One-Year Follow-Up of COVID-19 Patients Indicates Substantial Assay-Dependent Differences in the Kinetics of SARS-CoV-2 Antibodies

Egger, Alexander; Sahanic, Sabina; Gleiß, Andreas; Ratzinger, Franz; Holzer, Barbara; Irsara, Christian; Binder, Nikolaus B.; Winkler, Christoph; Binder, Christoph J.; Posch, Wilfried; Loacker, Lorin; Hartmann, Boris; Weiss, Guenter; Sonnweber, Thomas; Tancevski, Ivan; Griesmacher, Andrea; Löffler‐Ragg, Judith; Hoermann, Gregor

doi:10.1128/spectrum.00597-22

Cited by 7 publications

(13 citation statements)

References 40 publications

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“…For this reason, possible immune priming of undiagnosed pre-vaccination effects cannot be ruled out. The assay used only identifies SARS-CoV-2 IgG against spike glycoprotein, and differentiation between the vaccine response and pre-existing infection was therefore not possible; a combined assay also detecting SARS-CoV-2 nucleocapsid antibodies would be more useful [ 30 , 31 ]. Recently, our data concentrated on antibody titers and did not document breakthrough infections, which would have been of great interest to better understand correlations between antibody titers and the degree of protection.…”

Section: Discussionmentioning

confidence: 99%

Durability of Immune Response after Application of a Third Dose of SARS-CoV-2 Vaccination in Liver Transplant Recipients

et al. 2023

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Immunogenicity after SARS-CoV-2 vaccination is known to be impaired in liver transplant (LT) recipients, but the results after the application of a third dose show significant improvement in seroconversion rates. In the general population, the antibody response wanes over the course of time after two doses of the vaccination, but seems to be more robust after the application of three doses. Still, the durability of the antibody response in LT recipients who receive a third dose of SARS-CoV-2 vaccination has not been analyzed yet. We therefore assessed antibody responses in a total of 300 LT recipients and observed antibody titers for six months each after patients had received the second and the third doses of the vaccination, explicitly excluding all patients who had suffered from SARS-CoV-2 infection. The initial antibody response was compared to a control group of 122 healthcare workers. After the application of two doses of the vaccination, 74% of LT recipients (158 out of 213) developed antibodies against SARS-CoV-2; this result depended significantly on whether the patients were taking the medication mycophenolate mofetil, and on the age of the patients. Antibody titers declined significantly within six months from 407 BAU/mL (IQR: 0–1865) to 105 BAU/mL (IQR: 0–145) (p ≤ 0.001), but increased after the application of the third vaccine dose in 92% of patients (105 out of 114), showing an antibody response (p ≤ 0.001). After a further six-month period, despite showing a decline from 2055 BAU/mL (IQR: 500 to >2080) to 1805 BAU/mL (IQR: 517 to >2080), the waning of antibody titers was not significant (p = 0.706), and antibody durability appeared to be more robust than that after the second dose. In conclusion, our study confirms the high efficacy of the application of a third dose of SARS-CoV-2 vaccination in LT recipients, and a reasonably sustained humoral response with superior durability in comparison to antibody kinetics after the application of the second dose of the vaccination.

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Section: Discussionmentioning

confidence: 99%

Durability of Immune Response after Application of a Third Dose of SARS-CoV-2 Vaccination in Liver Transplant Recipients

et al. 2023

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“…collected at common timepoints post-infection, guided by knowledge of expected rates of seroconversion and decay Serological sampling timepoints varied considerably, given no accepted standards. 70,71 Results may differ depending on months post-infection at which blood is collected for serological analysis. [71][72][73] This is especially true if sampling timepoints vary between groups with and without persisting symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…However, some studies have found differences in recalibrated results derived from different assays. 70,81 Additionally, variable derivation of cut-offs and thresholds and units of quantitative results obscure understanding of findings. Studies that report strength of response using cut-offs (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…4.1.4 | Risk of bias-recommendations to improve the quality of evidence Common factors threatening study quality included failures to describe efforts to confirm that SARS-CoV-2 infection preceded the outcome, and to control for potential confounders. We identified acute severity of illness as the most important confounder to consider, given that substantial evidence has highlighted this to be a major driver of serological response, 70,73,75,79,85,86 and many studies have found more severe illness early on to be predictive of long COVID onset and trajectory. 15,16,20,87 Some studies also restricted serological follow-up to seropositive cases.…”

Section: Discussionmentioning

confidence: 99%

“…Serological sampling timepoints varied considerably, given no accepted standards 70,71 . Results may differ depending on months post‐infection at which blood is collected for serological analysis 71–73 .…”

Section: Discussionmentioning

confidence: 99%

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Serological markers and long COVID—A rapid systematic review

Collins,

Philippe,

Gravel

et al. 2023

Eur J Clin Investigation

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BackgroundLong COVID is highly heterogeneous, often debilitating, and may last for years after infection. The aetiology of long COVID remains uncertain. Examination of potential serological markers of long COVID, accounting for clinical covariates, may yield emergent pathophysiological insights.MethodsIn adherence to PRISMA guidelines, we carried out a rapid review of the literature. We searched Medline and Embase for primary observational studies that compared IgG response in individuals who experienced COVID‐19 symptoms persisting ≥12 weeks post‐infection with those who did not. We examined relationships between serological markers and long COVID status and investigated sources of inter‐study variability, such as severity of acute illness, long COVID symptoms assessed and target antigen(s).ResultsOf 8018 unique records, we identified 29 as being eligible for inclusion in synthesis. Definitions of long COVID varied. In studies that reported anti‐nucleocapsid (N) IgG (n = 10 studies; n = 989 participants in aggregate), full or partial anti‐Spike IgG (i.e. the whole trimer, S1 or S2 subgroups, or receptor binding domain, n = 19 studies; n = 2606 participants), or neutralizing response (n = 7 studies; n = 1123 participants), we did not find strong evidence to support any difference in serological markers between groups with and without persisting symptoms. However, most studies did not account for severity or level of care required during acute illness, and other potential confounders.ConclusionsPooling of studies would enable more robust exploration of clinical and serological predictors among diverse populations. However, substantial inter‐study variations hamper comparability. Standardized reporting practices would improve the quality, consistency and comprehension of study findings.

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Outpatient COVID-19 convalescent plasma recipient antibody thresholds correlated to reduced hospitalizations within a randomized trial

Park

Barranta

Yin

et al. 2023

Preprint

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SARS-CoV-2 antibody levels associated with reduced hospitalization risk remain undefined. Our outpatient COVID-19 convalescent plasma (CCP), placebo-controlled trial observed SARS-CoV-2 antibody levels decreasing 22-fold from matched donor units into post-transfusion seronegative recipients. Unvaccinated recipients were jointly stratified by a) early or late transfusion (< 5 or >5 days from symptom onset) and b) high or low post-transfusion SARS-CoV-2 antibody levels (< or > geometric mean). Early treatment with high post-transfusion antibody levels reduced hospitalization risk-0/102 (0%) compared to all other CCP recipients-17/370 (4.6%; Fisher exact-p-0.03) and to all control plasma recipients-35/461 (7.6%; Fisher exact p-0.001). A similar donor upper/lower half antibody level and early late transfusion stratified analyses indicated significant hospital risk reduction. Pre-transfusion nasal viral loads were similar in CCP and control recipients regardless of hospitalization outcome. Therapeutic CCP should comprise the upper 30% of donor antibody levels to provide effective outpatient use for immunocompromised and immunocompetent outpatients.

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One-Year Follow-Up of COVID-19 Patients Indicates Substantial Assay-Dependent Differences in the Kinetics of SARS-CoV-2 Antibodies

Cited by 7 publications

References 40 publications

Durability of Immune Response after Application of a Third Dose of SARS-CoV-2 Vaccination in Liver Transplant Recipients

Durability of Immune Response after Application of a Third Dose of SARS-CoV-2 Vaccination in Liver Transplant Recipients

Serological markers and long COVID—A rapid systematic review

Outpatient COVID-19 convalescent plasma recipient antibody thresholds correlated to reduced hospitalizations within a randomized trial

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