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. 2022 Jul 8;7(13):e156372. doi: 10.1172/jci.insight.156372

Figure 3. Neutralizing antibody levels correlate with disease severity.

Figure 3

(A) Neutralizing antibody levels. Neutralization titers were higher in the individuals admitted to the ICU with COVID-19. There was no significant difference between individuals admitted to an ICU with fatal or nonfatal COVID-19 outcomes (t test: P = 0.99). (B) ACE2 inhibition assay results. Samples were also analyzed with an MSD R-PLEX ACE2 inhibition assay. The level of ACE2-binding inhibition was not statistically significant for the full-length spike protein, but the individuals admitted to an ICU with fatal COVID-19 outcomes showed statistically lower ACE2-RBD binding inhibition in comparison with the nonfatal ICU cohort (t test: P = 0.02). (C) Neutralizing antibody levels as a proportion of total spike antibody response. There was no statistically significant difference between any of the groups. (D) ACE2-binding inhibition as a proportion of total spike antibody response. ACE2-binding inhibition responses were significantly lower in individuals with fatal COVID-19 outcomes in comparison with those with nonfatal COVID-19 outcomes when measured by the R-PLEX full-length spike but not the RBD inhibition assays (t test: RBD; P = 0.25, spike; P = 0.018). t tests were used to assess significance, and the reported P values were adjusted for multiple comparisons using the Holm-Bonferroni method. *P < 0.05, ****P < 0.0001.