Longitudinal observation and decline of neutralizing antibody responses in the three months following SARS-CoV-2 infection in humans

Type Journal Article Author Jeffrey Seow Author Carl Graham Author Blair Merrick Author Sam Acors Author Suzanne Pickering Author Kathryn J. A. Steel Author Oliver Hemmings Author Aoife O’Byrne Author Neophytos Kouphou Author Rui Pedro Galao Author Gilberto Betancor Author Harry D. Wilson Author Adrian W. Signell Author Helena Winstone Author Claire Kerridge Author Isabella Huettner Author Jose M. Jimenez-Guardeño Author Maria Jose Lista Author Nigel Temperton Author Luke B. Snell Author Karen Bisnauthsing Author Amelia Moore Author Adrian Green Author Lauren Martinez Author Brielle Stokes Author Johanna Honey Author Alba Izquierdo-Barras Author Gill Arbane Author Amita Patel Author Mark Kia Ik Tan Author Lorcan O’Connell Author Geraldine O’Hara Author Eithne MacMahon Author Sam Douthwaite Author Gaia Nebbia Author Rahul Batra Author Rocio Martinez-Nunez Author Manu Shankar-Hari Author Jonathan D. Edgeworth Author Stuart J. D. Neil Author Michael H. Malim Author Katie J. Doores URL https://www.nature.com/articles/s41564-020-00813-8 Rights 2020 The Author(s), under exclusive licence to Springer Nature Limited Pages 1-10 Publication Nature Microbiology ISSN 2058-5276 Date 26/10/2020 Extra Publisher: Nature Publishing Group DOI 10.1038/s41564-020-00813-8 Library Catalog www.nature.com Language en 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.