodies induced by vaccination or vaccination plus breakthrough infection (figure B; appendix pp 1–2). Plasma of triple vaccinated individuals had almost no detectable neutralising activity against XBB.1_pp (neutralising titre 50 [NT₅₀] 2), whereas the neutralising activity against B.1_pp was high (NT₅₀ 1165) and against BA.5_pp was moderate (NT₅₀ 127). Next, we measured the plasma of triple vaccinated individuals with breakthrough infection during the BA.5 wave in Germany (June to November, 2022). The plasma samples showed high neutralising activity against B.1_pp (NT₅₀ 1779), moderate neutralising activity against BA.5_pp (NT₅₀ 538), and low neutralising activity against XBB.1_pp (NT₅₀ 14). Similar findings were made for plasma from triple vaccinated individuals who received either monovalent or bivalent (ie, B.1 or B.1 plus BA.5) booster vaccination: B.1_pp NT₅₀ 1806 for B.1 or 1939 for B.1 plus BA.5; BA.5_pp NT₅₀ 206 for B.1 or 525 for B.1 plus BA.5; and XBB.1_pp NT₅₀ 8 for B.1 or 5 for B.1 plus BA.5.

Collectively, our data suggest that the SARS-CoV-2 XBB.1 lineage exhibits an extraordinarily strong ability for antibody evasion, which makes XBB.1 similar to BQ.1 and BQ.1.1;⁹ two highly neutralisation-resistant sublineages of omicron that are currently increasing in incidence in several countries worldwide. The finding that most mAbs do not neutralise XBB.1_pp highlights that novel mAbs are needed for the treatment of COVID-19 and that other or additional treatment options (eg, paxlovid, molnupiravir, or remdesivir) should be considered in areas with high incidence of the XBB sublineages. The observation that host-cell entry of XBB.1_pp is reduced as compared with BA.5_pp suggests that the increased ability of XBB.1 to evade antibody-mediated neutralisation might have come at the cost of a moderately reduced efficiency of host-cell entry.

https://www.thelancet.com/journals/l...831-3/fulltext