Durable antibody response one year after hospitalization for COVID-19: A longitudinal cohort study

• Published in: Journal of autoimmunity Vol. 123; p. 102703
• Main Authors: Masiá, Mar, Fernández-González, Marta, Telenti, Guillermo, Agulló, Vanesa, García, José A., Padilla, Sergio, García-Abellán, Javier, Galiana, Antonio, Gonzalo-Jiménez, Nieves, Gutiérrez, Félix
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.09.2021
• Subjects: Adult; Aged; Anti-nucleocapsid antibodies; Anti-spike antibodies; Antibodies, Neutralizing - immunology; Antibodies, Viral - immunology; Antibody responses; Antibody titers; Antigens, Viral - immunology; Convalescence; Coronavirus Nucleocapsid Proteins - immunology; COVID-19; COVID-19 - immunology; Female; Follow-Up Studies; Hospitalization; Humans; Humoral immune response; Immunoglobulin G - immunology; Male; Middle Aged; One year; Phosphoproteins - immunology; Post-infection immunity; Prospective Studies; RNA, Viral - blood; S-IgG; SARS-CoV-2; SARS-CoV-2 - immunology; Spike Glycoprotein, Coronavirus - immunology; Time Factors; Viremia - blood; Viremia - immunology; COVID-19; Antibody titers; SARS-CoV-2; Anti-nucleocapsid antibodies; S-IgG; One year; Humoral immune response; Antibody responses; Anti-spike antibodies; Post-infection immunity
• ISSN: 0896-8411; 1095-9157; 1095-9157
• DOI: 10.1016/j.jaut.2021.102703

Durability of the humoral immune response to SARS-CoV-2 has yet to be defined. We longitudinally evaluated during a 12-month period the antibody responses to SARS-CoV-2, and analysed predictors of antibody titres decline and seroreversion. Prospective study conducted in a cohort of patients hospitalized for microbiologically-confirmed COVID-19. Blood and nasopharyngeal samples were sequentially obtained during hospital stay and at 1, 2, 6 and 12 months after patients’ discharge for measuring anti-spike (S) and anti-nucleocapsid (N) IgG antibody levels and SARS-CoV-2 RNA, respectively. 80 non-vaccinated patients were analysed. At month 12 after discharge, 73 (91.2%) patients exhibited detectable S-IgG and 35 (43.8%) N-IgG antibody titres. A gradual wane was observed in S-IgG and N-IgG antibody titres. Linear regression showed that S-IgG decline was positively associated with peak antibody titres (coefficient [95% CI] 0.059 [0.05–0.067], p < 0.001), inversely with WHO severity score (coefficient [95% CI] −0.042 [-0.079/-0.004], p = 0.033), and there was a trivial positive association with age (coefficient [95% CI] 0.002 [0–0.005], p = 0.10); N-IgG decline was positively associated with peak antibody titres (coefficient [95% CI] 0.091 [0.078–0.105], p < 0.001). Logistic regression showed that seroreversion for S-IgG was inversely associated with peak S-IgG (OR 0.19; 95% CI, 0.04-0.45; p = 0.004); seroreversion for N-IgG was inversely associated with peak N-IgG (OR 0.71; 95% 0.53–0.90; p = 0.009) and positively with cycle threshold of RT-PCR (OR 1.14; 95% CI, 1.00–1.33; p = 0.062). Anti-spike IgG antibodies remain detectable one year after hospitalization for COVID-19. Higher peak antibody titres and disease severity were associated with increased durability of detectable antibodies. •Postinfection humoral immunity may protect against SARS-CoV-2 reinfection.•Durability of the humoral immune response remains unknown.•Most COVID-19 patients show persistent S-IgG antibodies one year after hospitalization.•Durability of antibody response associated with higher peak titres and disease severity.