Antiviral and autoimmune antibody levels for two years post SAR-CoV-2 infection show uniquely durable vaccination responses and partial waning of self-reactive IgG

Abstract As temporal distance from the start of the COVID-19 pandemic increases, there is mounting concern of the long-term immunological consequences of SARS-CoV-2 infection(s). Abnormally high levels of a panoply of autoantibodies are found during acute COVID-19, and to date it is still unclear if these antibodies are sustained for a year or longer post-infection. Additionally, if there is improved longevity of vaccine-induced antibodies when administered against the immune backdrop of previous SARS-CoV-2 infection remains to be elucidated. To address these questions, we measured a series of anti-viral and autoimmune antibodies from samples taken at intervals from seven subjects infected with SARS-CoV-2 in the spring of 2020 (five outpatient and two hospitalized). Blood draws were performed beginning at acute disease and for an additional 10–25 months. Plasma IgG and IgA antibodies reactive with SARS-CoV-2 spike, RBD, and nucleocapsid, as well as CMV Mosaic, EBV GP 350, and Flu H1 were measured using the BU ELISA protocol, autoantibodies to self-antigens associated with connective tissue disease were measured using a commercial kit. Anti-viral antibody responses induced by vaccination were sustained for more than one year post SARS-CoV-2 infection in multiple subjects. Autoantibody trajectories varied, with many positive ‘hits’ falling below baseline after 1 year, and others remaining high for all time points measured. Future work will include increasing subject numbers to a larger cohort with differing clinical presentations and outcomes to define connections between serological signatures, protection from re-infection, and PASC. Supported by grants from CTSI Pilot grant (NIH/NCATS 5UL1TR001430-05), BU Internal Funding, MassCPR PASC Subaward #FP-0034311, and NIH R01 AG065050-01A1