Monoclonal antibody levels and protection from COVID-19

Eva Stadler, Martin T. Burgess, Timothy E. Schlub, Shanchita R. Khan, Khai Li Chai, Zoe K. McQuilten, Erica M. Wood, Mark N. Polizzotto, Stephen J. Kent, Deborah Cromer, Miles P. Davenport () and David S. Khoury ()
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Eva Stadler: University of New South Wales
Martin T. Burgess: University of New South Wales
Timothy E. Schlub: University of Sydney
Shanchita R. Khan: University of New South Wales
Khai Li Chai: Monash University
Zoe K. McQuilten: Monash University
Erica M. Wood: Monash University
Mark N. Polizzotto: The Australian National University
Stephen J. Kent: University of Melbourne at the Peter Doherty Institute for Infection and Immunity
Deborah Cromer: University of New South Wales
Miles P. Davenport: University of New South Wales
David S. Khoury: University of New South Wales

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

Abstract: Abstract Multiple monoclonal antibodies have been shown to be effective for both prophylaxis and therapy for SARS-CoV-2 infection. Here we aggregate data from randomized controlled trials assessing the use of monoclonal antibodies (mAb) in preventing symptomatic SARS-CoV-2 infection. We use data on the in vivo concentration of mAb and the associated protection from COVID-19 over time to model the dose-response relationship of mAb for prophylaxis. We estimate that 50% protection from COVID-19 is achieved with a mAb concentration of 96-fold of the in vitro IC50 (95% CI: 32—285). This relationship provides a tool for predicting the prophylactic efficacy of new mAb and against SARS-CoV-2 variants. Finally, we compare the relationship between neutralization titer and protection from COVID-19 after either mAb treatment or vaccination. We find no significant difference between the 50% protective titer for mAb and vaccination, although sample sizes limited the power to detect a difference.

Date: 2023
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DOI: 10.1038/s41467-023-40204-1

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