Kinetics and correlates of the neutralizing antibody response to SARS-CoV-2 infection in humans

Vanshylla, Kanika; Di Cristanziano, Veronica; Kleipass, Franziska; Dewald, Felix; Schommers, Philipp; Gieselmann, Lutz; Gruell, Henning; Schlotz, Maike; Ercanoglu, Meryem S.; Stumpf, Ricarda; Mayer, Petra; Zehner, Matthias; Heger, Eva; Johannis, Wibke; Horn, Carola; Suárez, Isabelle; Jung, Norma; Salomon, Susanne; Eberhardt, Kirsten Alexandra; Gathof, Birgit; Fätkenheuer, Gerd; Pfeifer, Nico; Eggeling, Ralf; Augustin, Max; Lehmann, Clara; Klein, Florian

Understanding antibody-based SARS-CoV-2 immunity is critical for overcoming the COVID-19 pandemic and informing vaccination strategies. We evaluated SARS-CoV-2 antibody dynamics over 10 months in 963 individuals who predominantly experienced mild COVID-19. Investigating 2,146 samples, we initially detected SARS-CoV-2 antibodies in 94.4% individuals, with 82% and 79% exhibiting serum and IgG neutralization, respectively. Approximately 3% of individuals demonstrated exceptional SARS-CoV-2-neutralization, with these ‘elite neutralizers’ also possessing SARS-CoV-1 cross-neutralizing IgG. Multivariate statistical modeling revealed age, symptomatic infection, disease severity and gender as key factors predicting SARS-CoV-2 neutralizing activity. A loss of reactivity to the virus spike protein was observed in 13% individuals 10 months after infection. Neutralizing activity had half-lives of 14.7 weeks in serum versus 31.4 weeks in purified IgG, indicating a stable long-term IgG antibody response. Our results demonstrate a broad spectrum in the initial SARS-CoV-2-neutralizing antibody response, with sustained antibodies in most individuals for 10 months after mild COVID-19.