Distinct receptor binding domain IgG thresholds predict protective host immunity across SARS-CoV-2 variants and time

Grace Kenny (), Sophie O’Reilly, Neil Wrigley Kelly, Riya Negi, Colette Gaillard, Dana Alalwan, Gurvin Saini, Tamara Alrawahneh, Nathan Francois, Matthew Angeliadis, Alejandro Abner Garcia Leon, Willard Tinago, Eoin R. Feeney, Aoife G. Cotter, Eoghan Barra, Obada Yousif, Mary Horgan, Peter Doran, Jannik Stemler, Philipp Koehler, Rebecca Jane Cox, Donal O’Shea, Ole F. Olesen, Alan Landay, Andrew E. Hogan, Jean-Daniel Lelievre, Virginie Gautier, Oliver A. Cornely and Patrick W. G. Mallon
Additional contact information
Grace Kenny: University College Dublin
Sophie O’Reilly: University College Dublin
Neil Wrigley Kelly: St Vincent’s University Hospital
Riya Negi: University College Dublin
Colette Gaillard: University College Dublin
Dana Alalwan: University College Dublin
Gurvin Saini: University College Dublin
Tamara Alrawahneh: University College Dublin
Nathan Francois: University College Dublin
Matthew Angeliadis: University College Dublin
Alejandro Abner Garcia Leon: University College Dublin
Willard Tinago: University College Dublin
Eoin R. Feeney: University College Dublin
Aoife G. Cotter: University College Dublin
Eoghan Barra: Beaumont Hospital
Obada Yousif: Wexford General Hospital, Carricklawn
Mary Horgan: Cork University Hospital
Peter Doran: University College Dublin
Jannik Stemler: University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Internal Medicine and University of Cologne, Faculty of Medicine Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD)
Philipp Koehler: University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Internal Medicine and University of Cologne, Faculty of Medicine Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD)
Rebecca Jane Cox: University of Bergen
Donal O’Shea: St Vincent’s University Hospital
Ole F. Olesen: European Vaccine Initiative
Alan Landay: Rush University
Andrew E. Hogan: Maynooth University
Jean-Daniel Lelievre: Université Paris Est Créteil
Virginie Gautier: University College Dublin
Oliver A. Cornely: University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Internal Medicine and University of Cologne, Faculty of Medicine Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD)
Patrick W. G. Mallon: University College Dublin

Nature Communications, 2023, vol. 14, issue 1, 1-11

Abstract: Abstract SARS-CoV-2 neutralising antibodies provide protection against COVID-19. Evidence from early vaccine trials suggested binding antibody thresholds could serve as surrogate markers of neutralising capacity, but whether these thresholds predict sufficient neutralising capacity against variants of concern (VOCs), and whether this is impacted by vaccine or infection history remains unclear. Here we analyse individuals recovered from, vaccinated or with hybrid immunity against SARS-CoV-2. An NT50 ≥ 100 IU confers protection in vaccine trials, however, as VOC induce a reduction in NT50, we use NT50 ≥ 1000 IU as a cut off for WT NT50 that would retain neutralisation against VOC. In unvaccinated convalescent participants, a receptor binding domain (RBD) IgG of 456 BAU/mL predicts an NT50 against WT of 1000 IU with an accuracy of 80% (95%CI 73–86%). This threshold maintains accuracy in determining loss of protective immunity against VOC in two vaccinated cohorts. It predicts an NT50

Date: 2023
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DOI: 10.1038/s41467-023-42717-1

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