Author: Lucas, Carolina; Klein, Jon; Sundaram, Maria E; Liu, Feimei; Wong, Patrick; Silva, Julio; Mao, Tianyang; Oh, Ji Eun; Mohanty, Subhasis; Huang, Jiefang; Tokuyama, Maria; Lu, Peiwen; Venkataraman, Arvind; Park, Annsea; Israelow, Benjamin; Vogels, Chantal B F; Muenker, M Catherine; Chang, C-Hong; Casanovas-Massana, Arnau; Moore, Adam J; Zell, Joseph; Fournier, John B; Wyllie, Anne L; Campbell, Melissa; Lee, Alfred; Chun, Hyung J; Grubaugh, Nathan D; Schulz, Wade L; Farhadian, Shelli; Dela Cruz, Charles; Ring, Aaron M; Shaw, Albert C; Wisnewski, Adam V; Yildirim, Inci; Ko, Albert I; Omer, Saad; Iwasaki, Akiko
Title: Delayed production of neutralizing antibodies correlates with fatal COVID-19. Cord-id: itwp8mlj Document date: 2021_5_5
ID: itwp8mlj
Snippet: Recent studies have provided insights into innate and adaptive immune dynamics in coronavirus disease 2019 (COVID-19). However, the exact features of antibody responses that govern COVID-19 disease outcomes remain unclear. In this study, we analyzed humoral immune responses in 229 patients with asymptomatic, mild, moderate and severe COVID-19 over time to probe the nature of antibody responses in disease severity and mortality. We observed a correlation between anti-spike (S) immunoglobulin G (I
Document: Recent studies have provided insights into innate and adaptive immune dynamics in coronavirus disease 2019 (COVID-19). However, the exact features of antibody responses that govern COVID-19 disease outcomes remain unclear. In this study, we analyzed humoral immune responses in 229 patients with asymptomatic, mild, moderate and severe COVID-19 over time to probe the nature of antibody responses in disease severity and mortality. We observed a correlation between anti-spike (S) immunoglobulin G (IgG) levels, length of hospitalization and clinical parameters associated with worse clinical progression. Although high anti-S IgG levels correlated with worse disease severity, such correlation was time dependent. Deceased patients did not have higher overall humoral response than discharged patients. However, they mounted a robust, yet delayed, response, measured by anti-S, anti-receptor-binding domain IgG and neutralizing antibody (NAb) levels compared to survivors. Delayed seroconversion kinetics correlated with impaired viral control in deceased patients. Finally, although sera from 85% of patients displayed some neutralization capacity during their disease course, NAb generation before 14 d of disease onset emerged as a key factor for recovery. These data indicate that COVID-19 mortality does not correlate with the cross-sectional antiviral antibody levels per se but, rather, with the delayed kinetics of NAb production.
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