2020
DOI: 10.1101/2020.12.18.20248331
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Kinetics of antibody responses dictate COVID-19 outcome

Abstract: SummaryRecent studies have provided insights into innate and adaptive immune dynamics in coronavirus disease 2019 (COVID-19). Yet, the exact feature of antibody responses that governs COVID-19 disease outcomes remain unclear. Here, we analysed humoral immune responses in 209 asymptomatic, mild, moderate and severe COVID-19 patients over time to probe the nature of antibody responses in disease severity and mortality. We observed a correlation between anti-Spike (S) IgG levels, length of hospitalization and cli… Show more

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Cited by 52 publications
(52 citation statements)
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“…In the Salmonella infected mouse model, the antibody responses important for the bacteria clearance are established by day 3 through 5 weeks, and GC formation is observed approximately one month after infection, indicating GC formation is not necessary for these early responses 43 . Similarly, in COVID-19 human samples, earlier antibody responses are likely to be associated with better recovery 44,45 , which is consistent with our findings that the rapid induction of inflammatory tissue-homing plasmablasts was linked with a better clinical outcome. Additionally, we detected that PD-1 high CXCR5 − Tph cells in the activated state had the capacity to support the induction of tissue-homing plasmablasts, and these T cells were significantly increased in stable patients at the earlier stage of disease.…”
Section: Discussionsupporting
confidence: 90%
“…In the Salmonella infected mouse model, the antibody responses important for the bacteria clearance are established by day 3 through 5 weeks, and GC formation is observed approximately one month after infection, indicating GC formation is not necessary for these early responses 43 . Similarly, in COVID-19 human samples, earlier antibody responses are likely to be associated with better recovery 44,45 , which is consistent with our findings that the rapid induction of inflammatory tissue-homing plasmablasts was linked with a better clinical outcome. Additionally, we detected that PD-1 high CXCR5 − Tph cells in the activated state had the capacity to support the induction of tissue-homing plasmablasts, and these T cells were significantly increased in stable patients at the earlier stage of disease.…”
Section: Discussionsupporting
confidence: 90%
“…Although the study has a limited follow-up, further data presented by Lucas et al in a recent preprint leads to similar conclusions. These researchers showcased that not only is there a delayed antibody response in lethal COVID-19, but also that an early-mounted neutralizing response correlates with discharge (71). The authors speculate on a possible window of 14 days POS in which antibody responses must be mounted for increasing odds of survival.…”
Section: Kineticsmentioning
confidence: 97%
“…Hence, passive antibody immunotherapy with broadly neutralizing molecules, to prevent or suppress viral replication in the lower airways, will likely find an important place in rescuing COVID-19 patients. Indeed, the early development of sufficient titers of neutralizing antibodies by the patient correlates with avoidance of progression to severe disease 8 , and early administration of recombinant neutralizing antibodies or those present in high-titer convalescent plasma can avert severe disease 911 . An advantage of antibodies and antibody Fc-based fusions compared with small molecule drugs is their long circulatory half-life imparted by the FcRn-mediated recycling into the bloodstream, which provides for long term control of virus replication even after a single administration 12 .…”
mentioning
confidence: 99%