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Nat Commun . Variant-specific antibody correlates of protection against SARS-CoV-2 Omicron symptomatic and overall infections

tetano

Editor, Senior Moderator
Nat Commun


. 2025 Nov 21;16(1):10305.
doi: 10.1038/s41467-025-65235-8. Variant-specific antibody correlates of protection against SARS-CoV-2 Omicron symptomatic and overall infections

José Victor Zambrana[SUP] #[/SUP][SUP] 1 2 [/SUP], Ian A Mellis[SUP] #[/SUP][SUP] 3 4 5 [/SUP], Abigail Shotwell[SUP] 1 [/SUP], Hannah E Maier[SUP] 1 [/SUP], Yara Saborio[SUP] 2 6 [/SUP], Carlos Barillas[SUP] 2 [/SUP], Roger Lopez[SUP] 2 6 [/SUP], Gerald Vasquez[SUP] 2 [/SUP], Miguel Plazaola[SUP] 2 [/SUP], Nery Sanchez[SUP] 2 [/SUP], Sergio Ojeda[SUP] 2 [/SUP], Isabel Gilbertson[SUP] 1 [/SUP], Guillermina Kuan[SUP] 2 7 [/SUP], Qian Wang[SUP] 3 [/SUP], Lihong Liu[SUP] 3 [/SUP], Angel Balmaseda[SUP] 2 6 [/SUP], David D Ho[SUP] 8 [/SUP], Aubree Gordon[SUP] 9 [/SUP]



Affiliations
Abstract

Vaccination and prior infection elicit neutralizing antibodies targeting SARS-CoV-2, yet the quantitative relationship between serum antibodies and infection risk against viral variants remains uncertain, particularly in underrepresented regions. We investigated the protective correlation of pre-exposure serum neutralizing antibody levels, employing a panel of SARS-CoV-2 pseudoviruses (Omicron BA.1, Omicron BA.2, and ancestral D614G), and Spike-binding antibody levels, with symptomatic BA.1 or BA.2 SARS-CoV-2 infections and overall infection, in 345 household contacts from a SARS-CoV-2 household cohort study in Nicaragua. A four-fold increase in homotypic-neutralizing (e.g., BA.1-neutralizing vs. BA.1 exposure) titers was correlated with protection from symptomatic infections (BA.1 protection: 28% [95%CI 12-42%]; BA.2 protection: 43% [20-62%]), and ancestral-neutralizing titers were also correlated with protection from either variant, but only at higher average levels than homotypic. Mediation analyses revealed that homotypic and D614G-neutralizing antibodies mediated protection from infection and symptomatic infection both from prior infection and vaccination. These findings underscore the importance of monitoring variant-specific antibody responses and highlight that antibodies targeting circulating strains may be more predictive of protection from infection. Nevertheless, ancestral-strain-neutralizing antibodies remain relevant as a correlate of protection. Our study emphasizes the need for continued efforts to assess antibody correlates of protection.


 
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