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Long-Term Persistence of SARS-CoV-2 Neutralizing Antibody Responses After Infection and Estimates of the Duration of Protection

20 Pages Posted: 7 Jul 2021

See all articles by Eric H.Y. Lau

Eric H.Y. Lau

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control

David S. C. Hui

The Chinese University of Hong Kong (CUHK) - Department of Medicine and Therapeutics

Owen Tak-Yin Tsang

Princess Margaret Hospital - Department of Medicine

Wai-Hung Chan

Queen Elizabeth Hospital, Hong Kong - Department of Paediatrics

Mike YE Kwan

Princess Margaret Hospital - Department of Paediatric and Adolescent Medicine

Susan S. Chiu

The University of Hong Kong

Samuel MS Cheng

The University of Hong Kong

Ronald LW Ko

The University of Hong Kong

John KC Li

The University of Hong Kong - School of Public Health

Sara Chaothai

The University of Hong Kong - School of Public Health

Chi H. Tsang

The University of Hong Kong - School of Public Health

Leo LM Poon

The University of Hong Kong - School of Public Health

J.S. Malik Peiris

The University of Hong Kong - School of Public Health

More...

Abstract

The duration of immunity in SARS-CoV-2 infected people remains unclear. Neutralizing antibody responses are the best available correlate of protection against re-infection. Recent studies have estimated that the correlate of 50% protection from re-infection was 20% of the mean convalescent neutralizing antibody titre. We used sera collected from a cohort of 125 individuals with RT-PCR confirmed SARS-CoV-2 infections up to 386 days after symptom onset. In the subset of 65 sera collected from day 151 to 386 after symptom onset, all remained positive in 50% plaque reduction neutralization tests (PRNT50). Because antibody waning follows a bimodal pattern with slower waning beyond day 90 after illness, we fitted lines of decay to 115 sera from 62 patients collected beyond 90 after symptom onset and estimate that PRNT50 antibody will remain detectable for around 1,717 days after symptom onset and that 50% protective antibody titers will be maintained for around 990 days post-symptom onset, in symptomatic patients. Peak PRNT titres in mildly symptomatic children did not differ from those in mildly symptomatic adults but these antibody titres appear to wane faster in children. There was a high level of correlation between PRNT50 antibody titers and the % of inhibition in surrogate virus neutralization tests. We conclude that there will be relatively long-lived protection from re-infection following symptomatic COVID-19 disease.

Funding Information: The study was supported by the Health and Medical Research Fund, Commissioned research on Novel Coronavirus Disease (COVID-19) (Reference no COVID190126) from the Food and Health Bureau, Hong Kong SAR Government and the Theme-based Research Scheme project no. T11-712/19-N, the University Grants Committee of the Hong Kong Government.

Declaration of Interests: None of the authors have any conflicts of interest to declare.

Ethics Approval Statement: Written informed consent was obtained from the participants or their parents (when the participant was a child) and the studies were approved by the institutional review boards of the respective hospitals, viz. Kowloon West Cluster (KW/EX-20-039 (144-27)), Kowloon Central / Kowloon East cluster (KC/KE-20-0154/ER2) and HKU/HA Hong Kong West Cluster (UW 20-273).

Keywords: COVID-19, SARS-CoV-2, coronavirus, neutralizing antibody, kinetics, protection, immunity, duration

Suggested Citation

Lau, Eric H.Y. and Hui, David S. C. and Tsang, Owen Tak-Yin and Chan, Wai-Hung and Kwan, Mike YE and Chiu, Susan S. and Cheng, Samuel MS and Ko, Ronald LW and Li, John KC and Chaothai, Sara and Tsang, Chi H. and Poon, Leo LM and Peiris, J.S. Malik, Long-Term Persistence of SARS-CoV-2 Neutralizing Antibody Responses After Infection and Estimates of the Duration of Protection. Available at SSRN: https://ssrn.com/abstract=3881728 or http://dx.doi.org/10.2139/ssrn.3881728

Eric H.Y. Lau

The University of Hong Kong - WHO Collaborating Centre for Infectious Disease Epidemiology and Control ( email )

Hong Kong
China

David S. C. Hui

The Chinese University of Hong Kong (CUHK) - Department of Medicine and Therapeutics ( email )

China

Owen Tak-Yin Tsang

Princess Margaret Hospital - Department of Medicine ( email )

China

Wai-Hung Chan

Queen Elizabeth Hospital, Hong Kong - Department of Paediatrics ( email )

Hong Kong

Mike YE Kwan

Princess Margaret Hospital - Department of Paediatric and Adolescent Medicine ( email )

China

Susan S. Chiu

The University of Hong Kong

Pokfulam Road
Hong Kong, HK
China

Samuel MS Cheng

The University of Hong Kong

Pokfulam Road
Hong Kong, HK
China

Ronald LW Ko

The University of Hong Kong

Pokfulam Road
Hong Kong, HK
China

John KC Li

The University of Hong Kong - School of Public Health

Sara Chaothai

The University of Hong Kong - School of Public Health

Chi H. Tsang

The University of Hong Kong - School of Public Health

Leo LM Poon

The University of Hong Kong - School of Public Health ( email )

Hong Kong, Pokfulam
China

J.S. Malik Peiris (Contact Author)

The University of Hong Kong - School of Public Health ( email )

Hong Kong, Pokfulam
China

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