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[Preprint]. 2020 May 8:2020.05.03.20084442. [Version 1] doi: 10.1101/2020.05.03.20084442

Rapid generation of neutralizing antibody responses in COVID-19 patients

Mehul S Suthar, Matthew Zimmerman, Robert Kauffman, Grace Mantus, Susanne Linderman, Abigail Vanderheiden, Lindsay Nyhoff, Carl Davis, Seyi Adekunle, Maurizio Affer, Melanie Sherman, Stacian Reynolds, Hans Verkerke, David N Alter, Jeannette Guarner, Janetta Bryksin, Michael Horwath, Connie Arthur, Natia Saakadze, Geoffrey Hughes Smith, Srilatha Edupuganti, Erin M Scherer, Kieffer Hellmeister, Andrew Cheng, Juliet A Morales, Andrew S Neish, Sean R Stowell, Filipp Frank, Eric Ortlund, Evan Anderson, Vineet Menachery, Nadine Rouphael, Aneesh Metha, David S Stephens, Rafi Ahmed, John Roback, Jens Wrammert
PMCID: PMC7274246  PMID: 32511565

Abstract

SARS-CoV-2 is currently causing a devastating pandemic and there is a pressing need to understand the dynamics, specificity, and neutralizing potency of the humoral immune response during acute infection. Herein, we report the dynamics of antibody responses to the receptor-binding domain (RBD) of the spike protein and virus neutralization activity in 44 COVID-19 patients. RBD-specific IgG responses were detectable in all patients 6 days after PCR confirmation. Using a clinical isolate of SARS-CoV-2, neutralizing antibody titers were also detectable in all patients 6 days after PCR confirmation. The magnitude of RBD-specific IgG binding titers correlated strongly with viral neutralization. In a clinical setting, the initial analysis of the dynamics of RBD-specific IgG titers was corroborated in a larger cohort of PCR-confirmed patients (n=231). These findings have important implications for our understanding of protective immunity against SARS-CoV-2, the use of immune plasma as a therapy, and the development of much-needed vaccines.

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