While anti-SARS-CoV-2 antibody kinetics have been described in large  populations  of  vaccinated individuals, we still poorly understand how they evolve during a natural infection of Covid-19 and how this impacts viral clearance. For that purpose, the authors analysed the kinetics of both viral load and neutralizing  antibody levels  in  a  prospective  cohort  of  individuals  during  acute  infection  with  alpha  variant. Using a mathematical  model,  the authors  show  that  the  progressive  increase in neutralizing antibodies leads to a shortening of the half-life of both infected cells and  infectious  viral  particles. They estimated  that  the  neutralizing  activity  reached  90%  of  its  maximal  level  within  11    days  after  symptom  onset  and  could  reduce  the  half-life  of  both  infected cells and circulating virus by a 6-fold factor, thus playing a key role to achieve rapid viral clearance. Using this model, we conducted a simulation study to predict in a more general context the protection conferred by pre-existing neutralization titers, due to either vaccination or prior infection. We predicted that a neutralizing activity, as measured by ED50 >103, could reduce by 46% the risk of having viral load detectable by standard PCR assays and by 98% the  risk  of  having  viral  load  above  the  threshold  of  infectiousness.  This model  shows  that  neutralizing  activity  could  be  used  to  define  correlates  of  protection  against  infection  and  transmission.1

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References

  1. Lingas, G., Planas, D., Péré, H., Porrot, F., Guivel‐Benhassine, F., Staropoli, I., Duffy, D., Chapuis, N., Gobeaux, C., Veyer, D., Delaugerre, C., Goff, J. L., Getten, P., Hadjadj, J., Bellino, A., Parfait, B., Tréluyer, J., Schwartz, O., Guedj, J., . . . Terrier, B. (2023). Neutralizing antibody levels as a correlate of protection against SARS‐CoV‐2 infection: a modeling analysis. Clinical Pharmacology & Therapeutics. https://doi.org/10.1002/cpt.3069

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