Convergent Antibody Responses to SARS-CoV-2 in Convalescent Individuals
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Abstract
During the coronavirus disease-2019 (COVID-19) pandemic, severe acute respiratory syndrome-related coronavirus-2 (SARS-CoV-2) has led to the infection of millions of people and has claimed hundreds of thousands of lives. The entry of the virus into cells depends on the receptor-binding domain (RBD) of the spike (S) protein of SARS-CoV-2. Although there is currently no vaccine, it is likely that antibodies will be essential for protection. However, little is known about the human antibody response to SARS-CoV-2 1-5. Here we report on 149 COVID-19-convalescent individuals. Plasma samples collected an average of 39 days after the onset of symptoms had variable half-maximal pseudovirus neutralizing titres; titres were less than 50 in 33% of samples, below 1,000 in 79% of samples and only 1% of samples had titres above 5,000. Antibody sequencing revealed the expansion of clones of RBD-specific memory B cells that expressed closely related antibodies in different individuals. Despite low plasma titres, antibodies to three distinct epitopes on the RBD neutralized the virus with half-maximal inhibitory concentrations (IC 50 values) as low as 2 ng ml-1. In conclusion, most convalescent plasma samples obtained from individuals who recover from COVID-19 do not contain high levels of neutralizing activity. Nevertheless, rare but recurring RBD-specific antibodies with potent antiviral activity were found in all individuals tested, suggesting that a vaccine designed to elicit such antibodies could be broadly effective.
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Some studies suggest that elicited neutralizing activity is maintained for up to 8 months after natural infection with SARS-CoV-2.
“Although it is unclear how long protective effects last beyond the first few months after vaccination, some studies suggest that the elicited neutralizing activity is maintained for up to 8 months after the natural infection with SARS-CoV-2 (refs. 41,42).”
From Modeling vaccination rollouts, SARS-CoV-2 variants and the requirement for non-pharmaceutical interventions in Italy (2021) · cites this paper as [41]
The paper reports neutralizing activity in plasma from convalescent individuals, but its cohort description (Abstract; page unavailable) places collection 17–67 days after symptom onset. It does not establish that neutralizing activity is maintained for up to eight months after infection. (LLM, conf=0.88)
Experimental — accuracy not yet measuredNeutralizing antibody levels correlate with viral load and are higher in more severe disease and in older versus younger adults.
“The magnitude of these NAb responses appear to correlate with viral load, with higher responses reported in patients with more severe disease, and in older adults compared with younger adults26–29.”
From Immunological mechanisms of vaccine-induced protection against COVID-19 in humans (2021) · cites this paper as [26]
Eight weeks after the second mRNA vaccine dose, volunteers had high IgM and IgG binding titers to SARS-CoV-2 S and RBD.
“8 weeks after the second vaccine injection volunteers showed high levels of IgM, and IgG anti-SARS-CoV-2 spike protein (S) and receptor binding domain (RBD) binding titers3,5,6.”
From mRNA vaccine-elicited antibodies to SARS-CoV-2 and circulating variants (2021) · cites this paper as [6]
Vaccinees had significantly higher IgG and IgM than convalescent patients tested 1.3 and 6.2 months after infection; IgA was comparable.
“In line with previous reports3,6,9, IgG and IgM levels were significantly higher in the vaccinated group compared to a cohort of convalescent patients assayed 1.3 and 6.2 months after infection, while IgA levels were similar (Extended Data Fig 1j–l).”
From mRNA vaccine-elicited antibodies to SARS-CoV-2 and circulating variants (2021) · cites this paper as [6]
Neutralizing activity in plasma varied widely 3-14 weeks after the second dose; it resembled that in convalescent individuals at 1.3 months and exceeded that at 6.2 months.
“In agreement with previous reports3,6,9, there was a broad range of plasma neutralizing activity 3–14 weeks after the second vaccine dose that was similar to that elicited by natural infection in a convalescent cohort after 1.3 months, and greater than the activity at 6.2 months after infection (Fig. 1a, Extended Data Table 1).”
From mRNA vaccine-elicited antibodies to SARS-CoV-2 and circulating variants (2021) · cites this paper as [6]
Plasma RBD antibodies are strongly correlated with neutralizing activity.
“We limited our analysis to RBD because plasma RBD antibodies are strongly correlated with neutralizing activity3,10–12.”
From Naturally enhanced neutralizing breadth against SARS-CoV-2 one year after infection (2021) · cites this paper as [3]
There was an overall increase in the apparent avidity of plasma antibodies between 1.3 and 12 months (P < 0.0001).
“Consistent with this observation, there was an overall increase in the apparent avidity of plasma antibodies between 1.3 and 12 months3,4 (P < 0.0001) (Extended Data Fig. 7c).”
From Naturally enhanced neutralizing breadth against SARS-CoV-2 one year after infection (2021) · cites this paper as [3]
13 of 15 neutralizing antibodies obtained after 12 months interfered only with C121, a class 2 antibody.
“In contrast to the earlier time point, 13 of 15 neutralizing antibodies obtained after 12 months interfered only with C121, a class 2 antibody3,23 (Fig. 4c, Extended Data Fig. 9).”
From Naturally enhanced neutralizing breadth against SARS-CoV-2 one year after infection (2021) · cites this paper as [3]
Most serum nAb responses elicited during natural infection are directed at the RBD.
“Most serum nAb responses elicited during natural infection are directed at the RBD (21, 23, 30, 31).”
From mRNA vaccination boosts cross-variant neutralizing antibodies elicited by SARS-CoV-2 infection (2021) · cites this paper as [23]
Numerous neutralizing anti-RBD monoclonal antibodies have been characterized, the most potent of which block the RBD-ACE2 interaction.
“Numerous neutralizing anti-RBD monoclonal antibodies (mAbs) have been characterized, the most potent of which block the RBD-ACE2 interaction (16, 17, 22–24, 32–37).”
From mRNA vaccination boosts cross-variant neutralizing antibodies elicited by SARS-CoV-2 infection (2021) · cites this paper as [23]
SARS-CoV-2 infection rapidly elicits nAbs that decline, but remain detectable, over several months.
“SARS-CoV-2 infection rapidly elicits nAbs (16, 21–24) that decline, but remain detectable, over several months (25–29).”
From mRNA vaccination boosts cross-variant neutralizing antibodies elicited by SARS-CoV-2 infection (2021) · cites this paper as [23]
Analyses of B cell responses to spike generally focus on the RBD and on cells sorted with RBD baits, introducing a bias by omitting non-RBD targets.
“Analyses of the B cell responses to the spike generally focus on the RBD and on cells sorted with RBD baits introducing an inherent bias by omitting non-RBD targets”
From SARS-CoV-2 mRNA vaccination induces functionally diverse antibodies to NTD, RBD, and S2 (2021) · cites this paper as Robbiani et al., 2020
Neutralizing antibodies against SARS-CoV-2 exhibit little to no somatic hypermutation and are produced by B cells with a wide range of V genes.
“The neutralizing antibodies are produced by B cells with a wide range of heavy chain and light chain V genes (Robbiani et al., 2020; Rogers et al., 2020). SARS-CoV-2 neutralizing antibodies also exhibit little to no somatic hypermutation (Gaebler et al., 2020; Robbiani et al., 2020; Rogers et al., 2020).”
From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Robbiani et al., 2020
The receptor binding domain of Spike is the target of more than 90% of neutralizing antibodies in COVID-19 cases, with some targeting the N-terminal domain.
“Spike is the target of SARS-CoV-2 neutralizing antibodies, and the receptor binding domain (RBD) of Spike is the target of >90% of neutralizing antibodies in COVID-19 cases (Brouwer et al., 2020; Piccoli et al., 2020; Robbiani et al., 2020; Rogers et al., 2020; Suthar et al., 2020), with some neutralizing antibodies instead targeting the N-terminal domain (NTD) (Liu et al., 2020).”
From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Robbiani et al., 2020
Neutralizing antibody titers have not correlated with reduced COVID-19 severity.
“Although neutralizing antibody titers have not correlated with reduced COVID-19 severity (Dan et al., 2021; Piccoli et al., 2020; Robbiani et al., 2020), SARS-CoV-2 cTfh cell frequencies have been associated with reduced disease severity (Rydyznski Moderbacher et al., 2020).”
From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Robbiani et al., 2020
Neutralizing antibody titers and total Spike antibody titers positively correlate with COVID-19 disease severity in large cohort studies.
“This appears to hold true in the case of SARS-CoV-2, where neutralizing antibody titers (and total Spike antibody titers) have positively correlated with COVID-19 disease severity in large cohort studies (Piccoli et al., 2020; Robbiani et al., 2020).”
From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Robbiani et al., 2020
Circulating SARS-CoV-2 neutralizing antibody titers are relatively low in a substantial fraction of recovered COVID-19 cases.
“However, it should also be noted that circulating SARS-CoV-2 neutralizing antibody titers are relatively low in a substantial fraction of recovered COVID-19 cases (Dan et al., 2021; Robbiani et al., 2020; Wajnberg et al., 2020), indicating that either the neutralizing antibody potency or the serum concentration is suboptimal in this subset.”
From Adaptive immunity to SARS-CoV-2 and COVID-19 (2021) · cites this paper as Robbiani et al., 2020
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Immunological memory to SARS-CoV-2 assessed for up to 8 months after infection.
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Breton, G., Mendoza, P., Hägglöf, T., Oliveira, T. Y., Schaefer-Babajew, D., Gaebler, C., Turroja, M., Hurley, A., Caskey, M., & Nussenzweig, M. C. (2021) · Journal of Experimental Medicine · doi:10.1084/jem.20202515 · Cited by 129 · see citing works
Self-citationDeep geometric representations for modeling effects of mutations on protein-protein binding affinity
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Asymptomatic and symptomatic SARS-CoV-2 infections elicit polyfunctional antibodies
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Discrete SARS-CoV-2 antibody titers track with functional humoral stability
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“S2M11 was not further developed, while C144 mAb is in early clinical development by Bristol Myers Squibb (phase 1, NCT04700163) in combination with another RBM mAb named C135 (both developed with LS mutations in Fc for half-life extension) (Robbiani et al., 2020; Weisblum et al., 2020).”
Multiscale PHATE identifies multimodal signatures of COVID-19
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Presence of antibody-dependent cellular cytotoxicity (ADCC) against SARS-CoV-2 in COVID-19 plasma
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Cryo-EM: the resolution revolution and drug discovery
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- Authors
- Robbiani, D. F., Gaebler, C., Muecksch, F., Lorenzi, J. C. C., Wang, Z., Cho, A., Agudelo, M., Barnes, C. O., Gazumyan, A., Finkin, S., Hägglöf, T., Oliveira, T. Y., Viant, C., Hurley, A., Hoffmann, H.-H., Millard, K. G., Kost, R. G., Cipolla, M., Gordon, K., Bianchini, F., Chen, S. T., Ramos, V., Patel, R., Dizon, J., Shimeliovich, I., Mendoza, P., Hartweger, H., Nogueira, L., Pack, M., Horowitz, J., Schmidt, F., Weisblum, Y., Michailidis, E., Ashbrook, A. W., Waltari, E., Pak, J. E., Huey-Tubman, K. E., Koranda, N., Hoffman, P. R., West, A. P., Rice, C. M., Hatziioannou, T., Bjorkman, P. J., Bieniasz, P. D., Caskey, M., & Nussenzweig, M. C.
- Affiliations
- Institute for Research in Biomedicine (CH)
- Rockefeller University (US)
- California Institute of Technology (US)
- Chan Zuckerberg Biohub San Francisco (US)
- Howard Hughes Medical Institute (US)
- Corresponding author
- Robbiani, Davide F.
- Bieniasz, Paul D.
- Caskey, Marina
- Nussenzweig, Michel C.
- ORCID
- Robbiani, Davide F.
- Gaebler, Christian
- Muecksch, Frauke
- Lorenzi, Julio C. C.
- Wang, Zijun
- Cho, Alice
- Agudelo, Marianna
- Barnes, Christopher O.
- Gazumyan, Anna
- Finkin, Shlomo
- Hägglöf, Thomas
- Oliveira, Thiago Y.
- Viant, Charlotte
- Hurley, Arlene
- Hoffmann, Hans-Heinrich
- Millard, Katrina G.
- Kost, Rhonda G.
- Cipolla, Melissa
- Bianchini, Filippo
- Chen, Spencer T.
- Dizon, Juan
- Shimeliovich, Irina
- Mendoza, Pilar
- Hartweger, Harald
- Nogueira, Lilian
- Schmidt, Fabian
- Weisblum, Yiska
- Michailidis, Eleftherios
- Ashbrook, Alison W.
- Waltari, Eric
- Pak, John E.
- Koranda, Nicholas
- Hoffman, Pauline R.
- West, Anthony P.
- Rice, Charles M.
- Bjorkman, Pamela J.
- Bieniasz, Paul D.
- Caskey, Marina
- Nussenzweig, Michel C.
- Venue
- Nature
- Published
- 2020-06-18
- Volume
- 584
- Issue
- 7821
- Pages
- 437-442
- ISSN
- 0028-0836 (ISSN-L)
- 1476-4687
- PMC
- PMC7442695
- OpenAlex
- W3036386821
- Cited by
- 1,853
- References
- 46
- Citations by year
- 2026: 49 · 2025: 79 · 2024: 115 · 2023: 194 · 2022: 403 · 2021: 691 · 2020: 321
- FWCI
- 52.98
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Nature (publishedVersion)
- bioRxiv (Cold Spring Harbor Laboratory) (acceptedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- PubMed Central (submittedVersion, cc-by-nc-nd)
- CaltechAUTHORS (California Institute of Technology) (submittedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Funders
- Howard Hughes Medical Institute (UL1TR001866)
- George Mason University
- California Institute of Technology
- Fast Grants
- National Institutes of Health (P01-AI138398-S1, AI150464, TR001866, UL1TR001866)
- Beckman Institute, California Institute of Technology
- National Institute of Allergy and Infectious Diseases (R01AI091707, R01AI078788, P50AI150464, U19AI111825, P01AI138938, R37AI064003, T32AI070084)
- National Center for Advancing Translational Sciences (TR001866)
- Topics
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › vaccines and immunoinformatics approaches
- Life Sciences › Agricultural and Biological Sciences › Animal Science and Zoology › Animal Virus Infections Studies
- Keywords
- SARS-CoV-2, COVID-19 pandemic, convalescent plasma, neutralizing antibodies, receptor binding domain, spike protein, antibody response, memory B cells, pseudovirus neutralization, vaccine design, antibody epitopes
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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