PLoS Medicine (Jul 2021)

SARS-CoV-2 neutralizing antibodies: Longevity, breadth, and evasion by emerging viral variants.

  • Fiona Tea,
  • Alberto Ospina Stella,
  • Anupriya Aggarwal,
  • David Ross Darley,
  • Deepti Pilli,
  • Daniele Vitale,
  • Vera Merheb,
  • Fiona X Z Lee,
  • Philip Cunningham,
  • Gregory J Walker,
  • Christina Fichter,
  • David A Brown,
  • William D Rawlinson,
  • Sonia R Isaacs,
  • Vennila Mathivanan,
  • Markus Hoffmann,
  • Stefan Pöhlman,
  • Ohan Mazigi,
  • Daniel Christ,
  • Dominic E Dwyer,
  • Rebecca J Rockett,
  • Vitali Sintchenko,
  • Veronica C Hoad,
  • David O Irving,
  • Gregory J Dore,
  • Iain B Gosbell,
  • Anthony D Kelleher,
  • Gail V Matthews,
  • Fabienne Brilot,
  • Stuart G Turville

DOI
https://doi.org/10.1371/journal.pmed.1003656
Journal volume & issue
Vol. 18, no. 7
p. e1003656

Abstract

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The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) antibody neutralization response and its evasion by emerging viral variants and variant of concern (VOC) are unknown, but critical to understand reinfection risk and breakthrough infection following vaccination. Antibody immunoreactivity against SARS-CoV-2 antigens and Spike variants, inhibition of Spike-driven virus-cell fusion, and infectious SARS-CoV-2 neutralization were characterized in 807 serial samples from 233 reverse transcription polymerase chain reaction (RT-PCR)-confirmed Coronavirus Disease 2019 (COVID-19) individuals with detailed demographics and followed up to 7 months. A broad and sustained polyantigenic immunoreactivity against SARS-CoV-2 Spike, Membrane, and Nucleocapsid proteins, along with high viral neutralization, was associated with COVID-19 severity. A subgroup of "high responders" maintained high neutralizing responses over time, representing ideal convalescent plasma donors. Antibodies generated against SARS-CoV-2 during the first COVID-19 wave had reduced immunoreactivity and neutralization potency to emerging Spike variants and VOC. Accurate monitoring of SARS-CoV-2 antibody responses would be essential for selection of optimal responders and vaccine monitoring and design.