Sex Disparities and Neutralizing-Antibody Durability to SARS-CoV-2 Infection in Convalescent Individuals

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  • Markmann, Alena J.
    • Affiliation: School of Medicine, Department of Medicine
  • Giallourou, Natasa
    • Other Affiliation: University of Cyprus
  • Bhowmik, D. Ryan
    • Affiliation: School of Medicine, Department of Microbiology and Immunology
  • Hou, Yixuan J.
    • Affiliation: Gillings School of Global Public Health, Department of Epidemiology
  • Lerner, Aaron
    • Affiliation: School of Medicine, Department of Medicine
  • Martinez, David R.
    • Affiliation: Gillings School of Global Public Health, Department of Epidemiology
  • Premkumar, Lakshmanane
    • Affiliation: School of Medicine, Department of Microbiology and Immunology
  • Root, Heather
    • Affiliation: School of Medicine, Department of Medicine
  • van Duin, David
    • Affiliation: School of Medicine, Department of Medicine
  • Napravnik, Sonia
    • Affiliation: School of Medicine, Department of Medicine
  • Graham, Stephen D.
    • Affiliation: School of Medicine, Department of Microbiology and Immunology
  • Guerra, Quique
    • Affiliation: School of Medicine, Department of Microbiology and Immunology
  • Raut, Rajendra
    • Affiliation: School of Medicine, Department of Microbiology and Immunology
  • Petropoulos, Christos J.
    • Other Affiliation: LabCorp-Monogram Biosciences
  • Wrin, Terri
    • Other Affiliation: LabCorp-Monogram Biosciences
  • Cornaby, Caleb
    • Affiliation: School of Medicine, Department of Pathology and Laboratory Medicine
  • Schmitz, John
    • Affiliation: School of Medicine, Department of Microbiology and Immunology
  • Kuruc, JoAnn
    • Affiliation: School of Medicine, Department of Medicine
  • Weiss, Susan
    • Affiliation: School of Medicine, Department of Pathology and Laboratory Medicine
  • Park, Yara
    • Affiliation: School of Medicine, Department of Pathology and Laboratory Medicine
  • Baric, Ralph
    • Affiliation: School of Medicine, Department of Microbiology and Immunology
  • de Silva, Aravinda M.
    • Affiliation: School of Medicine, Department of Microbiology and Immunology
  • Margolis, David M.
    • Affiliation: School of Medicine, Department of Medicine
  • Bartelt, Luther A.
    • Affiliation: School of Medicine, Department of Medicine
Abstract
  • The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) has now caused over 2 million deaths worldwide and continues to expand. Currently, much is unknown about functionally neutralizing human antibody responses and durability to SARS-CoV-2 months after infection or the reason for the discrepancy in COVID-19 disease and sex. Using convalescent-phase sera collected from 101 COVID-19-recovered individuals 21 to 212 days after symptom onset with 48 additional longitudinal samples, we measured functionality and durability of serum antibodies. We also evaluated associations of individual demographic and clinical parameters with functional neutralizing antibody responses to COVID-19. We found robust antibody durability out to 6 months, as well as significant positive associations with the magnitude of the neutralizing antibody response and male sex and in individuals with cardiometabolic comorbidities. IMPORTANCE In this study, we found that neutralizing antibody responses in COVID-19-convalescent individuals vary in magnitude but are durable and correlate well with receptor binding domain (RBD) Ig binding antibody levels compared to other SARS-CoV-2 antigen responses. In our cohort, higher neutralizing antibody titers are independently and significantly associated with male sex compared to female sex. We also show for the first time that higher convalescent antibody titers in male donors are associated with increased age and symptom grade. Furthermore, cardiometabolic comorbidities are associated with higher antibody titers independently of sex. Here, we present an indepth evaluation of serologic, demographic, and clinical correlates of functional antibody responses and durability to SARS-CoV-2 which supports the growing literature on sex discrepancies regarding COVID-19 disease morbidity and mortality, as well as functional neutralizing antibody responses to SARS-CoV-2.
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  • Article
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  • In Copyright
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  • Attribution 3.0 United States
Journal title
  • mSphere
Journal volume
  • 6
Journal issue
  • 4
Page start
  • e00275-21
Language
  • English
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