The effect of circulating neutralizing antibodies on the replication of SARS-CoV-2 variants following post-vaccination infections
Year: 2024
Type: preprint
Study design: Observational Study
Abstract: ABSTRACT The impact of pre-existing neutralizing antibodies (NAbs) titers on SARS-CoV-2 viral shedding dynamics in post-vaccination infection (PVI) are not well understood. We characterized viral shedding longitudinally in nasal specimens in relation to baseline (pre/peri-infection) serum neutralizing antibody titers in 125 participants infected with distinct SARS-CoV-2 variants. Among 68 participants who had received vaccinations, we quantified the effect of baseline serum NAb titers on maximum viral RNA titers and on the duration of infectivity. Baseline NAb titers were higher and efficiently targeted a broader range of variants in participants who received one or two monovalent ancestral booster vaccinations compared to those with a full primary vaccine series. In participants with Delta variant infections, baseline NAb titers targeting Delta were negatively correlated with maximum viral RNA copies. Per log 10 increase in baseline NAb IC50, maximum viral load was reduced -2.43 (95% confidence interval [CI] -3.76, -1.11) log10 N copies and days of infectious viral shedding were reduced -2.79 [95% CI: -4.99, -0.60] days. By contrast, in those with Omicron infections (BA.1, BA.2, BA.4 or BA.5 lineages) baseline NAb responses against Omicron lineages did not predict viral outcomes. Our results provide robust estimates of the effect of baseline NAbs on the magnitude and duration of nasal viral replication after PVI (albeit with an unclear effect on transmission) and show how immune escape variants efficiently evade these modulating effects.
Authors: Miguel A. Garcia-Knight, J. Daniel Kelly, Scott Lu, Michel Tassetto, Sarah A. Goldberg, Amethyst Zhang, Jesus Pineda-Ramirez, Khamal Anglin, Michelle C. Davidson, Jessica Y. Chen, Maya Fortes-Cobby, Sara Park, Ana Martinez, Matthew So, Aidan Donovan, Badri Viswanathan, Eugene T. Richardson, David R. McIlwain, Brice Gaudilliere, Rachel L. Rutishauser, Ahmed Chenna, Christos Petropoulos, Terri Wrin, Steve G. Deeks, Glen R. Abedi, Sharon Saydah, Jeffrey N. Martin, Melissa Briggs-Hagen, Claire M. Midgley, Michael J. Peluso, Raul Andino
Institutions: University of California, San Francisco, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Universidad Nacional Autónoma de México, San Francisco VA Medical Center, Brigham and Women's Hospital, Harvard University, Stanford University, Stanford Medicine, LabCorp (United States), San Francisco General Hospital, Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, University of California San Francisco Medical Center
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4399869005