PreprintCited by 139SARS-CoV-2 and COVID-19 ResearchCOVID-19 epidemiological studiesCOVID-19 Clinical Research Studies

Neutralising antibodies predict protection from severe COVID-19

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Cromer, Deborah, Steain, Megan, Reynaldi, Arnold, Schlub, Timothy E, Sasson, Sarah C, Kent, Stephen J, Khoury, David S, Davenport, Miles Philip·2022·Nature Communications

Abstract

Background: Vaccine protection from COVID-19 has been shown to decline with time-since-vaccination and against SARS-CoV-2 variants. Protection against severe COVID-19 is higher than against symptomatic infection, and also appears relatively preserved over time and against variants. Although Protection protection from symptomatic SARS-CoV-2 infection has been shown to be strongly correlated with neutralising antibody titres, however, this relationship has been is less well described for severe COVID-19. Protection against severe COVID-19 is higher than against symptomatic infection, and also appears relatively preserved over time and against variants. Here we analyse whether neutralising antibody titre remains predictive of protection against severe COVID-19 in the face of waning neutralising antibody levels and emerging variants. Methods: We extracted data from 15 studies reporting on protection against a range of SARS-CoV-2 clinical endpoints ("any infection", "symptomatic infection" and "severe COVID-19"). We then estimated the concurrent neutralising antibody titres using existing parameters on vaccine potency, neutralising antibody decay, and loss of recognition of variants and investigated the relationship between neutralising antibody titre and vaccine effectiveness against severe COVID-19. Findings: Predicted neutralising antibody titres are strongly correlated with vaccine effectiveness against symptomatic and severe COVID-19 (Spearman rho = .94 and 0.63 respectively, p<.001 for both), consistent with previous estimates of the relationship between neutralisation and protection. Indeed 82% (137 of 167) of reported values of protection against severe COVID-19 across a range of vaccines and variants lie within the 95% confidence intervals of the published model. Interpretation: Neutralising antibody titres are predictive of vaccine effectiveness against severe COVID-19 including in realistic scenarios of waning immunity and viral variants. Funding: National Health and Medical Research Council (Australia), Medical Research Future Fund (Australia).

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  1. [36]Walsh EE Safety and immunogenicity of two RNA-based Covid-19 vaccine candidates N. Engl. J. Med. 2020 383 2439 2450 10.1056/NEJMoa2027906 33053279 PMC7583697 · DOI · Paper page
  2. [39]Stadler, E. et al. Determinants of passive antibody effectiveness in SARS-CoV-2 infection. Preprint at medRxiv10.1101/2022.1103.1121.22272672 (2022).
  3. [47]Andrews, N. et al. Effectiveness of COVID-19 vaccines against the Omicron (B.1.1.529) variant of concern. Preprint at medRxiv10.1101/2021.1112.1114.21267615 (2021).

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Authors
Cromer, D., Steain, M., Reynaldi, A., Schlub, T. E., Sasson, S. C., Kent, S. J., Khoury, D. S., & Davenport, M. P.
Affiliations
  • UNSW Sydney (AU)
  • The University of Sydney (AU)
  • The University of Melbourne (AU)
Corresponding author
Cromer, Deborah
Venue
Nature Communications
Publisher
openRxiv
Published
2022-06-14
Volume
14
Issue
1
Pages
1633-1633
ISSN
2041-1723 (ISSN-L)
OpenAlex
W4360871696
Cited by
139
References
53
Citations by year
2026: 15 · 2025: 40 · 2024: 50 · 2023: 30 · 2022: 3 · 2021: 1
FWCI
6.39
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Nature Communications (publishedVersion, cc-by)
  • medRxiv (acceptedVersion, cc-by-nd)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Minerva Access (University of Melbourne) (submittedVersion, cc-by)
Funders
  • University of New South Wales
  • Medical Research Council
  • National Health and Medical Research Council (1149990, 1136452, 1173528)
  • Medical Research Future Fund
Topics
  • Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
  • Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
  • Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
Keywords
COVID-19 vaccine effectiveness, severe COVID-19, SARS-CoV-2, neutralizing antibodies, antibody waning, SARS-CoV-2 variants of concern, time since vaccination, vaccine regimens, symptomatic infection
MeSH terms
COVID-19, SARS-CoV-2, Vaccine Efficacy, Antibodies, Viral, Humans, Vaccination, Antibodies, Neutralizing

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