COVID-19 neutralizing antibodies predict disease severity and survival: Cell

https://www.cell.com/cell/fulltext/S0092-8674(20)31685-8

COVID-19 neutralizing antibodies predict disease severity and survival

Highlights

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  Severe COVID-19 associates with higher antibody production and neutralization titers
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  Neutralization potency of anti-RBD antibodies predicts disease severity and survival
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  Immunomodulatory COVID-19-directed therapies modulate antibody responses
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  COVID-19 sera neutralize D614 and G614 variants, but not pre-emergent WIV1-CoV

Summary

COVID-19 exhibits variable symptom severity ranging from asymptomatic to life-threatening, yet the relationship between severity and the humoral immune response is poorly understood. We examined antibody responses in 113 COVID-19 patients and found that severe cases resulting in intubation or death exhibited increased inflammatory markers, lymphopenia, pro-inflammatory cytokines, and high anti-RBD antibody levels. While anti-RBD IgG levels generally correlated with neutralization titer, quantitation of neutralization potency revealed that high potency was a predictor of survival. In addition to neutralization of wild-type SARS-CoV-2, patient sera were also able to neutralize the recently emerged SARS-CoV-2 mutant D614G, suggesting cross-protection from reinfection by either strain. However, SARS-CoV-2 sera generally lacked cross-neutralization to a highly-homologous pre-emergent bat coronavirus, WIV1-CoV, that has not yet crossed the species barrier. These results highlight the importance of neutralizing humoral immunity on disease progression and the need to develop broadly protective interventions to prevent future coronavirus pandemics.

Article Info

Publication History

Accepted: December 9, 2020

Received in revised form: November 17, 2020

Received: October 12, 2020

Publication stage

In Press Accepted Manuscript

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