Neutralizing antibody responses to SARS-CoV-2 in symptomatic COVID-19 is persistent and critical for survival

Stefania Dispinseri, Massimiliano Secchi, Maria Franca Pirillo, Monica Tolazzi, Martina Borghi, Cristina Brigatti, Maria Laura Angelis, Marco Baratella, Elena Bazzigaluppi, Giulietta Venturi, Francesca Sironi, Andrea Canitano, Ilaria Marzinotto, Cristina Tresoldi, Fabio Ciceri, Lorenzo Piemonti, Donatella Negri, Andrea Cara, Vito Lampasona and Gabriella Scarlatti ()
Additional contact information
Stefania Dispinseri: Viral Evolution and Transmission Unit, IRCCS Ospedale San Raffaele
Massimiliano Secchi: Diabetes Research Institute, IRCCS Ospedale San Raffaele
Maria Franca Pirillo: National Center for Global Health, Istituto Superiore di Sanità
Monica Tolazzi: Viral Evolution and Transmission Unit, IRCCS Ospedale San Raffaele
Martina Borghi: Department of Infectious Diseases, Istituto Superiore di Sanità
Cristina Brigatti: Diabetes Research Institute, IRCCS Ospedale San Raffaele
Maria Laura Angelis: Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità
Marco Baratella: Viral Evolution and Transmission Unit, IRCCS Ospedale San Raffaele
Elena Bazzigaluppi: Diabetes Research Institute, IRCCS Ospedale San Raffaele
Giulietta Venturi: Department of Infectious Diseases, Istituto Superiore di Sanità
Francesca Sironi: Viral Evolution and Transmission Unit, IRCCS Ospedale San Raffaele
Andrea Canitano: National Center for Global Health, Istituto Superiore di Sanità
Ilaria Marzinotto: Diabetes Research Institute, IRCCS Ospedale San Raffaele
Cristina Tresoldi: Molecular Hematology Unit, IRCCS Ospedale San Raffaele
Fabio Ciceri: Hematology and Bone Marrow Transplantation Unit, IRCCS Ospedale San Raffaele
Lorenzo Piemonti: Diabetes Research Institute, IRCCS Ospedale San Raffaele
Donatella Negri: Department of Infectious Diseases, Istituto Superiore di Sanità
Andrea Cara: National Center for Global Health, Istituto Superiore di Sanità
Vito Lampasona: Diabetes Research Institute, IRCCS Ospedale San Raffaele
Gabriella Scarlatti: Viral Evolution and Transmission Unit, IRCCS Ospedale San Raffaele

Nature Communications, 2021, vol. 12, issue 1, 1-12

Abstract: Abstract Understanding how antibody responses to SARS-CoV-2 evolve during infection may provide important insight into therapeutic approaches and vaccination for COVID-19. Here we profile the antibody responses of 162 COVID-19 symptomatic patients in the COVID-BioB cohort followed longitudinally for up to eight months from symptom onset to find SARS-CoV-2 neutralization, as well as antibodies either recognizing SARS-CoV-2 spike antigens and nucleoprotein, or specific for S2 antigen of seasonal beta-coronaviruses and hemagglutinin of the H1N1 flu virus. The presence of neutralizing antibodies within the first weeks from symptoms onset correlates with time to a negative swab result (p = 0.002), while the lack of neutralizing capacity correlates with an increased risk of a fatal outcome (p = 0.008). Neutralizing antibody titers progressively drop after 5–8 weeks but are still detectable up to 8 months in the majority of recovered patients regardless of age or co-morbidities, with IgG to spike antigens providing the best correlate of neutralization. Antibody responses to seasonal coronaviruses are temporarily boosted, and parallel those to SARS-CoV-2 without dampening the specific response or worsening disease progression. Our results thus suggest compromised immune responses to the SARS-CoV-2 spike to be a major trait of COVID-19 patients with critical conditions, and thereby inform on the planning of COVID-19 patient care and therapy prioritization.

Date: 2021
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DOI: 10.1038/s41467-021-22958-8

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