Neutralizing Antibody Responses in COVID-19 Convalescent Sera

  1. William T Lee
  2. Roxanne C Girardin
  3. Alan P Dupuis
  4. Karen E Kulas
  5. Anne F Payne
  6. Susan J Wong
  7. Suzanne Arinsburg
  8. Freddy T Nguyen
  9. Damodara Rao Mendu
  10. Adolfo Firpo-Betancourt
  11. Jeffrey Jhang
  12. Ania Wajnberg
  13. Florian Krammer
  14. Carlos Cordon-Cardo
  15. Sherlita Amler
  16. Marisa Montecalvo
  17. Brad Hutton
  18. Jill Taylor
  19. Kathleen A McDonough

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Abstract

Passive transfer of antibodies from COVID-19 convalescent patients is being used as an experimental treatment for eligible patients with SARS-CoV-2 infections. The United States Food and Drug Administration’s (FDA) guidelines for convalescent plasma initially recommended target antibody titers of 160. We evaluated SARS-CoV-2 neutralizing antibodies in sera from recovered COVID-19 patients using plaque reduction neutralization tests (PRNT) at moderate (PRNT50) and high (PRNT90) stringency thresholds. We found that neutralizing activity significantly increased with time post symptom onset (PSO), reaching a peak at 31–35 days PSO. At this point, the number of sera having neutralizing titers of at least 160 was approximately 93% (PRNT50) and approximately 54% (PRNT90). Sera with high SARS-CoV-2 antibody levels (>960 enzyme-linked immunosorbent assay titers) showed maximal activity, but not all high-titer sera contained neutralizing antibody at FDA recommended levels, particularly at high stringency. These results underscore the value of serum characterization for neutralization activity.

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  1. Version published to 10.1093/infdis/jiaa673
  2. ScreenIT

    SciScore for 10.1101/2020.07.10.20150557: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: Study Participants: Specimens were collected with informed consent obtained from individuals in accordance with guidelines of Mount Sinai Hospital (MSH) and the Westchester County Department of Health (WCDH).
    IRB: Testing at the Wadsworth Center was done under a declared Public Health Emergency with a waiver from the NYSDOH Institutional Review Board.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.07.10.20150557v1 on medRxiv