Spike-specific T-cell responses in patients with COVID-19 successfully treated with neutralizing monoclonal antibodies against SARS-CoV-2

Objectives: Neutralizing monoclonal antibodies (moAbs) improves clinical outcomes in patients with COVID-19 when administered during the initial days of infection. The action of moAbs may impair the generation or maintenance of effective immune memory, similar to that demonstrated in other viral dis-eases. We aimed to evaluate short-term memory T-cell responses in patients effectively treated with bam-lanivimab/etesevimab, casirivimab/imdevimab, or sotrovimab (SOT).Methods: Spike (S)-specific T-cell responses were analyzed in 23 patients with COVID-19 (vaccinated or unvaccinated) before and after a median of 50 (range: 28-93) days from moAb treatment, compared with 11 vaccinated healthy controls. T-cell responses were measured by interferon-gamma-enzyme-linked im-munospot and flow cytometric activation-induced marker assay.Results: No statistically significant difference in S-specific T-cell responses was observed be-tween patients treated with moAb and vaccinated healthy controls. Bamlanivimab/etesevimab and casirivimab/imdevimab groups showed significant increases in cellular responses in paired base-line/postrecovery series, as well as vaccinated patients receiving SOT. In contrast, unvaccinated patients prescribed SOT presented no statistically significant increases in T-cell-responses, suggesting diverse im-pacts of different moAbs on the evolution of S-specific T-cell responses in vaccinated and unvaccinated patients.Conclusion: The moAbs did not hinder short-term memory S-specific T-cell responses in the overall group of patients; however, differences among moAbs must be further investigated both in vaccinated and un-vaccinated individuals.(c) 2022 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )

Automated summary

This study found that short-term memory T-cell responses were not significantly hindered in COVID-19 patients after receiving neutralizing monoclonal antibody treatment. Different moAbs may have diverse impacts on the evolution of S-specific T-cell responses in vaccinated and unvaccinated patients.