Antibodies to SARS-CoV-2 are associated with protection against reinfection

Lumley, Sheila F; Stoesser, Nicole; Matthews, Philippa C.; Howarth, Alison; Hatch, Stephanie B.; Marsden, Brian D.; Cox, Stuart; James, Tim; Warren, Fiona C; Peck, Liam J; Ritter, Thomas G.; Toledo, Zoe de; Warren, Laura; Axten, David; Cornall, Richard J.; Jones, Elizabeth; Stuart, D.I.; Screaton, Gavin; Ebner, Daniel; Hoosdally, Sarah; Chand, Meera; Crook, Derrick W.; Conlon, Christopher P.; Pouwels, Koen B; Walker, A Sarah; Peto, Tim; Hopkins, Susan; Walker, Tim; Jeffery, Katie; Eyre, David W

doi:10.1101/2020.11.18.20234369

Cited by 62 publications

(78 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Given the possible reduction in nAb titre over time the protection they provide could be limited. However, more recent evidence from a large cohort of UK health professionals has shown anti-S IgG generated following natural infection may protect from re-infection up to six months [173], consistent with emerging data on the durability of neutralising antibodies. Further evidence on longer durability and correlates is required.…”

Section: Plos Onesupporting

confidence: 71%

Antibody response to SARS-CoV-2 infection in humans: A systematic review

et al. 2020

View full text Add to dashboard Cite

Background Progress in characterising the humoral immune response to Severe Acute Respiratory Syndrome 2 (SARS-CoV-2) has been rapid but areas of uncertainty persist. Assessment of the full range of evidence generated to date to understand the characteristics of the antibody response, its dynamics over time, its determinants and the immunity it confers will have a range of clinical and policy implications for this novel pathogen. This review comprehensively evaluated evidence describing the antibody response to SARS-CoV-2 published from 01/01/2020-26/06/2020. Methods Systematic review. Keyword-structured searches were carried out in MEDLINE, Embase and COVID-19 Primer. Articles were independently screened on title, abstract and full text by two researchers, with arbitration of disagreements. Data were double-extracted into a pre-designed template, and studies critically appraised using a modified version of the Public Health Ontario Meta-tool for Quality Appraisal of Public Health Evidence (MetaQAT) tool, with resolution of disagreements by consensus. Findings were narratively synthesised. Results 150 papers were included. Most studies (113 or 75%) were observational in design, were based wholly or primarily on data from hospitalised patients (108, 72%) and had important methodological limitations. Few considered mild or asymptomatic infection. Antibody dynamics were well described in the acute phase, up to around three months from disease onset, but the picture regarding correlates of the antibody response was inconsistent. IgM was consistently detected before IgG in included studies, peaking at weeks two to five and declining over a further three to five weeks post-symptom onset depending on the patient group; IgG peaked around weeks three to seven post-symptom onset then plateaued, generally persisting for at least eight weeks. Neutralising antibodies were detectable within seven to 15 days following disease onset, with levels increasing until days 14–22 before levelling and then decreasing, but titres were lower in those with asymptomatic or clinically mild disease. Specific and potent neutralising antibodies have been isolated from convalescent plasma. Cross-reactivity but limited cross-neutralisation with other human coronaviridae was reported. Evidence for protective immunity in vivo was limited to small, short-term animal studies, showing promising initial results in the immediate recovery phase. Conclusions Literature on antibody responses to SARS-CoV-2 is of variable quality with considerable heterogeneity of methods, study participants, outcomes measured and assays used. Although acute phase antibody dynamics are well described, longer-term patterns are much less well evidenced. Comprehensive assessment of the role of demographic characteristics and disease severity on antibody responses is needed. Initial findings of low neutralising antibody titres and possible waning of titres over time may have implications for sero-surveillance and disease control policy, although further evidence is needed. The detection of potent neutralising antibodies in convalescent plasma is important in the context of development of therapeutics and vaccines. Due to limitations with the existing evidence base, large, cross-national cohort studies using appropriate statistical analysis and standardised serological assays and clinical classifications should be prioritised.

show abstract

Section: Plos Onesupporting

confidence: 71%

Antibody response to SARS-CoV-2 infection in humans: A systematic review

et al. 2020

View full text Add to dashboard Cite

show abstract

“… 8 Recent unpublished studies in HCWs reported no evidence of symptomatic reinfection, suggesting that immunity is maintained for at least 6 months. 9 , 10 In these studies there was a relatively low event rate (123 and 20 symptomatic infections respectively). It is possible that the protective immunity observed may have been explained in part by the relatively low incidence of SARS-CoV-2 infection.…”

mentioning

confidence: 88%

Prior SARS-CoV-2 infection is associated with protection against symptomatic reinfection

Hanrath

Payne

Duncan

2021

Journal of Infection

111

114

View full text Add to dashboard Cite

Prior SARS-CoV-2 infection is associated with protection against symptomatic reinfectionTo the editor, It has been recently suggested that prior exposure to seasonal coronaviruses might confer cross-protection against SARS-CoV-2. 1 Whether SARS-CoV-2 infection itself confers immunity to reinfection has not been established. Immunity is probable, at least in the short term, because reinfections are infrequently reported, despite over 55 million primary infections occurring worldwide since December 2019. 2 Protection against short term reinfection has been observed in a non-human primate model of SARS-CoV-2. 3 A small clinical study was also suggestive. 4 Immunity to seasonal coronaviruses is maintained for up to 12 months. 5 The second wave of SARS-CoV-2 transmission provides an opportunity to detect early signals of immunity. We previously defined a large cohort of over 11,0 0 0 healthcare workers (HCWs) with documented evidence of previous infection status during the first wave of the SARS-CoV-2 pandemic, from March to April 2020. A second wave of SARS-CoV-2 transmission occurred in our setting from October to November 2020, approximately 7 months later. We undertook a retrospective analysis of HCW testing data during this second wave, to address the question of whether previous SARS-CoV-2 infection was associated with protection.

show abstract

“…Individuals who are infected with SARS-CoV-2 develop both cellular and humoral immune responses to the virus ( Robbiani et al, 2020 ; Gaebler et al, 2020 Preprint ; Suthar et al, 2020 ; Ni et al, 2020 ; Grifoni et al, 2020 ; Peng et al, 2020 ; Sekine et al, 2020 ; Rydyznski Moderbacher et al, 2020 ; Braun et al, 2020 ; Zhou et al, 2020 ). Antibody responses develop to most of the structural proteins expressed by the virus, and nearly all individuals develop neutralizing antibodies directed to the receptor binding domain of the Spike trimer (S; Robbiani et al, 2020 ; Gaebler et al, 2020 Preprint ; Suthar et al, 2020 ; Ni et al, 2020 ; Lumley et al, 2020 Preprint ). Cellular immune responses can be broad but vary widely ( Grifoni et al, 2020 ; Peng et al, 2020 ; Sekine et al, 2020 ; Rydyznski Moderbacher et al, 2020 ; Braun et al, 2020 ; Zhou et al, 2020 ), and lymphopenia is a prominent feature of more severe infection, affecting CD4 + and CD8 + T cells, as well as B cells ( Tavakolpour et al, 2020 ; Chen and John Wherry, 2020 ; Huang et al, 2020 ; Giamarellos-Bourboulis et al, 2020 ; Tan et al, 2020 ; Kuri-Cervantes et al, 2020 ; Mathew et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Persistent cellular immunity to SARS-CoV-2 infection

Breton

Mendoza

Hägglöf

et al. 2021

Journal of Experimental Medicine

134

View full text Add to dashboard Cite

SARS-CoV-2 is responsible for an ongoing pandemic that has affected millions of individuals around the globe. To gain further understanding of the immune response in recovered individuals, we measured T cell responses in paired samples obtained an average of 1.3 and 6.1 mo after infection from 41 individuals. The data indicate that recovered individuals show persistent polyfunctional SARS-CoV-2 antigen–specific memory that could contribute to rapid recall responses. Recovered individuals also show enduring alterations in relative overall numbers of CD4+ and CD8+ memory T cells, including expression of activation/exhaustion markers, and cell division.

show abstract

Antibodies to SARS-CoV-2 are associated with protection against reinfection

Cited by 62 publications

References 27 publications

Antibody response to SARS-CoV-2 infection in humans: A systematic review

Antibody response to SARS-CoV-2 infection in humans: A systematic review

Prior SARS-CoV-2 infection is associated with protection against symptomatic reinfection

Persistent cellular immunity to SARS-CoV-2 infection

Contact Info

Product

Resources

About