COVID-19-neutralizing antibodies predict disease severity and survival.

Cell
Wilfredo F Garcia-BeltranAlejandro B Balazs

Abstract

Coronavirus disease 2019 (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-receptor binding domain (RBD) antibody levels. Although anti-RBD immunoglobulin G (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, which 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.

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Datasets Mentioned

BETA
MN975262.1

Methods Mentioned

BETA
ELISA
PCR
ELISAs
flow cytometry
Confocal microscopy
transfection
transfections

Key Resources (RRID) Mentioned

Addgene_50005

Software Mentioned

Graphpad Prism
JMP Pro R
SAS
ImageJ
R
JMP Pro
Addgene

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