Rapid decline of neutralizing antibodies against SARS-CoV-2 among infected healthcare workers

Marot, Stéphane; Malet, Isabelle; Leducq, Valentin; Zafilaza, Karen; Sterlin, Delphine; Planas, Delphine; Gothland, Adélie; Jary, Aude; Dorgham, Karim; Bruel, Timothée; Burrel, Sonia; Boutolleau, David; Schwartz, Olivier; Gorochov, Guy; Calvez, Vincent; Marcelin, Anne-Geneviève

There are only few data concerning persistence of neutralizing antibodies (NAbs) among SARS-CoV-2-infected healthcare workers (HCW). These individuals are particularly exposed to SARS-CoV-2 infection and at potential risk of reinfection. We followed 26 HCW with mild COVID-19 three weeks (D21), two months (M2) and three months (M3) after the onset of symptoms. All the HCW had anti-receptor binding domain (RBD) IgA at D21, decreasing to 38.5% at M3 (p < 0.0001). Concomitantly a significant decrease in NAb titers was observed between D21 and M2 (p = 0.03) and between D21 and M3 (p < 0.0001). Here, we report that SARS-CoV-2 can elicit a NAb response correlated with anti-RBD antibody levels. However, this neutralizing activity declines, and may even be lost, in association with a decrease in systemic IgA antibody levels, from two months after disease onset. This short-lasting humoral protection supports strong recommendations to maintain infection prevention and control measures in HCW, and suggests that periodic boosts of SARS-CoV-2 vaccination may be required.