We limited our analysis to RBD because plasma RBD antibodies are strongly correlated with neutralizing activity 3, 10, 11, 12. The demographics and clinical characteristics of the participants are shown in Supplementary Tables 1, 2.Īntibody reactivity in plasma to the RBD and nucleoprotein (N) were measured by enzyme-linked immunosorbent assay (ELISA) 3. All participants tested negative for active infection at the 12-month time point as measured by a saliva-based PCR assay 4. Symptom persistence was not associated with the duration and severity of acute disease or with vaccination status (Extended Data Fig. Only 14% of the individuals reported persistent long-term symptoms after 12 months, reduced from 44% at the 6-month time point 4. Participants were almost evenly split between the sexes (43% female) and of the individuals who returned for the 12-month follow-up, only 10% had been hospitalized and the remainder had experienced relatively mild initial infections. Among those, 26 (41%) had received at least one dose of either the Moderna (mRNA-1273) or Pfizer-BioNTech (BNT162b2) vaccines, on average 40 days (range 2–82 days) before their study visit and 311 days (range 272–373 days) after the onset of acute illness (Supplementary Table 1). Between 8 February and 26 March 2021, 63 participants between the ages of 26 and 73 years old (median 47 years old) returned for a 12-month follow-up visit. We initially characterized immune responses to SARS-CoV-2 in a cohort of patients who have recovered from COVID-19 infection (hereafter referred to as convalescent individuals) 1.3 and 6.2 months after infection 3, 4.
The data suggest that immunity in convalescent individuals will be very long lasting and that convalescent individuals who receive available mRNA vaccines will produce antibodies and memory B cells that should be protective against circulating SARS-CoV-2 variants. In addition, B cell clones expressing broad and potent antibodies are selectively retained in the repertoire over time and expand markedly after vaccination. The mechanism underlying these broad-based responses involves ongoing antibody somatic mutation, memory B cell clonal turnover and development of monoclonal antibodies that are exceptionally resistant to SARS-CoV-2 RBD mutations, including those found in the variants of concern 4, 9. Vaccination increases all components of the humoral response and, as expected, results in serum neutralizing activities against variants of concern similar to or greater than the neutralizing activity against the original Wuhan Hu-1 strain achieved by vaccination of naive individuals 2, 5, 6, 7, 8. In the absence of vaccination, antibody reactivity to the receptor binding domain (RBD) of SARS-CoV-2, neutralizing activity and the number of RBD-specific memory B cells remain relatively stable between 6 and 12 months after infection. Here we report on a cohort of 63 individuals who have recovered from COVID-19 assessed at 1.3, 6.2 and 12 months after SARS-CoV-2 infection, 41% of whom also received mRNA vaccines 3, 4. Progress in controlling the pandemic is slowed by the emergence of variants that appear to be more transmissible and more resistant to antibodies 1, 2. More than one year after its inception, the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains difficult to control despite the availability of several working vaccines. Nature volume 595, pages 426–431 ( 2021) Cite this article Naturally enhanced neutralizing breadth against SARS-CoV-2 one year after infection
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