Kinetics and correlates of the neutralizing antibody response to SARS-CoV-2 infection in humans
Open accessAbstract
Understanding antibody-based SARS-CoV-2 immunity is critical for overcoming the COVID-19 pandemic and informing vaccination strategies. We evaluated SARS-CoV-2 antibody dynamics over 10 months in 963 individuals who predominantly experienced mild COVID-19. Investigating 2,146 samples, we initially detected SARS-CoV-2 antibodies in 94.4% of individuals, with 82% and 79% exhibiting serum and IgG neutralization, respectively. Approximately 3% of individuals demonstrated exceptional SARS-CoV-2 neutralization, with these "elite neutralizers" also possessing SARS-CoV-1 cross-neutralizing IgG. Multivariate statistical modeling revealed age, symptomatic infection, disease severity, and gender as key factors predicting SARS-CoV-2-neutralizing activity. A loss of reactivity to the virus spike protein was observed in 13% of individuals 10 months after infection. Neutralizing activity had half-lives of 14.7 weeks in serum versus 31.4 weeks in purified IgG, indicating a rather long-term IgG antibody response. Our results demonstrate a broad spectrum in the initial SARS-CoV-2-neutralizing antibody response, with sustained antibodies in most individuals for 10 months after mild COVID-19.
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In people recovered from SARS-CoV-2 infection, several studies found only modest declines in IgG and neutralizing antibody levels at 8 to 10 months after infection.
“Several studies on the durability of humoral response in persons who have recovered from SARS-CoV-2 infection showed that both IgG and neutralizing antibody levels decrease only modestly at 8 to 10 months after the infection.22,23”
From Waning Immune Humoral Response to BNT162b2 Covid-19 Vaccine over 6 Months (2021) · cites this paper as [23]
Taken together, evidence from this study and others indicates that previously infected people have better long-term humoral response and vaccine effectiveness than recipients of two vaccine doses.
“Overall, the accumulating evidence from our study and others22-25 shows that long-term humoral response and vaccine effectiveness in previously infected persons were superior to that in recipients of two doses of vaccine.”
From Waning Immune Humoral Response to BNT162b2 Covid-19 Vaccine over 6 Months (2021) · cites this paper as [23]
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- Authors
- Vanshylla, K., Di Cristanziano, V., Kleipass, F., Dewald, F., Schommers, P., Gieselmann, L., Gruell, H., Schlotz, M., Ercanoglu, M. S., Stumpf, R., Mayer, P., Zehner, M., Heger, E., Johannis, W., Horn, C., Suárez, I., Jung, N., Salomon, S., Eberhardt, K. A., Gathof, B., Fätkenheuer, G., Pfeifer, N., Eggeling, R., Augustin, M., Lehmann, C., & Klein, F.
- Affiliations
- University of Cologne (DE)
- University Medical Center Hamburg-Eppendorf (DE)
- University Hospital Cologne (DE)
- German Center for Infection Research (DE)
- University of Tübingen (DE)
- Corresponding author
- Klein, Florian
- ORCID
- Vanshylla, Kanika
- Kleipass, Franziska
- Schommers, Philipp
- Gieselmann, Lutz
- Gruell, Henning
- Ercanoglu, Meryem S.
- Mayer, Petra
- Zehner, Matthias
- Heger, Eva
- Johannis, Wibke
- Horn, Carola
- Suárez, Isabelle
- Jung, Norma
- Salomon, Susanne
- Eberhardt, Kirsten Alexandra
- Gathof, Birgit
- Fätkenheuer, Gerd
- Pfeifer, Nico
- Eggeling, Ralf
- Augustin, Max
- Lehmann, Clara
- Klein, Florian
- Venue
- Cell Host & Microbe
- Publisher
- Elsevier BV
- Published
- 2021-06
- Volume
- 29
- Issue
- 6
- Pages
- 917-929.e4
- ISSN
- 1931-3128 (ISSN-L)
- PMC
- PMC8090990
- OpenAlex
- W3158483423
- Cited by
- 153
- References
- 80
- Citations by year
- 2026: 7 · 2025: 14 · 2024: 12 · 2023: 27 · 2022: 56 · 2021: 36 · 2018: 1
- FWCI
- 10.36
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- www.elsevier.com/legal/tdmrep-license (tdm)
- www.elsevier.com/open-access/userlicense/1.0/ (vor, 373 d)
- doi.org/10.15223/policy-017 (stm-asf)
- doi.org/10.15223/policy-037 (stm-asf)
- doi.org/10.15223/policy-012 (stm-asf)
- doi.org/10.15223/policy-029 (stm-asf)
- doi.org/10.15223/policy-004 (stm-asf)
- Locations
- Cell Host & Microbe (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Kölner Universitäts PublikationsServer (Universität zu Köln) (publishedVersion)
- Funders
- German Centre for Infection Research (TTU01.923)
- European Research Council (KX2021, 01KX2021, ERC-StG639961)
- Deutsche Forschungsgemeinschaft (CRC1310, EXC 2064/1 - 390727645, CRC1279)
- Bundesministerium für Bildung und Forschung (IS18039A)
- Topics
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 detection and testing
- Keywords
- SARS-CoV-2, COVID-19 pandemic, neutralizing antibodies, antibody kinetics, IgG, elite neutralizers, spike protein, antibody half-life, mild COVID-19, long-term antibody persistence
- MeSH terms
- COVID-19, SARS-CoV-2, Adolescent, Adult, Aged, Antibodies, Viral, Female, Humans, Immunoglobulin G, Male, Middle Aged, Time Factors, Cohort Studies, Young Adult, Antibodies, Neutralizing
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