IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0244126.html
   My bibliography  Save this article

Antibody response to SARS-CoV-2 infection in humans: A systematic review

Author

Listed:
  • Nathan Post
  • Danielle Eddy
  • Catherine Huntley
  • May C I van Schalkwyk
  • Madhumita Shrotri
  • David Leeman
  • Samuel Rigby
  • Sarah V Williams
  • William H Bermingham
  • Paul Kellam
  • John Maher
  • Adrian M Shields
  • Gayatri Amirthalingam
  • Sharon J Peacock
  • Sharif A Ismail

Abstract

Background: Progress in characterising the humoral immune response to Severe Acute Respiratory Syndrome 2 (SARS-CoV-2) has been rapid but areas of uncertainty persist. Assessment of the full range of evidence generated to date to understand the characteristics of the antibody response, its dynamics over time, its determinants and the immunity it confers will have a range of clinical and policy implications for this novel pathogen. This review comprehensively evaluated evidence describing the antibody response to SARS-CoV-2 published from 01/01/2020-26/06/2020. Methods: Systematic review. Keyword-structured searches were carried out in MEDLINE, Embase and COVID-19 Primer. Articles were independently screened on title, abstract and full text by two researchers, with arbitration of disagreements. Data were double-extracted into a pre-designed template, and studies critically appraised using a modified version of the Public Health Ontario Meta-tool for Quality Appraisal of Public Health Evidence (MetaQAT) tool, with resolution of disagreements by consensus. Findings were narratively synthesised. Results: 150 papers were included. Most studies (113 or 75%) were observational in design, were based wholly or primarily on data from hospitalised patients (108, 72%) and had important methodological limitations. Few considered mild or asymptomatic infection. Antibody dynamics were well described in the acute phase, up to around three months from disease onset, but the picture regarding correlates of the antibody response was inconsistent. IgM was consistently detected before IgG in included studies, peaking at weeks two to five and declining over a further three to five weeks post-symptom onset depending on the patient group; IgG peaked around weeks three to seven post-symptom onset then plateaued, generally persisting for at least eight weeks. Neutralising antibodies were detectable within seven to 15 days following disease onset, with levels increasing until days 14–22 before levelling and then decreasing, but titres were lower in those with asymptomatic or clinically mild disease. Specific and potent neutralising antibodies have been isolated from convalescent plasma. Cross-reactivity but limited cross-neutralisation with other human coronaviridae was reported. Evidence for protective immunity in vivo was limited to small, short-term animal studies, showing promising initial results in the immediate recovery phase. Conclusions: Literature on antibody responses to SARS-CoV-2 is of variable quality with considerable heterogeneity of methods, study participants, outcomes measured and assays used. Although acute phase antibody dynamics are well described, longer-term patterns are much less well evidenced. Comprehensive assessment of the role of demographic characteristics and disease severity on antibody responses is needed. Initial findings of low neutralising antibody titres and possible waning of titres over time may have implications for sero-surveillance and disease control policy, although further evidence is needed. The detection of potent neutralising antibodies in convalescent plasma is important in the context of development of therapeutics and vaccines. Due to limitations with the existing evidence base, large, cross-national cohort studies using appropriate statistical analysis and standardised serological assays and clinical classifications should be prioritised.

Suggested Citation

  • Nathan Post & Danielle Eddy & Catherine Huntley & May C I van Schalkwyk & Madhumita Shrotri & David Leeman & Samuel Rigby & Sarah V Williams & William H Bermingham & Paul Kellam & John Maher & Adrian , 2020. "Antibody response to SARS-CoV-2 infection in humans: A systematic review," PLOS ONE, Public Library of Science, vol. 15(12), pages 1-27, December.
  • Handle: RePEc:plo:pone00:0244126
    DOI: 10.1371/journal.pone.0244126
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0244126
    Download Restriction: no

    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0244126&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pone.0244126?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Alberto L. Garcia-Basteiro & Gemma Moncunill & Marta Tortajada & Marta Vidal & Caterina Guinovart & Alfons Jiménez & Rebeca Santano & Sergi Sanz & Susana Méndez & Anna Llupià & Ruth Aguilar & Selena A, 2020. "Seroprevalence of antibodies against SARS-CoV-2 among health care workers in a large Spanish reference hospital," Nature Communications, Nature, vol. 11(1), pages 1-9, December.
    2. Nicholas K. Hurlburt & Emilie Seydoux & Yu-Hsin Wan & Venkata Viswanadh Edara & Andrew B. Stuart & Junli Feng & Mehul S. Suthar & Andrew T. McGuire & Leonidas Stamatatos & Marie Pancera, 2020. "Structural basis for potent neutralization of SARS-CoV-2 and role of antibody affinity maturation," Nature Communications, Nature, vol. 11(1), pages 1-7, December.
    3. Davide F. Robbiani & Christian Gaebler & Frauke Muecksch & Julio C. C. Lorenzi & Zijun Wang & Alice Cho & Marianna Agudelo & Christopher O. Barnes & Anna Gazumyan & Shlomo Finkin & Thomas Hägglöf & Th, 2020. "Convergent antibody responses to SARS-CoV-2 in convalescent individuals," Nature, Nature, vol. 584(7821), pages 437-442, August.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Haisheng Yu & Banghui Liu & Yudi Zhang & Xijie Gao & Qian Wang & Haitao Xiang & Xiaofang Peng & Caixia Xie & Yaping Wang & Peiyu Hu & Jingrong Shi & Quan Shi & Pingqian Zheng & Chengqian Feng & Guofan, 2023. "Somatically hypermutated antibodies isolated from SARS-CoV-2 Delta infected patients cross-neutralize heterologous variants," Nature Communications, Nature, vol. 14(1), pages 1-14, December.
    2. Hanna Renk & Alex Dulovic & Alina Seidel & Matthias Becker & Dorit Fabricius & Maria Zernickel & Daniel Junker & Rüdiger Groß & Janis Müller & Alexander Hilger & Sebastian F. N. Bode & Linus Fritsch &, 2022. "Robust and durable serological response following pediatric SARS-CoV-2 infection," Nature Communications, Nature, vol. 13(1), pages 1-11, December.
    3. Kevin J. Kramer & Erin M. Wilfong & Kelsey Voss & Sierra M. Barone & Andrea R. Shiakolas & Nagarajan Raju & Caroline E. Roe & Naveenchandra Suryadevara & Lauren M. Walker & Steven C. Wall & Ariana Pau, 2022. "Single-cell profiling of the antigen-specific response to BNT162b2 SARS-CoV-2 RNA vaccine," Nature Communications, Nature, vol. 13(1), pages 1-20, December.
    4. Ching-Lin Hsieh & Sarah R. Leist & Emily Happy Miller & Ling Zhou & John M. Powers & Alexandra L. Tse & Albert Wang & Ande West & Mark R. Zweigart & Jonathan C. Schisler & Rohit K. Jangra & Kartik Cha, 2024. "Prefusion-stabilized SARS-CoV-2 S2-only antigen provides protection against SARS-CoV-2 challenge," Nature Communications, Nature, vol. 15(1), pages 1-14, December.
    5. Leire Campos-Mata & Benjamin Trinité & Andrea Modrego & Sonia Tejedor Vaquero & Edwards Pradenas & Anna Pons-Grífols & Natalia Rodrigo Melero & Diego Carlero & Silvia Marfil & César Santiago & Dàlia R, 2024. "A monoclonal antibody targeting a large surface of the receptor binding motif shows pan-neutralizing SARS-CoV-2 activity," Nature Communications, Nature, vol. 15(1), pages 1-13, December.
    6. Kuan-Ying A. Huang & Xiaorui Chen & Arpita Mohapatra & Hong Thuy Vy Nguyen & Lisa Schimanski & Tiong Kit Tan & Pramila Rijal & Susan K. Vester & Rory A. Hills & Mark Howarth & Jennifer R. Keeffe & Ale, 2023. "Structural basis for a conserved neutralization epitope on the receptor-binding domain of SARS-CoV-2," Nature Communications, Nature, vol. 14(1), pages 1-13, December.
    7. A. Brenda Kapingidza & Daniel J. Marston & Caitlin Harris & Daniel Wrapp & Kaitlyn Winters & Dieter Mielke & Lu Xiaozhi & Qi Yin & Andrew Foulger & Rob Parks & Maggie Barr & Amanda Newman & Alexandra , 2023. "Engineered immunogens to elicit antibodies against conserved coronavirus epitopes," Nature Communications, Nature, vol. 14(1), pages 1-18, December.
    8. Qihong Yan & Xijie Gao & Banghui Liu & Ruitian Hou & Ping He & Yong Ma & Yudi Zhang & Yanjun Zhang & Zimu Li & Qiuluan Chen & Jingjing Wang & Xiaohan Huang & Huan Liang & Huiran Zheng & Yichen Yao & X, 2024. "Antibodies utilizing VL6-57 light chains target a convergent cryptic epitope on SARS-CoV-2 spike protein and potentially drive the genesis of Omicron variants," Nature Communications, Nature, vol. 15(1), pages 1-17, December.
    9. Tingting Li & Xiaojian Han & Chenjian Gu & Hangtian Guo & Huajun Zhang & Yingming Wang & Chao Hu & Kai Wang & Fengjiang Liu & Feiyang Luo & Yanan Zhang & Jie Hu & Wang Wang & Shenglong Li & Yanan Hao , 2021. "Potent SARS-CoV-2 neutralizing antibodies with protective efficacy against newly emerged mutational variants," Nature Communications, Nature, vol. 12(1), pages 1-11, December.
    10. Andrew P. Hederman & Harini Natarajan & Leo Heyndrickx & Kevin K. Ariën & Joshua A. Wiener & Peter F. Wright & Evan M. Bloch & Aaron A. R. Tobian & Andrew D. Redd & Joel N. Blankson & Amihai Rottenstr, 2023. "SARS-CoV-2 vaccination elicits broad and potent antibody effector functions to variants of concern in vulnerable populations," Nature Communications, Nature, vol. 14(1), pages 1-11, December.
    11. Maryam Yaghoubi & Mohammad Salimi & Mohammad Meskarpour‐Amiri, 2022. "Systematic review of productivity loss among healthcare workers due to Covid‐19," International Journal of Health Planning and Management, Wiley Blackwell, vol. 37(1), pages 94-111, January.
    12. Irene A. Abela & Chloé Pasin & Magdalena Schwarzmüller & Selina Epp & Michèle E. Sickmann & Merle M. Schanz & Peter Rusert & Jacqueline Weber & Stefan Schmutz & Annette Audigé & Liridona Maliqi & Anni, 2021. "Multifactorial seroprofiling dissects the contribution of pre-existing human coronaviruses responses to SARS-CoV-2 immunity," Nature Communications, Nature, vol. 12(1), pages 1-18, December.
    13. Mark Chernyshev & Mrunal Sakharkar & Ruth I. Connor & Haley L. Dugan & Daniel J. Sheward & C. G. Rappazzo & Aron Stålmarck & Mattias N. E. Forsell & Peter F. Wright & Martin Corcoran & Ben Murrell & L, 2023. "Vaccination of SARS-CoV-2-infected individuals expands a broad range of clonally diverse affinity-matured B cell lineages," Nature Communications, Nature, vol. 14(1), pages 1-12, December.
    14. Elham Khatamzas & Markus H. Antwerpen & Alexandra Rehn & Alexander Graf & Johannes Christian Hellmuth & Alexandra Hollaus & Anne-Wiebe Mohr & Erik Gaitzsch & Tobias Weiglein & Enrico Georgi & Clemens , 2022. "Accumulation of mutations in antibody and CD8 T cell epitopes in a B cell depleted lymphoma patient with chronic SARS-CoV-2 infection," Nature Communications, Nature, vol. 13(1), pages 1-12, December.
    15. Chengzi I. Kaku & Tyler N. Starr & Panpan Zhou & Haley L. Dugan & Paul Khalifé & Ge Song & Elizabeth R. Champney & Daniel W. Mielcarz & James C. Geoghegan & Dennis R. Burton & Raiees Andrabi & Jesse D, 2023. "Evolution of antibody immunity following Omicron BA.1 breakthrough infection," Nature Communications, Nature, vol. 14(1), pages 1-13, December.
    16. John S. Kim & Yifei Sun & Pallavi Balte & Mary Cushman & Rebekah Boyle & Russell P. Tracy & Linda M. Styer & Taison D. Bell & Michaela R. Anderson & Norrina B. Allen & Pamela J. Schreiner & Russell P., 2024. "Demographic and Clinical Factors Associated With SARS-CoV-2 Spike 1 Antibody Response Among Vaccinated US Adults: the C4R Study," Nature Communications, Nature, vol. 15(1), pages 1-12, December.
    17. Leander Witte & Viren A. Baharani & Fabian Schmidt & Zijun Wang & Alice Cho & Raphael Raspe & Camila Guzman-Cardozo & Frauke Muecksch & Marie Canis & Debby J. Park & Christian Gaebler & Marina Caskey , 2023. "Epistasis lowers the genetic barrier to SARS-CoV-2 neutralizing antibody escape," Nature Communications, Nature, vol. 14(1), pages 1-11, December.
    18. Noemia S. Lima & Maryam Musayev & Timothy S. Johnston & Danielle A. Wagner & Amy R. Henry & Lingshu Wang & Eun Sung Yang & Yi Zhang & Kevina Birungi & Walker P. Black & Sijy O’Dell & Stephen D. Schmid, 2022. "Primary exposure to SARS-CoV-2 variants elicits convergent epitope specificities, immunoglobulin V gene usage and public B cell clones," Nature Communications, Nature, vol. 13(1), pages 1-14, December.
    19. Mathieu Claireaux & Tom G. Caniels & Marlon Gast & Julianna Han & Denise Guerra & Gius Kerster & Barbera D. C. Schaik & Aldo Jongejan & Angela I. Schriek & Marloes Grobben & Philip J. M. Brouwer & Kar, 2022. "A public antibody class recognizes an S2 epitope exposed on open conformations of SARS-CoV-2 spike," Nature Communications, Nature, vol. 13(1), pages 1-15, December.
    20. Romain Rouet & Jake Y. Henry & Matt D. Johansen & Meghna Sobti & Harikrishnan Balachandran & David B. Langley & Gregory J. Walker & Helen Lenthall & Jennifer Jackson & Stephanie Ubiparipovic & Ohan Ma, 2023. "Broadly neutralizing SARS-CoV-2 antibodies through epitope-based selection from convalescent patients," Nature Communications, Nature, vol. 14(1), pages 1-13, December.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0244126. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.