Evaluating the Association of Clinical Characteristics With Neutralizing Antibody Levels in Patients Who Have Recovered From Mild COVID-19 in Shanghai, China

Cohort study (n=175) found that neutralising antibody titres to SARS-CoV-2 varied substantially at the time of discharge. Authors highlight that further research is needed to understand the clinical implications of differing antibody titres for protection against future infection

SPS commentary:

A related editorial observes that, in this study, higher antibody levels were seen in men, older patients, and those with indicators of stronger immunologic response, as well as older persons; however, these groups have generally fared worse, suggesting that the higher titres of antibodies do not necessarily lead to higher recovery rate. As this study looked only at patients with mild disease who survived, it could not correlate antibody levels with prognosis, and it is not known whether certain groups need higher antibody levels to overcome the illness. Equally unclear is whether higher levels of antibody production, generally seen as an intermediary indicator of vaccine success, will result in greater protection against the virus. Furtheremore, 10 patients had undetectable antibody levels despite documented infection. The editorial questions whether these patients are susceptible to future infection, or whether they may have protection based on their infection sensitizing killer T cells or memory B cells. It concludes that answers to these pointed questions can lead to better protection when faced with this still largely unknown adversary.


JAMA Internal Medicine

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