Antibody response decline in 3 months following human SARS-CoV-2 infection

• Jeffrey Seow  ORCID: orcid.org/0000-0003-0722-8561^1 na1,
• Carl Graham^1 na1,
• Blair Merrick  ORCID: orcid.org/0000-0002-6061-6064^2 na1,
• Sam Acors  ORCID: orcid.org/0000-0001-6428-7707^1 na1,
• Suzanne Pickering  ORCID: orcid.org/0000-0002-2747-9029¹,
• Kathryn J. A. Steel³,
• Oliver Hemmings⁴,
• Aoife O’Byrne³,
• Neophytos Kouphou¹,
• Rui Pedro Galao  ORCID: orcid.org/0000-0003-3368-5053¹,
• Gilberto Betancor¹,
• Harry D. Wilson  ORCID: orcid.org/0000-0002-3185-1073¹,
• Adrian W. Signell  ORCID: orcid.org/0000-0003-4620-6891¹,
• Helena Winstone¹,
• Claire Kerridge¹,
• Isabella Huettner¹,
• Jose M. Jimenez-Guardeño  ORCID: orcid.org/0000-0002-1726-8033¹,
• Maria Jose Lista¹,
• Nigel Temperton  ORCID: orcid.org/0000-0002-7978-3815⁵,
• Luke B. Snell  ORCID: orcid.org/0000-0002-6263-9497²,
• Karen Bisnauthsing²,
• Amelia Moore⁶,
• Adrian Green⁶,
• Lauren Martinez  ORCID: orcid.org/0000-0002-5830-2496⁶,
• Brielle Stokes  ORCID: orcid.org/0000-0001-5371-2448⁶,
• Johanna Honey⁶,
• Alba Izquierdo-Barras  ORCID: orcid.org/0000-0003-0665-311X⁶,
• Gill Arbane⁷,
• Amita Patel  ORCID: orcid.org/0000-0001-5945-7791²,
• Mark Kia Ik Tan  ORCID: orcid.org/0000-0002-7774-3836²,
• Lorcan O’Connell²,
• Geraldine O’Hara  ORCID: orcid.org/0000-0002-1922-9492²,
• Eithne MacMahon²,
• Sam Douthwaite²,
• Gaia Nebbia²,
• Rahul Batra²,
• Rocio Martinez-Nunez¹,
• Manu Shankar-Hari  ORCID: orcid.org/0000-0002-5338-2538^1,7,
• Jonathan D. Edgeworth^1,2,
• Stuart J. D. Neil¹,
• […]
• Michael H. Malim  ORCID: orcid.org/0000-0002-7699-2064¹ &
• Katie J. Doores  ORCID: orcid.org/0000-0002-5507-1725¹ 
• -Show fewer authors

Nature Microbiology (2020)

PDF: https://www.nature.com/articles/s41564-020-00813-8.pdf

Abstract

Antibody responses to SARS-CoV-2 can be detected in most infected individuals 10–15 d after the onset of COVID-19 symptoms. However, due to the recent emergence of SARS-CoV-2 in the human population, it is not known how long antibody responses will be maintained or whether they will provide protection from reinfection. Using sequential serum samples collected up to 94 d post onset of symptoms (POS) from 65 individuals with real-time quantitative PCR-confirmed SARS-CoV-2 infection, we show seroconversion (immunoglobulin (Ig)M, IgA, IgG) in >95% of cases and neutralizing antibody responses when sampled beyond 8 d POS. We show that the kinetics of the neutralizing antibody response is typical of an acute viral infection, with declining neutralizing antibody titres observed after an initial peak, and that the magnitude of this peak is dependent on disease severity. Although some individuals with high peak infective dose (ID₅₀ > 10,000) maintained neutralizing antibody titres >1,000 at >60 d POS, some with lower peak ID₅₀ had neutralizing antibody titres approaching baseline within the follow-up period. A similar decline in neutralizing antibody titres was observed in a cohort of 31 seropositive healthcare workers. The present study has important implications when considering widespread serological testing and antibody protection against reinfection with SARS-CoV-2, and may suggest that vaccine boosters are required to provide long-lasting protection.

https://www.nature.com/articles/s41564-020-00813-8