Neutralizing antibody response and associated factors in Coronavirus-19 disease (COVID-19) up to one month

Background There is a knowledge gap about the characteristics of neutralizing antibody (NAb) response in patients who recovered COVID-19. In this study, it is aimed to elucidate the factors affecting the presence and titers of antibodies up to 30-days after onset. Material and methods A total of 129 laboratory-confirmed COVID-19 patients were enrolled. Clinical data were obtained retrospectively. SARS-CoV-2 specific NAb, IgM, and IgG antibody responses were analyzed. Results SARS-CoV-2 specific NAb, IgM and IgG, were detected at the time of hospital discharge in 60.5%, 30.2%, and 51.9% of the patients, respectively. The median time for obtaining serum samples for antibody tests after symptoms' onset was 11 days. The median titer of neutralizing antibody (SN50) was significantly higher in severe patients (25 vs. 7.5, p=0.009). Of the 23 severe patients, 52.2% (n=12) had higher NAb titers (i.e., SN50 >= 1:25) when compared to that in non-severe patients (OR=2.89; 95%CI=1.15-7.28, p=0.021), yet, the potential effect of follow-up time on NAb status and titers could not be ruled out. Conclusions The presence of antibody response is not the only determinative factor for recovery. The presence and higher titers of NAb were detected more in severe patients than their non-severe counterparts. Survival analysis suggested that this difference could at least be partially explained by the length of follow-up through antibody testing (at discharge) after symptoms' onset.

Automated summary

Factors affecting the presence and titers of neutralizing antibodies in COVID-19 recovered patients were studied. Higher titers of neutralizing antibodies were found in severe patients. The presence of antibody response is not the only determinative factor for recovery.