SARS-CoV-2 humoral immune responses in convalescent individuals over 12 months reveal severity-dependent antibody dynamics

Abstract Background Defining the kinetics of SARS-CoV-2 antibody responses is critical for informing the management of reinfections, vaccinations, and therapeutics of Coronavirus disease 2019 (COVID-19). Methods Using four antibody assays, we evaluated antibody titers against SARS-CoV-2 nucleocapsid...

Full description

Saved in:
Bibliographic Details
Main Authors: Nadia Siles Alvarado, Maisey Schuler, Cole Maguire, Dzifa A. Amengor, Annalee W. Nguyen, Rebecca E. Wilen, Jacob Rogers, Sam Bazzi, Blaine Caslin, Christopher DiPasquale, Melissa Abigania, Eric Olson, Janelle Creaturo, Kerin Hurley, Todd A. Triplett, Justin F. Rousseau, Stephen M. Strakowski, Dennis Wylie, Jennifer A. Maynard, Lauren I. R. Ehrlich, Esther Melamed
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:Communications Medicine
Online Access:https://doi.org/10.1038/s43856-025-00828-4
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849314845707468800
author Nadia Siles Alvarado
Maisey Schuler
Cole Maguire
Dzifa A. Amengor
Annalee W. Nguyen
Rebecca E. Wilen
Jacob Rogers
Sam Bazzi
Blaine Caslin
Christopher DiPasquale
Melissa Abigania
Eric Olson
Janelle Creaturo
Kerin Hurley
Todd A. Triplett
Justin F. Rousseau
Stephen M. Strakowski
Dennis Wylie
Jennifer A. Maynard
Lauren I. R. Ehrlich
Esther Melamed
author_facet Nadia Siles Alvarado
Maisey Schuler
Cole Maguire
Dzifa A. Amengor
Annalee W. Nguyen
Rebecca E. Wilen
Jacob Rogers
Sam Bazzi
Blaine Caslin
Christopher DiPasquale
Melissa Abigania
Eric Olson
Janelle Creaturo
Kerin Hurley
Todd A. Triplett
Justin F. Rousseau
Stephen M. Strakowski
Dennis Wylie
Jennifer A. Maynard
Lauren I. R. Ehrlich
Esther Melamed
author_sort Nadia Siles Alvarado
collection DOAJ
description Abstract Background Defining the kinetics of SARS-CoV-2 antibody responses is critical for informing the management of reinfections, vaccinations, and therapeutics of Coronavirus disease 2019 (COVID-19). Methods Using four antibody assays, we evaluated antibody titers against SARS-CoV-2 nucleocapsid (N), spike (S), and receptor binding domain (RBD) in 98 convalescent participants with varying COVID-19 disease severities (asymptomatic, mild, moderate or severe) at 1, 3, 6, and 12-months post-SARS-CoV-2-positive PCR and in 17 non-vaccinated, non-infected controls. Results Increasing acute COVID-19 disease severity correlates with higher anti-N and anti-RBD titers throughout 12 months post-infection. Anti-N and anti-RBD titers decline over time in all participants, except for increased anti-RBD titers post-vaccination, with hospitalized participants exhibiting faster decay rates. Less than 50% of participants retain anti-N titers above controls at 12 months, with non-hospitalized participants falling below controls sooner. Nearly all participants maintain anti-RBD titers above controls for 12 months, suggesting long-term protection against severe reinfections. Nonetheless, by 6 months, few participants retain >50% of their initial 1-month anti-N or anti-RBD titers. Notably, vaccine-induced anti-RBD titers are higher in non-hospitalized participants. Lastly, early convalescent titers correlate with age but not with Post-Acute Sequelae of SARS-CoV-2 infection (PASC) status or steroid use. Conclusion Hospitalized participants initially develop higher anti-SARS-CoV-2 antibody titers that decline faster relative to non-hospitalized participants. While anti-N titers fall below control levels in some participants, anti-RBD titers remain above controls over 12 months, demonstrating long-lived antibody responses known to protect against severe disease. These findings advance our understanding of COVID-19 antibody dynamics.
format Article
id doaj-art-02db8d5a39df4fc6b5c262fdd8925b2f
institution Kabale University
issn 2730-664X
language English
publishDate 2025-05-01
publisher Nature Portfolio
record_format Article
series Communications Medicine
spelling doaj-art-02db8d5a39df4fc6b5c262fdd8925b2f2025-08-20T03:52:19ZengNature PortfolioCommunications Medicine2730-664X2025-05-015111310.1038/s43856-025-00828-4SARS-CoV-2 humoral immune responses in convalescent individuals over 12 months reveal severity-dependent antibody dynamicsNadia Siles Alvarado0Maisey Schuler1Cole Maguire2Dzifa A. Amengor3Annalee W. Nguyen4Rebecca E. Wilen5Jacob Rogers6Sam Bazzi7Blaine Caslin8Christopher DiPasquale9Melissa Abigania10Eric Olson11Janelle Creaturo12Kerin Hurley13Todd A. Triplett14Justin F. Rousseau15Stephen M. Strakowski16Dennis Wylie17Jennifer A. Maynard18Lauren I. R. Ehrlich19Esther Melamed20Department of Neurology, Dell Medical School, The University of Texas at AustinDepartment of Neurology, Dell Medical School, The University of Texas at AustinDepartment of Neurology, Dell Medical School, The University of Texas at AustinDepartment of Molecular Biosciences, The University of Texas at AustinDepartment of Chemical Engineering, The University of Texas at AustinDepartment of Chemical Engineering, The University of Texas at AustinDepartment of Neurology, Dell Medical School, The University of Texas at AustinDepartment of Neurology, Dell Medical School, The University of Texas at AustinDepartment of Neurology, Dell Medical School, The University of Texas at AustinBabson DiagnosticsBabson DiagnosticsBabson DiagnosticsDepartment of Neurology, Dell Medical School, The University of Texas at AustinDepartment of Neurology, Dell Medical School, The University of Texas at AustinDepartment of Oncology, Dell Medical School, The University of Texas at AustinDepartment of Population Health, Dell Medical School, The University of Texas at AustinDepartment of Psychiatry, Indiana University School of MedicineCenter for Biomedical Research Support, The University of Texas at AustinDepartment of Chemical Engineering, The University of Texas at AustinDepartment of Molecular Biosciences, The University of Texas at AustinDepartment of Neurology, Dell Medical School, The University of Texas at AustinAbstract Background Defining the kinetics of SARS-CoV-2 antibody responses is critical for informing the management of reinfections, vaccinations, and therapeutics of Coronavirus disease 2019 (COVID-19). Methods Using four antibody assays, we evaluated antibody titers against SARS-CoV-2 nucleocapsid (N), spike (S), and receptor binding domain (RBD) in 98 convalescent participants with varying COVID-19 disease severities (asymptomatic, mild, moderate or severe) at 1, 3, 6, and 12-months post-SARS-CoV-2-positive PCR and in 17 non-vaccinated, non-infected controls. Results Increasing acute COVID-19 disease severity correlates with higher anti-N and anti-RBD titers throughout 12 months post-infection. Anti-N and anti-RBD titers decline over time in all participants, except for increased anti-RBD titers post-vaccination, with hospitalized participants exhibiting faster decay rates. Less than 50% of participants retain anti-N titers above controls at 12 months, with non-hospitalized participants falling below controls sooner. Nearly all participants maintain anti-RBD titers above controls for 12 months, suggesting long-term protection against severe reinfections. Nonetheless, by 6 months, few participants retain >50% of their initial 1-month anti-N or anti-RBD titers. Notably, vaccine-induced anti-RBD titers are higher in non-hospitalized participants. Lastly, early convalescent titers correlate with age but not with Post-Acute Sequelae of SARS-CoV-2 infection (PASC) status or steroid use. Conclusion Hospitalized participants initially develop higher anti-SARS-CoV-2 antibody titers that decline faster relative to non-hospitalized participants. While anti-N titers fall below control levels in some participants, anti-RBD titers remain above controls over 12 months, demonstrating long-lived antibody responses known to protect against severe disease. These findings advance our understanding of COVID-19 antibody dynamics.https://doi.org/10.1038/s43856-025-00828-4
spellingShingle Nadia Siles Alvarado
Maisey Schuler
Cole Maguire
Dzifa A. Amengor
Annalee W. Nguyen
Rebecca E. Wilen
Jacob Rogers
Sam Bazzi
Blaine Caslin
Christopher DiPasquale
Melissa Abigania
Eric Olson
Janelle Creaturo
Kerin Hurley
Todd A. Triplett
Justin F. Rousseau
Stephen M. Strakowski
Dennis Wylie
Jennifer A. Maynard
Lauren I. R. Ehrlich
Esther Melamed
SARS-CoV-2 humoral immune responses in convalescent individuals over 12 months reveal severity-dependent antibody dynamics
Communications Medicine
title SARS-CoV-2 humoral immune responses in convalescent individuals over 12 months reveal severity-dependent antibody dynamics
title_full SARS-CoV-2 humoral immune responses in convalescent individuals over 12 months reveal severity-dependent antibody dynamics
title_fullStr SARS-CoV-2 humoral immune responses in convalescent individuals over 12 months reveal severity-dependent antibody dynamics
title_full_unstemmed SARS-CoV-2 humoral immune responses in convalescent individuals over 12 months reveal severity-dependent antibody dynamics
title_short SARS-CoV-2 humoral immune responses in convalescent individuals over 12 months reveal severity-dependent antibody dynamics
title_sort sars cov 2 humoral immune responses in convalescent individuals over 12 months reveal severity dependent antibody dynamics
url https://doi.org/10.1038/s43856-025-00828-4
work_keys_str_mv AT nadiasilesalvarado sarscov2humoralimmuneresponsesinconvalescentindividualsover12monthsrevealseveritydependentantibodydynamics
AT maiseyschuler sarscov2humoralimmuneresponsesinconvalescentindividualsover12monthsrevealseveritydependentantibodydynamics
AT colemaguire sarscov2humoralimmuneresponsesinconvalescentindividualsover12monthsrevealseveritydependentantibodydynamics
AT dzifaaamengor sarscov2humoralimmuneresponsesinconvalescentindividualsover12monthsrevealseveritydependentantibodydynamics
AT annaleewnguyen sarscov2humoralimmuneresponsesinconvalescentindividualsover12monthsrevealseveritydependentantibodydynamics
AT rebeccaewilen sarscov2humoralimmuneresponsesinconvalescentindividualsover12monthsrevealseveritydependentantibodydynamics
AT jacobrogers sarscov2humoralimmuneresponsesinconvalescentindividualsover12monthsrevealseveritydependentantibodydynamics
AT sambazzi sarscov2humoralimmuneresponsesinconvalescentindividualsover12monthsrevealseveritydependentantibodydynamics
AT blainecaslin sarscov2humoralimmuneresponsesinconvalescentindividualsover12monthsrevealseveritydependentantibodydynamics
AT christopherdipasquale sarscov2humoralimmuneresponsesinconvalescentindividualsover12monthsrevealseveritydependentantibodydynamics
AT melissaabigania sarscov2humoralimmuneresponsesinconvalescentindividualsover12monthsrevealseveritydependentantibodydynamics
AT ericolson sarscov2humoralimmuneresponsesinconvalescentindividualsover12monthsrevealseveritydependentantibodydynamics
AT janellecreaturo sarscov2humoralimmuneresponsesinconvalescentindividualsover12monthsrevealseveritydependentantibodydynamics
AT kerinhurley sarscov2humoralimmuneresponsesinconvalescentindividualsover12monthsrevealseveritydependentantibodydynamics
AT toddatriplett sarscov2humoralimmuneresponsesinconvalescentindividualsover12monthsrevealseveritydependentantibodydynamics
AT justinfrousseau sarscov2humoralimmuneresponsesinconvalescentindividualsover12monthsrevealseveritydependentantibodydynamics
AT stephenmstrakowski sarscov2humoralimmuneresponsesinconvalescentindividualsover12monthsrevealseveritydependentantibodydynamics
AT denniswylie sarscov2humoralimmuneresponsesinconvalescentindividualsover12monthsrevealseveritydependentantibodydynamics
AT jenniferamaynard sarscov2humoralimmuneresponsesinconvalescentindividualsover12monthsrevealseveritydependentantibodydynamics
AT laurenirehrlich sarscov2humoralimmuneresponsesinconvalescentindividualsover12monthsrevealseveritydependentantibodydynamics
AT esthermelamed sarscov2humoralimmuneresponsesinconvalescentindividualsover12monthsrevealseveritydependentantibodydynamics