Specific thresholds of circulating antibody titers predict against infection and reduced disease severity in SARS-CoV-2 close contacts

  • Joanne Byrne
  • , Colette Marie Gaillard
  • , Lili Gu
  • , Alejandro Garcia-Leon
  • , Orlaith Casey
  • , Grace Kenny
  • , Gurvin Saini
  • , Dana Alalwan
  • , Tessa O'Gorman
  • , Siobhan O'Regan
  • , Peter Doran
  • , Eoin R. Feeney
  • , Jane A. O'Halloran
  • , Mary Horgan
  • , Aoife G. Cotter
  • , Eoghan de Barra
  • , Corinna Sadlier
  • , Alan Landay
  • , Virginie Gautier
  • , Patrick W.G. Mallon

Research output: Contribution to journalArticlepeer-review

Abstract

Higher circulating SARS-CoV-2 IgG titers correlate with SARS-CoV-2 ex vivo viral neutralization, but how well this translates to clinical protection in the real-world setting is unclear. In a prospective cohort study, we enrolled 44 SARS-CoV-2 negative, confirmed SARS-CoV-2 close contacts. Receptor-binding domain (RBD) and full-spike IgG and SARS-CoV-2 memory B-cell frequencies were measured at exposure, and participants were serially tested for incident infection over 14 days. Those who developed SARS-CoV-2 infection had significantly lower RBD titers, but not memory B-cell frequencies. An RBD IgG titer >6321 BAU/ml was associated with a reduced SARS-CoV-2 acquisition risk (HR 0.32, 95% CI 0.13-0.81), while an RBD IgG titer >456 BAU/ml was associated with a reduced moderate or severe COVID-19 risk (HR 0.15, 95% CI 0.03-0.81), identifying this threshold as a correlate of protection.

Original languageEnglish (US)
Pages (from-to)2238-2243
Number of pages6
JournalJournal of immunology (Baltimore, Md. : 1950)
Volume214
Issue number9
DOIs
StatePublished - Sep 1 2025

Keywords

  • antibodies
  • B cells
  • COVID-19
  • SARS-CoV-2

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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