Anti-SARS-CoV-2 Antibodies Persist up to 13 Months, Reduce Risk of Reinfection

 Floriane Gallais, Pierre Gantner, Timothee Bruel, Aurelie Velay, Delphine Planas, Marie-Josee Wendling, Sophie Bayer, Morgane Solis, Elodie Laugel, Nathalie Reix, Anne Schneider, Ludovic Glady, Baptiste Panaget, Nicolas Collongues, Marialuisa Partisani, Jean-Marc Lessinger, Arnaud Fontanet, David Rey, Yves Hansmann, Laurence Kling-Pillitteri, Olivier Schwartz, Jerome De Seze, Nicolas Meyer, Maria Gonzalez, Catherine Schmidt-Mutter, Samira Fafi-Kremer

doi: https://doi.org/10.1101/2021.05.07.21256823

This article is a preprint and has not been certified by peer review [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.

PDF: https://www.medrxiv.org/content/10.1101/2021.05.07.21256823v3.full.pdf

Abstract

Assessment of the kinetics of SARS-CoV-2 antibodies is essential in predicting protection against reinfection and durability of vaccine protection. Here, we longitudinally measured Spike (S) and Nucleocapsid (N)-specific antibodies in 1,309 healthcare workers (HCWs), including 916 COVID-19 negative HCWs and 393 convalescent COVID-19 for up to 422 days post-symptom. From month (M)1 to M7-9 post-infection, SARS-CoV-2 antibodies decreased moderately in convalescent HCWs in a biphasic model, with men showing a slower decay of anti-N (p=0.02), and a faster decay of anti-S (p=0.0008) than women. At M11-13, anti-N dramatically decreased (half-life: 283 days) while anti-S stabilized (half-life: 725 days) at a median of 2.39 log Arbitrary Units (AU)/mL (Interquartile Range (IQR): 2.10 -2.75). Overall, 69 SARS-CoV-2 infections developed in the COVID-19 negative group (incidence of 12.22 per 100 person-years) versus one in the COVID-19 positive group (incidence of 0.40 per 100 person-years), indicating a relative reduction in the incidence of SARS-CoV-2 reinfection of 96.7% (p<0.0001). Correlation with live-virus neutralization assay revealed that variants D614G and B.1.1.7, but not B.1.351, were sensitive to anti-S antibodies at 2.3 log AU/mL, while IgG ≥ 3 log AU/mL neutralized all three variants. After SARS-CoV-2 vaccination, anti-S levels reached at least 3 logs regardless of pre-vaccination IgG levels, type of vaccine, and number of doses. Our study demonstrates a long-term persistence of anti-S IgG antibodies that may protect against reinfection. By significantly increasing cross-neutralizing antibody titers, a single-dose vaccination strengthens protection against escape mutants.

Competing Interest Statement

The authors have declared no competing interest.

Clinical Trial

ClinicalTrials.gov Identifier: NCT04441684

Funding Statement

This work was supported by Strasbourg University Hospitals (SeroCoV-HUS; PRI 7782), the Agence Nationale de la Recherche (ANR-18-CE17-0028), Laboratoire d'Excellence TRANSPLANTEX (ANR-11-LABX-0070_TRANSPLANTEX), and Institut National de la Sante et de la Recherche Medicale (UMR_S 1109).

https://www.medrxiv.org/content/10.1101/2021.05.07.21256823v3