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Meta-Analysis
. 2021 Jul 8;15(7):e0009551.
doi: 10.1371/journal.pntd.0009551. eCollection 2021 Jul.

Prevalence of neutralising antibodies against SARS-CoV-2 in acute infection and convalescence: A systematic review and meta-analysis

Helen R Savage  1 , Victor S Santos  2   3   4 , Thomas Edwards  1 , Emanuele Giorgi  5 , Sanjeev Krishna  6   7   8 , Timothy D Planche  6   9 , Henry M Staines  6 , Joseph R A Fitchett  10   11 , Daniela E Kirwan  6 , Ana I Cubas Atienzar  1 , David J Clark  6 , Emily R Adams  1 , Luis E Cuevas  1   12
Affiliations
Meta-Analysis

Prevalence of neutralising antibodies against SARS-CoV-2 in acute infection and convalescence: A systematic review and meta-analysis

Helen R Savage et al. PLoS Negl Trop Dis. .

Abstract

Background: Individuals infected with SARS-CoV-2 develop neutralising antibodies. We investigated the proportion of individuals with SARS-CoV-2 neutralising antibodies after infection and how this proportion varies with selected covariates.

Methodology/principal findings: This systematic review and meta-analysis examined the proportion of individuals with SARS-CoV-2 neutralising antibodies after infection and how these proportions vary with selected covariates. Three models using the maximum likelihood method assessed these proportions by study group, covariates and individually extracted data (protocol CRD42020208913). A total of 983 reports were identified and 27 were included. The pooled (95%CI) proportion of individuals with neutralising antibodies was 85.3% (83.5-86.9) using the titre cut off >1:20 and 83.9% (82.2-85.6), 70.2% (68.1-72.5) and 54.2% (52.0-56.5) with titres >1:40, >1:80 and >1:160, respectively. These proportions were higher among patients with severe COVID-19 (e.g., titres >1:80, 84.8% [80.0-89.2], >1:160, 74.4% [67.5-79.7]) than those with mild presentation (56.7% [49.9-62.9] and 44.1% [37.3-50.6], respectively) and lowest among asymptomatic infections (28.6% [17.9-39.2] and 10.0% [3.7-20.1], respectively). IgG and neutralising antibody levels correlated poorly.

Conclusions/significance: 85% of individuals with proven SARS-CoV-2 infection had detectable neutralising antibodies. This proportion varied with disease severity, study setting, time since infection and the method used to measure antibodies.

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Conflict of interest statement

I have read the journal’s policy and the authors of this manuscript have the following competing interests: SK is advisor and together with HMS shareholders in QuantuMDx, a molecular nucleic acid test-based diagnostic company. SK is also member of the Scientific Advisory Committee for the Foundation for Innovative New Diagnostics (FIND), a not-for-profit organisation that produces global guidance on affordable diagnostics. The views expressed here are personal opinions and do not represent the recommendations of FIND. JF is an employee and shareholder of Mologic, a private biotechnology company, and a pro bono director of Global Access Diagnostics, a social enterprise delinked from commercial return. All other authors have no conflicts of interest to declare.

Figures

Fig 1
Fig 1. Flow diagram of study selection.
Fig 2
Fig 2. Estimated pooled proportion (95% confidence interval) of participants with neutralisation antibodies by titre cut-off and time.
Fig 3
Fig 3. Estimated proportion positive (95% confidence interval) by disease severity, titre cut-off and time.
Fig 4
Fig 4. Estimated correlation (95% confidence interval) of individual IgG and neutralising antibodies by study.
Fig 5
Fig 5. Scatterplot of individual neutralising and IgG antibody values by study.
See this image and copyright information in PMC

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