Longitudinal Serological Analysis and Neutralizing Antibody Levels in Coronavirus Disease 2019 Convalescent Patients.

Abstract

BACKGROUND:

Understanding the longitudinal trajectory of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies is crucial for diagnosis of prior infection and predicting future immunity.

METHODS:

We conducted a longitudinal analysis of coronavirus disease 2019 convalescent patients, with neutralizing antibody assays and SARS-CoV-2 serological assay platforms using SARS-CoV-2 spike (S) or nucleocapsid (N) antigens.

RESULTS:

Sensitivities of serological assays in diagnosing prior SARS-CoV-2 infection changed with time. One widely used commercial platform that had an initial sensitivity of >95% declined to 71% at 81-100 days after diagnosis. The trajectories of median binding antibody titers measured over approximately 3-4 months were not dependent on the use of SARS-CoV-2 N or S proteins as antigen. The median neutralization titer decreased by approximately 45% per month. Each serological assay gave quantitative antibody titers that were correlated with SARS-CoV-2 neutralization titers, but S-based serological assay measurements better predicted neutralization potency. Correlation between S-binding and neutralization titers deteriorated with time, and decreases in neutralization titers were not predicted by changes in S-binding antibody titers.

CONCLUSIONS:

Different SARS-CoV-2 serological assays are more or less well suited for surveillance versus prediction of serum neutralization potency. Extended follow-up should facilitate the establishment of appropriate serological correlates of protection against SARS-CoV-2 reinfection.

• Authors: Frauke Muecksch, Helen Wise, Becky Batchelor, Maria Squires, Elizabeth Semple, Claire Richardson, Jacqueline McGuire, Sarah Clearly, Elizabeth Furrie, Neil Greig, Gordon Hay, Kate Templeton, Julio C C Lorenzi, Theodora Hatziioannou, Sara Jenks, Paul D Bieniasz
• Journal: The Journal of infectious diseases (J Infect Dis) Vol. 223 Issue 3 Pg. 389-398 (02 13 2021) ISSN: 1537-6613 [Electronic] United States
• PMID: 33140086 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
• Copyright: © The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America.

Chemical References

• Antibodies, Neutralizing
• Antibodies, Viral
• Spike Glycoprotein, Coronavirus
• spike protein, SARS-CoV-2

Topics

• Adult
• Aged
• Antibodies, Neutralizing (blood)
• Antibodies, Viral (blood, immunology)
• COVID-19 (blood, immunology)
• COVID-19 Serological Testing (methods)
• Humans
• Longitudinal Studies
• Middle Aged
• Neutralization Tests
• SARS-CoV-2 (immunology)
• Spike Glycoprotein, Coronavirus (immunology)
• Young Adult