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Clin Immunol . Effect of monoclonal antibody therapy on the endogenous SARS-CoV-2 antibody response

tetano

Editor, Senior Moderator
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[SUP] 1 [/SUP], Derek E Dimcheff[SUP] 1 [/SUP], Andrew Siler[SUP] 2 [/SUP], Richard J Schildhouse[SUP] 1 [/SUP], Stephen W Chensue[SUP] 3 [/SUP]



Affiliations
Free PMC article

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.
 
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