Antibodies to SARS-CoV-2 and Their Potential for Therapeutic Passive Immunization

Abstract

<jats:p>We review aspects of the antibody response to SARS-CoV-2, the causative agent of the COVID- 19 pandemic. The topics we cover are relevant to immunotherapy with plasma from recovered patients and with monoclonal antibodies against the viral S-protein. The development of vaccines against SARS-CoV-2, an essential public health tool, will also be informed by an understanding of the antibody response in infected patients. Although virus-neutralizing antibodies are likely to protect, antibodies could potentially trigger immunopathogenic events in SARS-CoV-2-infected patients or enhance infection. An awareness of these possibilities may benefit clinicians and the developers of antibody-based therapies and vaccines. </jats:p>

Adjuvanted SARS-CoV-2 spike protein elicits neutralizing antibodies and CD4 T cell responses after a single immunization in mice

“…The immune profile required for vaccine-mediated protection against SARS-CoV-2 is currently unknown. Vaccine-induced antibody responses are the best correlate of protection for many infectious agents [1] and several anti-SARS-CoV-2 antibodies can neutralize the virus in vitro [ 4 , 52 ] and afford protection against SARS-CoV-2 when passively transferred to Syrian hamsters [53] . Vaccine-induced CD4 T cell responses may also play a role in protection against SARS-CoV-2, as CD4 T cells shape various immune effector functions, including orchestration of innate immunity, cytotoxic T cells and B cell functionality (reviewed in [54] ).…”

Testing-on-a-probe biosensors reveal association of early SARS-CoV-2 total antibodies and surrogate neutralizing antibodies with mortality in COVID-19 patients

“…Analyses of risk factors for a poor outcome in hospitalized COVID-19 patients ( Li et al, 2020 ; Ruan et al, 2020 ; Wolff et al, 2020 ; Zheng et al, 2020 ) have largely focused on patient clinical presentation, demographics, comorbidities, and non-specific laboratory testing results ( Wiersinga et al, 2020 ). However, patient humoral antibody responses to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are more disease specific and thus are likely to correlate better with disease severity and/or survival ( Klasse and More (2020) ). While many studies have reported that the magnitude of antibody response to SARS-CoV-2 tracks with the severity of COVID-19, these differences are generally seen more than 2–3 weeks after the onset of symptoms ( Long et al, 2020 ; Lynch et al, 2020 ; Yang et al, 2020 ; Zhao et al, 2020 ).…”

Testing-on-a-probe biosensors reveal association of early SARS-CoV-2 total antibodies and surrogate neutralizing antibodies with mortality in COVID-19 patients

“…Utilizing the TOP assays, we demonstrate, for the first time, that SARS-CoV-2 TAb and SNAb upon initial presentation are risk indicators for in-hospital mortality, and higher antibody levels are associated with a lower viral load. There has been significant controversy over the antibody response in patients with different levels of COVID-19 disease severity and different outcomes (Klasse and Moore 2020). Multiple studies have shown that SARS-CoV-2 specific antibody levels, such as IgM, IgG or NAb are elevated in patients with a more severe disease courses (Lynch KL 2020;Wang et al 2020a;Wang et al 2020b;Zohar and Alter 2020).…”

“…Analyses of risk factors for a poor outcome in hospitalized COVID-19 patients (Li et al 2020;Ruan et al 2020;Wolff et al 2020;Zheng et al 2020) have largely focused on patient clinical presentation, demographics, comorbidities, and non-specific laboratory testing results (Wiersinga et al 2020). However, COVID-19 serologic assays that evaluate patient humoral response to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are more disease specific and thus are likely to correlate better with disease severity and/or survival (Klasse and Moore 2020). While many studies have reported that the magnitude of antibody response to SARS-CoV-2 tracks with the severity of COVID-19, these differences are generally seen more than 2-3 weeks after the onset of symptoms (Long et al 2020;Lynch KL 2020;Yang et al 2020;.…”