Population-based study of the durability of humoral immunity after SARS-CoV-2 infection

David Peterhoff; Simon Wiegrebe; Sebastian Einhauser; Arisha J Patt; Stephanie Beileke; Felix Günther; Philipp Steininger; Hans H Niller; Ralph Burkhardt; Helmut Küchenhoff; Olaf Gefeller; Klaus Überla; Iris M Heid; Ralf Wagner

doi:10.3389/fimmu.2023.1242536

Population-based study of the durability of humoral immunity after SARS-CoV-2 infection

Front Immunol. 2023 Oct 5:14:1242536. doi: 10.3389/fimmu.2023.1242536. eCollection 2023.

Authors

David Peterhoff^{1

2}, Simon Wiegrebe^{3

4}, Sebastian Einhauser¹, Arisha J Patt², Stephanie Beileke⁵, Felix Günther^{3

4}, Philipp Steininger⁵, Hans H Niller¹, Ralph Burkhardt⁶, Helmut Küchenhoff⁴, Olaf Gefeller⁷, Klaus Überla⁵, Iris M Heid³, Ralf Wagner^{1

2}

Affiliations

¹ Institute of Medical Microbiology and Hygiene, Molecular Microbiology (Virology), University of Regensburg, Regensburg, Germany.
² Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany.
³ Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany.
⁴ Statistical Consulting Unit StaBLab, Department of Statistics, Ludwig-Maximilians-Universität (LMU) Munich, Munich, Germany.
⁵ Institute of Clinical and Molecular Virology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
⁶ Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Regensburg, Regensburg, Germany.
⁷ Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.

Abstract

SARS-CoV-2 antibody quantity and quality are key markers of humoral immunity. However, there is substantial uncertainty about their durability. We investigated levels and temporal change of SARS-CoV-2 antibody quantity and quality. We analyzed sera (8 binding, 4 avidity assays for spike-(S-)protein and nucleocapsid-(N-)protein; neutralization) from 211 seropositive unvaccinated participants, from the population-based longitudinal TiKoCo study, at three time points within one year after infection with the ancestral SARS-CoV-2 virus. We found a significant decline of neutralization titers and binding antibody levels in most assays (linear mixed regression model, p<0.01). S-specific serum avidity increased markedly over time, in contrast to N-specific. Binding antibody levels were higher in older versus younger participants - a difference that disappeared for the asymptomatic-infected. We found stronger antibody decline in men versus women and lower binding and avidity levels in current versus never-smokers. Our comprehensive longitudinal analyses across 13 antibody assays suggest decreased neutralization-based protection and prolonged affinity maturation within one year after infection.

Keywords: COVID-19; SARS-CoV-2; antibody; avidity; durability; longitudinal; neutralization; population-based.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Antibodies, Viral
Biological Assay
COVID-19*
Female
Humans
Immunity, Humoral*
Male
SARS-CoV-2

Substances

Antibodies, Viral

Grants and funding

The authors declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Bavarian States Ministry of Science and Arts (StMWK; grant to RW and KÜ) as well as by the National Research Network of the University Medicine (NUM; applied surveillance and testing; B-FAST) to KÜ and RW.