Kinetics of immune responses to SARS-CoV-2 proteins in individuals with varying severity of infection and following a single dose of the AZD1222

Abstract

To characterize the IgG and IgA responses to different SARS-CoV-2 proteins, we investigated the antibody responses to SARS-CoV-2 following natural infection and following a single dose of AZD1222(Covishield), in Sri Lankan individuals. The IgG and IgA responses were assessed to S1, S2, RBD and N proteins in patients at 4 weeks and 12 weeks since onset of illness or following vaccination. Antibodies to the receptor binding domain of SARS-CoV-2 wild type (WT), alpha, beta and delta and ACE2 (Angiotensin Converting Enzyme 2) receptor blocking antibodies were also assessed in these cohorts. Those with mild illness and in vaccinees, the IgG responses to S1, S2, RBD and N protein increased from 4 weeks to 12 weeks, while it remained unchanged in those with moderate/severe illness. In the vaccinees, IgG antibodies to the S2 subunit had the highest significant rise(p<0.0001). Vaccinees had several fold lower IgA antibodies to all the SARS-CoV-2 proteins tested than those with natural infection. At 12 weeks, the Haemagglutination test (HAT) titres were significantly lower to the alpha in vaccinees and significantly lower in those with mild illness and in vaccinees to beta and for delta. No such difference was seen in those with moderate/severe illness. Vaccinees had significantly less IgA to SARS-CoV-2, but comparable IgG responses those with natural infection. However, following a single dose vaccinees had reduced antibody levels to the VOCs, which further declined with time, suggesting the need to reduce the gap between the two doses, in countries experiencing outbreaks due to VOCs.