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Longitudinal analysis of neutralizing antibodies against SARS-CoV-1 and different SARS-CoV-2 strains in breakthrough and unvaccinated COVID-19 patients in Thailand

Abstract

The emergence of immune-evasive SARS-CoV-2 variants complicates COVID-19 prevention. In a study of 111 COVID-19 patients in Thailand (2021–2022), plasma neutralizing antibody (nAb) levels were measured against SARS-CoV-1 and 13 SARS-CoV-2 strains. Results showed a two-week post-infection nAb increase with strong responses to ancestral and non-Omicron variants but weaker responses to SARS-CoV-1 and Omicron variants. Breakthrough cases with heterologous vaccines had the highest nAb levels. nAb levels declined faster in older adults and patients with pneumonia. Findings emphasize that vaccine, age, and underlying conditions contribute to diverse immune responses and underscore the need for variant-specific vaccines for SARS-CoV-2 protection.