Long term anti-SARS-CoV-2 antibody kinetics and correlate of protection against Omicron BA.1/BA.2 infection

Javier Perez-Saez (), María-Eugenia Zaballa, Julien Lamour, Sabine Yerly, Richard Dubos, Delphine S. Courvoisier, Jennifer Villers, Jean-François Balavoine, Didier Pittet, Omar Kherad, Nicolas Vuilleumier, Laurent Kaiser, Idris Guessous, Silvia Stringhini and Andrew S. Azman
Additional contact information
Javier Perez-Saez: Geneva University Hospitals
María-Eugenia Zaballa: Geneva University Hospitals
Julien Lamour: Geneva University Hospitals
Sabine Yerly: Geneva University Hospitals
Richard Dubos: Geneva University Hospitals
Delphine S. Courvoisier: General Directorate of Health
Jennifer Villers: Geneva University Hospitals
Jean-François Balavoine: University of Geneva
Didier Pittet: University of Geneva
Omar Kherad: University of Geneva
Nicolas Vuilleumier: Geneva University Hospitals
Laurent Kaiser: Geneva University Hospitals
Idris Guessous: University of Geneva
Silvia Stringhini: Geneva University Hospitals
Andrew S. Azman: Geneva University Hospitals

Nature Communications, 2023, vol. 14, issue 1, 1-9

Abstract: Abstract Binding antibody levels against SARS-CoV-2 have shown to be correlates of protection against infection with pre-Omicron lineages. This has been challenged by the emergence of immune-evasive variants, notably the Omicron sublineages, in an evolving immune landscape with high levels of cumulative incidence and vaccination coverage. This in turn limits the use of widely available commercial high-throughput methods to quantify binding antibodies as a tool to monitor protection at the population-level. Here we show that anti-Spike RBD antibody levels, as quantified by the immunoassay used in this study, are an indirect correlate of protection against Omicron BA.1/BA.2 for individuals previously infected by SARS-CoV-2. Leveraging repeated serological measurements between April 2020 and December 2021 on 1083 participants of a population-based cohort in Geneva, Switzerland, and using antibody kinetic modeling, we found up to a three-fold reduction in the hazard of having a documented positive SARS-CoV-2 infection during the Omicron BA.1/BA.2 wave for anti-S antibody levels above 800 IU/mL (HR 0.30, 95% CI 0.22-0.41). However, we did not detect a reduction in hazard among uninfected participants. These results provide reassuring insights into the continued interpretation of SARS-CoV-2 binding antibody measurements as an independent marker of protection at both the individual and population levels.

Date: 2023
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DOI: 10.1038/s41467-023-38744-7

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