Neutralizing antibody levels are highly predictive of immune protection from symptomatic SARS-CoV-2 infection
Neutralizing antibody levels are highly predictive of immune protection from symptomatic SARS-CoV-2 infection
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DOI：
10.1038/s41591-021-01377-8
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发表时间：
2021-05-17
期刊：
影响因子：
82.9
通讯作者：
Davenport, Miles P.
中科院分区：
文献类型：
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作者：
Khoury, David S.;Cromer, Deborah;Davenport, Miles P.
目前迫切需要COVID-19免疫保护的预测模型，以确定保护的相关性，以协助未来疫苗的部署。为了解决这个问题，我们分析了体外中和水平和观察到的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染的保护之间的关系，使用来自7种现有疫苗和恢复期队列的数据。我们估计，对可检测到的SARS-CoV-2感染的50%保护的中和水平为平均恢复水平的20.2%（95%置信区间（CI）= 14.4-28.4%）。50%保护免受严重感染所需的估计中和水平显著较低（平均恢复期水平的3%; 95% CI = 0.7- 13%，P = 0.0004）。对免疫后前250天中和滴度衰减的建模预测，将发生对SARS-CoV-2感染的保护的显著损失，尽管对严重疾病的保护应在很大程度上保留。与疫苗株相比，针对某些SARS-CoV-2变异体的中和滴度降低，我们的模型预测了针对病毒变异体的中和和效力之间的关系。在这里，我们表明中和水平是免疫保护的高度预测，并提供了一个基于证据的SARS-CoV-2免疫保护模型，这将有助于制定疫苗策略，以控制大流行的未来轨迹。19是恢复期血清中平均水平的一部分，将有助于指导疫苗的推广。
Predictive models of immune protection from COVID-19 are urgently needed to identify correlates of protection to assist in the future deployment of vaccines. To address this, we analyzed the relationship between in vitro neutralization levels and the observed protection from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection using data from seven current vaccines and from convalescent cohorts. We estimated the neutralization level for 50% protection against detectable SARS-CoV-2 infection to be 20.2% of the mean convalescent level (95% confidence interval (CI) = 14.4-28.4%). The estimated neutralization level required for 50% protection from severe infection was significantly lower (3% of the mean convalescent level; 95% CI = 0.7-13%, P = 0.0004). Modeling of the decay of the neutralization titer over the first 250 d after immunization predicts that a significant loss in protection from SARS-CoV-2 infection will occur, although protection from severe disease should be largely retained. Neutralization titers against some SARS-CoV-2 variants of concern are reduced compared with the vaccine strain, and our model predicts the relationship between neutralization and efficacy against viral variants. Here, we show that neutralization level is highly predictive of immune protection, and provide an evidence-based model of SARS-CoV-2 immune protection that will assist in developing vaccine strategies to control the future trajectory of the pandemic.Estimates of the levels of neutralizing antibodies necessary for protection against symptomatic SARS-CoV-2 or severe COVID-19 are a fraction of the mean level in convalescent serum and will be useful in guiding vaccine rollouts.