Sera neutralizing activities against SARS-CoV-2 and multiple variants six month after hospitalization for COVID-19

Betton, Maureen; Livrozet, Marine; Planas, Delphine; Fayol, Antoine; Monel, Blandine; Védie, Benoit; Bruel, Timothée; Tartour, Eric; Robillard, Nicolas; Manuguerra, Jean-Claude; Blanchard, Anne; Ghosn, Jade; Visseaux, Benoit; Péré, Hélène; Lebeaux, David; Schwartz, Olivier; Veyer, David; Hulot, Jean-Sébastien

BACKGROUND: Humoral response to SARS-CoV-2 occurs within the first weeks after COVID-19. Those antibodies exert a neutralizing activity against SARS-CoV-2, whose evolution overtime after COVID-19 as well as efficiency against novel variants are however poorly characterized. METHODS: In this prospective study, sera of 107 patients hospitalized with COVID-19 were collected at 3- and 6-months post-infection. We performed quantitative neutralization experiments on top of high-throughput serological assays evaluating anti-Spike (S) and anti-Nucleocapsid (NP) IgG. FINDINGS: Levels of sero-neutralization and IgG rates against the ancestral strain decreased significantly over time. After 6 months, 2.8% of the patients had a negative serological status for both anti-S and anti-NP IgG. However, all sera had a persistent and effective neutralizing effect against SARS-CoV-2. IgG levels correlated with sero-neutralization and this correlation was stronger for anti-S than for anti-NP antibodies. The level of sero-neutralization quantified at 6 months correlated with markers of initial severity, notably admission in intensive care units and the need for mechanical invasive ventilation. In addition, sera collected at 6 months were tested against multiple SARS-CoV-2 variants and showed efficient neutralizing effects against D614G, B.1.1.7 and P.1 variants but a significantly weaker activity against B.1.351 variant. INTERPRETATION: Decrease of IgG rates and serological assays becoming negative did not imply loss of neutralizing capacity. Our results indicate a sustained humoral response against the ancestral strain and the D614G, B.1.1.7 and P.1 variants for at least 6 months in patients previously hospitalized for COVID-19. A weaker protection was however observed for the B.1.351 variant.