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Sci Adv . Longitudinal antibody repertoire in "mild" versus "severe" COVID-19 patients reveals immune markers associated with disease severity and r

tetano

Editor, Senior Moderator
Sci Adv


. 2021 Mar 5;7(10):eabf2467.
doi: 10.1126/sciadv.abf2467. Print 2021 Mar.
Longitudinal antibody repertoire in "mild" versus "severe" COVID-19 patients reveals immune markers associated with disease severity and resolution


Supriya Ravichandran[SUP] 1 [/SUP], Youri Lee[SUP] 1 [/SUP], Gabrielle Grubbs[SUP] 1 [/SUP], Elizabeth M Coyle[SUP] 1 [/SUP], Laura Klenow[SUP] 1 [/SUP], Osamu Akasaka[SUP] 2 [/SUP], Michiko Koga[SUP] 3 [/SUP], Eisuke Adachi[SUP] 3 [/SUP], Makoto Saito[SUP] 3 [/SUP], Ichiro Nakachi[SUP] 4 [/SUP], Takayuki Ogura[SUP] 5 [/SUP], Rie Baba[SUP] 4 [/SUP], Mutsumi Ito[SUP] 6 [/SUP], Maki Kiso[SUP] 6 [/SUP], Atsuhiro Yasuhara[SUP] 6 [/SUP], Shinya Yamada[SUP] 6 [/SUP], Yuko Sakai-Tagawa[SUP] 6 [/SUP], Kiyoko Iwatsuki-Horimoto[SUP] 6 [/SUP], Masaki Imai[SUP] 6 [/SUP], Seiya Yamayoshi[SUP] 6 [/SUP], Hiroshi Yotsuyanagi[SUP] 3 [/SUP], Yoshihiro Kawaoka[SUP] 6 7 [/SUP], Surender Khurana[SUP] 8 [/SUP]



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Free article

Abstract

Limited knowledge exists on immune markers associated with disease severity or recovery in patients with coronavirus disease 2019 (COVID-19). Here, we elucidated longitudinal evolution of SARS-CoV-2 antibody repertoire in patients with acute COVID-19. Differential kinetics was observed for immunoglobulin M (IgM)/IgG/IgA epitope diversity, antibody binding, and affinity maturation in "severe" versus "mild" COVID-19 patients. IgG profile demonstrated immunodominant antigenic sequences encompassing fusion peptide and receptor binding domain (RBD) in patients with mild COVID-19 who recovered early compared with "fatal" COVID-19 patients. In patients with severe COVID-19, high-titer IgA were observed, primarily against RBD, especially in patients who succumbed to SARS-CoV-2 infection. The patients with mild COVID-19 showed marked increase in antibody affinity maturation to prefusion SARS-CoV-2 spike that associated with faster recovery from COVID-19. This study revealed antibody markers associated with disease severity and resolution of clinical disease that could inform development and evaluation of effective immune-based countermeasures against COVID-19.
 
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