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Siles N, Schuler M, Maguire C, Amengor D, Nguyen A, Wilen R, Rogers J, Bazzi S, Caslin B, DiPasquale C, Abigania M, Olson E, Creaturo J, Hurley K, Triplett TA, Rousseau JF, Strakowski SM, Wylie D, Maynard J, Ehrlich LIR, Melamed E. SARS-CoV-2 Humoral Immune Responses in Convalescent Individuals Over 12 Months Reveal Severity-Dependent Antibody Dynamics. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.12.05.23299462. [PMID: 38106077 PMCID: PMC10723498 DOI: 10.1101/2023.12.05.23299462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Background Understanding the kinetics and longevity of antibody responses to SARS-CoV-2 is critical to informing strategies toward reducing Coronavirus disease 2019 (COVID-19) reinfections, and improving vaccination and therapy approaches. Methods We evaluated antibody titers against SARS-CoV-2 nucleocapsid (N), spike (S), and receptor binding domain (RBD) of spike in 98 convalescent participants who experienced asymptomatic, mild, moderate or severe COVID-19 disease and in 17 non-vaccinated, non-infected controls, using four different antibody assays. Participants were sampled longitudinally at 1, 3, 6, and 12 months post-SARS-CoV-2 positive PCR test. Findings Increasing acute COVID-19 disease severity correlated with higher anti-N and anti-RBD antibody titers throughout 12 months post-infection. Anti-N and anti-RBD titers declined over time in all participants, with the exception of increased anti-RBD titers post-vaccination, and the decay rates were faster in hospitalized compared to non-hospitalized participants. <50% of participants retained anti-N titers above control levels at 12 months, with non-hospitalized participants falling below control levels sooner. Nearly all hospitalized and non-hospitalized participants maintained anti-RBD titers above controls for up to 12 months, suggesting longevity of protection against severe reinfections. Nonetheless, by 6 months, few participants retained >50% of their 1-month anti-N or anti-RBD titers. Vaccine-induced increases in anti-RBD titers were greater in non-hospitalized relative to hospitalized participants. Early convalescent antibody titers correlated with age, but no association was observed between Post-Acute Sequelae of SARS-CoV-2 infection (PASC) status or acute steroid treatment and convalescent antibody titers. Interpretation Hospitalized participants developed higher anti-SARS-CoV-2 antibody titers relative to non-hospitalized participants, a difference that persisted throughout 12 months, despite the faster decline in titers in hospitalized participants. In both groups, while anti-N titers fell below control levels for at least half of the participants, anti-RBD titers remained above control levels for almost all participants over 12 months, demonstrating generation of long-lived antibody responses known to correlate with protection from severe disease across COVID-19 severities. Overall, our findings contribute to the evolving understanding of COVID-19 antibody dynamics. Funding Austin Public Health, NIAAA, Babson Diagnostics, Dell Medical School Startup.
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Affiliation(s)
- Nadia Siles
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Maisey Schuler
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Cole Maguire
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Dzifa Amengor
- Department of Molecular Biosciences, University of Texas at Austin, Austin, Texas
| | - Annalee Nguyen
- Department of Chemical Engineering, University of Texas at Austin, Austin, Texas
| | - Rebecca Wilen
- Department of Chemical Engineering, University of Texas at Austin, Austin, Texas
| | - Jacob Rogers
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Sam Bazzi
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Blaine Caslin
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, Texas
| | | | | | | | - Janelle Creaturo
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Kerin Hurley
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, Texas; Dell Seton Medical Center at the University of Texas, Austin, Texas
| | - Todd A Triplett
- Department of Oncology Dell Medical School, University of Texas at Austin, Austin, Texas; Department of Immunotherapeutics & Biotechnology, School of Pharmacy, Texas Tech University Health Sciences Center, Abilene, TX, USA
| | - Justin F Rousseau
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, Texas; Department of Population Health, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Stephen M Strakowski
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis; Department of Psychiatry, Dell Medical School, University of Texas at Austin, Austin, Texas
| | - Dennis Wylie
- Center for Biomedical Research Support, University of Texas at Austin, Austin Texas
| | - Jennifer Maynard
- Department of Chemical Engineering, University of Texas at Austin, Austin, Texas
| | - Lauren I R Ehrlich
- Department of Molecular Biosciences, University of Texas at Austin, Austin, Texas
| | - Esther Melamed
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, Texas
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