SARS-CoV-2 Antibody Responses Correlate with Resolution of RNAemia But Are Short-Lived in Patients with Mild Illness
Röltgen, K.; Wirz, O. F.; Stevens, B. A.; Powell, A. E.; Hogan, C. A.; Najeeb, J.; Hunter, M.; Sahoo, M. K.; Huang, C.; Yamamoto, F.; Manalac, J.; Otrelo-Cardoso, A. R.; Pham, T. D.; Rustagi, A.; Rogers, A. J.; Shah, N. H.; Blish, C. A.; Cochran, J. R.; Nadeau, K. C.; Jardetzky, T. S.; Zehnder, J. L.; Wang, T. T.; Kim, P. S.; Gombar, S.; Tibshirani, R.; Pinsky, B. A.; Boyd, S. D.
Show abstract
SARS-CoV-2-specific antibodies, particularly those preventing viral spike receptor binding domain (RBD) interaction with host angiotensin-converting enzyme 2 (ACE2) receptor, could offer protective immunity, and may affect clinical outcomes of COVID-19 patients. We analyzed 625 serial plasma samples from 40 hospitalized COVID-19 patients and 170 SARS-CoV-2-infected outpatients and asymptomatic individuals. Severely ill patients developed significantly higher SARS-CoV-2-specific antibody responses than outpatients and asymptomatic individuals. The development of plasma antibodies was correlated with decreases in viral RNAemia, consistent with potential humoral immune clearance of virus. Using a novel competition ELISA, we detected antibodies blocking RBD-ACE2 interactions in 68% of inpatients and 40% of outpatients tested. Cross-reactive antibodies recognizing SARS-CoV RBD were found almost exclusively in hospitalized patients. Outpatient and asymptomatic individuals serological responses to SARS-CoV-2 decreased within 2 months, suggesting that humoral protection may be short-lived.
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