Longitudinal Analysis of Antibody Response Following SARS-CoV-2 Infection Depending on Disease Severity: A Prospective Cohort Study.

Publication date: Nov 13, 2023

Severe coronavirus disease 19 (COVID-19) is characterized by a dysregulated inflammatory response, with humoral immunity playing a central role in the disease course. The objective of this study was to assess the immune response and the effects of vaccination in recovered individuals with variable disease severity up to one year following natural infection. A prospective cohort study was conducted including patients with laboratory-confirmed COVID-19. Disease severity was classified as mild, moderate, and severe based on clinical presentation and outcomes. Anti-RBD (receptor binding domain) and neutralizing antibodies were evaluated at multiple timepoints during the first year after COVID-19 diagnosis. A total of 106 patients were included; of them, 28 were diagnosed with mild, 38 with moderate, and 40 with severe disease. At least one vaccine dose was administered in 58 individuals during the follow-up. Participants with mild disease presented significantly lower anti-RBD and neutralizing antibodies compared to those with moderate and severe disease up to the 3rd and 6th months after the infection, respectively. After adjusting for covariates, in the third month, severe COVID-19 was associated with significantly higher anti-RBD (β: 563. 09; 95% confidence intervals (CI): 257. 02 to 869. 17) and neutralizing (β: 21. 47; 95% CI: 12. 04 to 30. 90) antibodies. Among vaccinated individuals, at the 12th month, a history of moderate disease was associated with significantly higher anti-RBD levels (β: 5615. 19; 95% CI: 657. 92 to 10,572. 46). Severe COVID-19 is associated with higher anti-RBD and neutralizing antibodies up to 6 months after the infection. Vaccination of recovered patients is associated with a remarkable augmentation of antibody titers up to one year after COVID-19 diagnosis, regardless of disease severity.

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Concepts Keywords
Antibodies Antibodies, Neutralizing
Coronavirus Antibodies, Neutralizing
Mild Antibodies, Viral
Month Antibodies, Viral
Antibody Formation
COVID-19 Testing
immune system
Patient Acuity
Prospective Studies


Type Source Name
disease MESH SARS-CoV-2 Infection
pathway REACTOME SARS-CoV-2 Infection
disease IDO disease course
disease IDO immune response
disease VO vaccination
disease MESH infection
disease VO vaccine dose
disease VO vaccinated
disease IDO history
disease VO Severe acute respiratory syndrome coronavirus 2
disease MESH pneumonia
disease MESH respiratory failure
disease MESH thrombosis
disease MESH sepsis
drug DRUGBANK Trestolone
drug DRUGBANK Coenzyme M
disease VO vaccine
disease MESH metabolic syndrome
disease IDO host
disease VO effective
disease IDO production
disease MESH emergency
disease VO time
disease MESH Comorbidity
drug DRUGBANK Oxygen
disease MESH acute respiratory distress syndrome
disease MESH septic shock
disease IDO blood
drug DRUGBANK Cysteamine
disease IDO assay
disease VO USA
drug DRUGBANK Angiotensin II
drug DRUGBANK Methionine
disease MESH obesity
disease VO population
disease MESH dyslipidemia
disease MESH hypertension
disease MESH diabetes mellitus
drug DRUGBANK Dexamethasone
disease MESH breakthrough infections
disease MESH Malignancy
disease IDO symptom

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