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. 2023 Mar 23;8(4):185.
doi: 10.3390/tropicalmed8040185.

Dynamics of Antibody Responses after Asymptomatic and Mild to Moderate SARS-CoV-2 Infections: Real-World Data in a Resource-Limited Country

Naruemit Sayabovorn  1 , Pochamana Phisalprapa  1 , Weerachai Srivanichakorn  1 , Thanet Chaisathaphol  1 , Chaiwat Washirasaksiri  1 , Tullaya Sitasuwan  1 , Rungsima Tinmanee  1 , Chayanis Kositamongkol  1 , Pongpol Nimitpunya  1 , Euarat Mepramoon  1 , Pinyapat Ariyakunaphan  1 , Diana Woradetsittichai  2 , Methee Chayakulkeeree  3 , Pakpoom Phoompoung  3 , Korapat Mayurasakorn  4 , Nitat Sookrung  5 , Anchalee Tungtrongchitr  6 , Rungsima Wanitphakdeedecha  7 , Saipin Muangman  8 , Sansnee Senawong  9 , Watip Tangjittipokin  9 , Gornmigar Sanpawitayakul  10 , Cherdchai Nopmaneejumruslers  1 , Visit Vamvanij  11 , Chonticha Auesomwang  1
Affiliations

Dynamics of Antibody Responses after Asymptomatic and Mild to Moderate SARS-CoV-2 Infections: Real-World Data in a Resource-Limited Country

Naruemit Sayabovorn et al. Trop Med Infect Dis. .

Abstract

The dynamics of humoral immune responses of patients after SARS-CoV-2 infection is unclear. This study prospectively observed changes in anti-receptor binding domain immunoglobulin G (anti-RBD IgG) and neutralizing antibodies against the Wuhan and Delta strains at 1, 3, and 6 months postinfection between October 2021 and May 2022. Demographic data, clinical characteristics, baseline parameters, and blood samples of participants were collected. Of 5059 SARS-CoV-2 infected adult patients, only 600 underwent assessment at least once between 3 and 6 months after symptom onset. Patients were categorized as immunocompetent (n = 566), immunocompromised (n = 14), or reinfected (n = 20). A booster dose of a COVID-19 vaccine was strongly associated with maintained or increased COVID-19 antibody levels. The booster dose was also more strongly associated with antibody responses than the primary vaccination series. Among patients receiving a booster dose of a mRNA vaccine or a heterologous regimen, antibody levels remained steady or even increased for 3 to 6 months after symptom onset compared with inactivated or viral vector vaccines. There was a strong correlation between anti-RBD IgG and neutralizing antibodies against the Delta variant. This study is relevant to resource-limited countries for administering COVID-19 vaccines 3 to 6 months after infection.

Keywords: COVID-19 vaccine; antibody response; booster; neutralizing antibody; waning of immunity.

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Conflict of interest statement

The authors have no conflict of interest to declare. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Flowchart of patient enrollment.
Figure 2
Figure 2
Timeline of the study.
Figure 3
Figure 3
Dynamic changes of antibody responses for various regimens of COVID-19 vaccine (n, number of participants in each group). (A) Log10Anti-RBD IgG; (B) Neutralizing antibody against Wuhan strain; (C) Neutralizing antibody against Delta strain. 000, did not receive vaccine at any time; 100, received vaccine before the illness but did not receive after the illness; 010, received vaccine only within 3 months postinfection; 110, received vaccine before the illness and boost after the illness within 3 months; 001, received vaccine between 3–6 months postinfection only; 101, received vaccine before the illness and boost after the illness only at 3–6 months postinfection; 011, did not receive vaccine before the illness and received booster vaccine two doses at 0–3 months and 3–6 months postinfection; 111, received vaccine all the period (before the illness, 0–3 months postinfection, 3–6 postinfection).
Figure 4
Figure 4
Correlations of antibody responses of post-SARS-CoV-2 infected participants (600 participants with 1126 blood samples). (A) Between anti-RBD IgG and neutralizing antibodies against Wuhan and Delta strains; (B) Between neutralizing antibodies against Wuhan and Delta strains.
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