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COVID-19-neutralizing antibodies predict disease severity and survival #MMPMID33412089
Garcia-Beltran WF; Lam EC; Astudillo MG; Yang D; Miller TE; Feldman J; Hauser BM; Caradonna TM; Clayton KL; Nitido AD; Murali MR; Alter G; Charles RC; Dighe A; Branda JA; Lennerz JK; Lingwood D; Schmidt AG; Iafrate AJ; Balazs AB
Cell 2021[Jan]; 184 (2): 476-488.e11 PMID33412089show ga
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.