Stable neutralizing antibody levels six months after mild and severe COVID-19 episode

Pradenas, Edwards; Trinité, Benjamín; Urrea, Víctor; Marfil, Sílvia; Ávila‐Nieto, Carlos; Concepción, Maria Luisa Rodrı́guez de la; Tarrés-Freixas, Ferran; Pérez-Yanes, Silvia; Rovirosa, Carla; Ainsua-Enrich, Erola; Rodón, Jordi; Vergara‐Alert, Júlia; Guallar, Vı́ctor; Valencia, Alfonso; Izquierdo-Useros, Núria; Paredes, Roger; Mateu, Lourdes; Chamorro, Anna; Massanella, Marta; Carrillo, Jorge; Clotet, Bonaventura; Blanco, Julià

doi:10.1101/2020.11.22.389056

Cited by 21 publications

(33 citation statements)

References 24 publications

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“…Important caveats to such an extrapolation are that (i) it assumes that neutralisation is a major mechanism of protection (or that the mechanism of protection remains correlated with neutralisation), although B cell memory and T cell responses may be more durable [3][4][5]23 (and indeed B cell responses have been shown to increase following infection 3 ), (ii) it applies the decay of neutralisation observed in convalescence to the vaccine data, and (iii) it assumes that the decay in titre is the same regardless of the initial starting titre (whereas others have suggested faster decay for higher initial levels 24 ). These limitations notwithstanding, we used All rights reserved.…”

Section: Main Textmentioning

confidence: 99%

What level of neutralising antibody protects from COVID-19?

Khoury

Cromer

Reynaldi

et al. 2021

Preprint

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Both previous infection and vaccination have been shown to provide potent protection from COVID-19. However, there are concerns that waning immunity and viral variation may lead to a loss of protection over time. Predictive models of immune protection are urgently needed to identify immune correlates of protection to assist in the future deployment of vaccines. To address this, we modelled the relationship between in vitro neutralisation levels and observed protection from SARS-CoV-2 infection using data from seven current vaccines as well as convalescent cohorts. Here we show that neutralisation level is highly predictive of immune protection. The 50% protective neutralisation level was estimated to be approximately 20% of the average convalescent level (95% CI = 14-28%). The estimated neutralisation level required for 50% protection from severe infection was significantly lower (3% of the mean convalescent level (CI = 0.7-13%, p = 0.0004). Given the relationship between in vitro neutralization titer and protection, we then used this to investigate how waning immunity and antigenic variation might affect vaccine efficacy. We found that the decay of neutralising titre in vaccinated subjects over the first 3-4 months after vaccination was at least as rapid as the decay observed in convalescent subjects. Modelling the decay of neutralisation titre over the first 250 days after immunisation predicts a significant loss in protection from SARS-CoV-2 infection will occur, although protection from severe disease should be largely retained. Neutralisation titres against some SARS-CoV-2 variants of concern are reduced compared to the vaccine strain and our model predicts the relationship between neutralisation and efficacy against viral variants. Our analyses provide an evidence-based prediction of SARS-CoV-2 immune protection that will assist in developing vaccine strategies to control the future trajectory of the pandemic.

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Section: Main Textmentioning

confidence: 99%

What level of neutralising antibody protects from COVID-19?

Khoury

Cromer

Reynaldi

et al. 2021

Preprint

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“…Generally, people with a previous history of COVID-19 in whom vaccination is currently advised [ 7 ] were excluded from the clinical trials [ 4 , 5 , 6 ]. Whilst it is accepted that prior infection with COVID-19 induces a natural immunity potentially lasting for at least six months [ 8 ], it is unknown if previous infection may be associated with a greater number of vaccination side effects. Moreover, the safety and reactogenicity of the different types of vaccines (mRNA or viral vector-based) have not been compared head-to-head.…”

Section: Introductionmentioning

confidence: 99%

Self-Reported Real-World Safety and Reactogenicity of COVID-19 Vaccines: A Vaccine Recipient Survey

Mathioudakis

Ghrew

Ustianowski

et al. 2021

Life

124

105

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An online survey was conducted to compare the safety, tolerability and reactogenicity of available COVID-19 vaccines in different recipient groups. This survey was launched in February 2021 and ran for 11 days. Recipients of a first COVID-19 vaccine dose ≥ 7 days prior to survey completion were eligible. The incidence and severity of vaccination side effects were assessed. The survey was completed by 2002 respondents of whom 26.6% had a prior COVID-19 infection. A prior COVID-19 infection was associated with an increased risk of any side effect (risk ratio 1.08, 95% confidence intervals (1.05–1.11)), fever (2.24 (1.86–2.70)), breathlessness (2.05 (1.28–3.29)), flu-like illness (1.78 (1.51–2.10)), fatigue (1.34 (1.20–1.49)) and local reactions (1.10 (1.06–1.15)). It was also associated with an increased risk of severe side effects leading to hospital care (1.56 (1.14–2.12)). While mRNA vaccines were associated with a higher incidence of any side effect (1.06 (1.01–1.11)) compared with viral vector-based vaccines, these were generally milder (p < 0.001), mostly local reactions. Importantly, mRNA vaccine recipients reported a considerably lower incidence of systemic reactions (RR < 0.6) including anaphylaxis, swelling, flu-like illness, breathlessness and fatigue and of side effects requiring hospital care (0.42 (0.31–0.58)). Our study confirms the findings of recent randomised controlled trials (RCTs) demonstrating that COVID-19 vaccines are generally safe with limited severe side effects. For the first time, our study links prior COVID-19 illness with an increased incidence of vaccination side effects and demonstrates that mRNA vaccines cause milder, less frequent systemic side effects but more local reactions.

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“…In severe acute respiratory syndrome (SARS), caused by the related SARS-associated coronavirus (SARS-CoV), anti-viral antibodies persist in the majority of patients for at least 3 years after disease (5-7). Less is known about SARS-CoV-2, but a few reports suggest that immunity may last at least 6 months (8-10). However, other reports (11-14) suggest that antibodies against SARS-CoV-2 can decline in the first few months (15), with some patients becoming seronegative (16, 17).…”

Section: Introductionmentioning

confidence: 99%

Fever, Diarrhea, and Severe Disease Correlate with High Persistent Antibody Levels against SARS-CoV-2

Amjadi

Armbrust

Mergaert

et al. 2021

Preprint

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Lasting immunity will be critical for overcoming the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, factors that drive the development of high titers of anti-SARS-CoV-2 antibodies and how long those antibodies persist remain unclear. Our objective was to comprehensively evaluate anti-SARS-CoV-2 antibodies in a clinically diverse COVID-19 convalescent cohort at defined time points to determine if anti-SARS-CoV-2 antibodies persist and to identify clinical and demographic factors that correlate with high titers. Using a novel multiplex assay to quantify IgG against four SARS-CoV-2 antigens, a receptor binding domain-angiotensin converting enzyme 2 inhibition assay, and a SARS-CoV-2 neutralization assay, we found that 98% of COVID-19 convalescent subjects had anti-SARS-CoV-2 antibodies five weeks after symptom resolution (n=113). Further, antibody levels did not decline three months after symptom resolution (n=79). As expected, greater disease severity, older age, male sex, obesity, and higher Charlson Comorbidity Index score correlated with increased anti-SARS-CoV-2 antibody levels. We demonstrated for the first time that COVID-19 symptoms, namely fever, abdominal pain, diarrhea and low appetite, correlated consistently with higher anti-SARS-CoV-2 antibody levels. Our results provide new insights into the development and persistence of anti-SARS-CoV-2 antibodies.

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Stable neutralizing antibody levels six months after mild and severe COVID-19 episode

Cited by 21 publications

References 24 publications

What level of neutralising antibody protects from COVID-19?

What level of neutralising antibody protects from COVID-19?

Self-Reported Real-World Safety and Reactogenicity of COVID-19 Vaccines: A Vaccine Recipient Survey

Fever, Diarrhea, and Severe Disease Correlate with High Persistent Antibody Levels against SARS-CoV-2

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