Antibody response and therapy in COVID-19 patients: what can be learned for vaccine development?

Sci China Life Sci. 2020 Dec;63(12):1833-1849. doi: 10.1007/s11427-020-1859-y. Epub 2020 Dec 1.

Abstract

The newly emerged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected millions of people and caused tremendous morbidity and mortality worldwide. Effective treatment for coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 infection is lacking, and different therapeutic strategies are under testing. Host humoral and cellular immunity to SARS-CoV-2 infection is a critical determinant for patients' outcomes. SARS-CoV-2 infection results in seroconversion and production of anti-SARS-CoV-2 antibodies. The antibodies may suppress viral replication through neutralization but might also participate in COVID-19 pathogenesis through a process termed antibody-dependent enhancement. Rapid progress has been made in the research of antibody response and therapy in COVID-19 patients, including characterization of the clinical features of antibody responses in different populations infected by SARS-CoV-2, treatment of COVID-19 patients with convalescent plasma and intravenous immunoglobin products, isolation and characterization of a large panel of monoclonal neutralizing antibodies and early clinical testing, as well as clinical results from several COVID-19 vaccine candidates. In this review, we summarize the recent progress and discuss the implications of these findings in vaccine development.

Keywords: COVID-19; SARS-CoV-2; convalescent plasma; neutralizing antibody; seroconversion; spike protein; vaccine.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Neutralizing / biosynthesis
  • Antibodies, Neutralizing / therapeutic use
  • Antibodies, Viral / biosynthesis*
  • Asymptomatic Infections
  • COVID-19 / immunology*
  • COVID-19 / prevention & control
  • COVID-19 / therapy*
  • COVID-19 Serotherapy
  • COVID-19 Vaccines / isolation & purification
  • COVID-19 Vaccines / therapeutic use*
  • China
  • Drug Development / trends
  • Host Microbial Interactions / immunology
  • Humans
  • Immunity, Humoral
  • Immunization, Passive
  • Immunoglobulins, Intravenous / therapeutic use
  • Models, Immunological
  • Pandemics
  • Reinfection / immunology
  • Reinfection / prevention & control
  • SARS-CoV-2 / immunology*
  • Seroconversion

Substances

  • Antibodies, Monoclonal
  • Antibodies, Neutralizing
  • Antibodies, Viral
  • COVID-19 Vaccines
  • Immunoglobulins, Intravenous