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Background <p>The ongoing evolution of SARS-CoV-2, particularly through the emergence of new variants, continues to challenge our understanding of immune protection. While antibody levels correlate with protection against earlier variants such as Alpha and Delta, their relationship with Omicron sub-variants remains unclear.</p> Methods <p>To investigate the role of antibody levels and neutralizing activity in preventing breakthrough infections, we analyzed longitudinal SARS-CoV-2 humoral responses and neutralizing activity against the ancestral virus and major emerging variants in a well-characterized cohort of healthcare workers in Spain (<i>N</i> = 405).</p> Results <p>We find that antibody levels and neutralization titers are key indicators of protection against SARS-CoV-2, including the more evasive BQ.1 and XBB Omicron variants. Higher IgG and IgA levels are associated with protection over three 6-month follow-up periods sequentially dominated by BA.1, BA.2, BA.5, BQ.1, and XBB Omicron sub-variants, although the strength of the association between antibody levels and protection declines over time.</p> Conclusions <p>Our findings demonstrate that binding antibody levels and neutralizing responses are valid correlates of protection against more evasive BQ.1 and XBB Omicron variants, although the strength of this association diminishes over time. Additionally, our results underscore the importance of continuous monitoring and updating vaccination strategies to maintain effective protection against emerging SARS-CoV-2 variants.</p>

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Determinants of antibody levels and protection against omicron BQ.1/XBB breakthrough infection

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月20日

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  • Carla Martín Pérez,
  • Anna Ramírez-Morros,
  • Alfons Jiménez,
  • Marta Vidal,
  • Edwards Pradenas,
  • Diana Barrios,
  • Mar Canyelles,
  • Rocío Rubio,
  • Inocencia Cuamba,
  • Luis Izquierdo,
  • Pere Santamaria,
  • Benjamin Trinité,
  • Josep Vidal-Alaball,
  • Luis M. Molinos-Albert,
  • Julià Blanco,
  • Ruth Aguilar,
  • Anna Ruiz-Comellas,
  • Gemma Moncunill,
  • Carlota Dobaño

摘要

Background

The ongoing evolution of SARS-CoV-2, particularly through the emergence of new variants, continues to challenge our understanding of immune protection. While antibody levels correlate with protection against earlier variants such as Alpha and Delta, their relationship with Omicron sub-variants remains unclear.

Methods

To investigate the role of antibody levels and neutralizing activity in preventing breakthrough infections, we analyzed longitudinal SARS-CoV-2 humoral responses and neutralizing activity against the ancestral virus and major emerging variants in a well-characterized cohort of healthcare workers in Spain (N = 405).

Results

We find that antibody levels and neutralization titers are key indicators of protection against SARS-CoV-2, including the more evasive BQ.1 and XBB Omicron variants. Higher IgG and IgA levels are associated with protection over three 6-month follow-up periods sequentially dominated by BA.1, BA.2, BA.5, BQ.1, and XBB Omicron sub-variants, although the strength of the association between antibody levels and protection declines over time.

Conclusions

Our findings demonstrate that binding antibody levels and neutralizing responses are valid correlates of protection against more evasive BQ.1 and XBB Omicron variants, although the strength of this association diminishes over time. Additionally, our results underscore the importance of continuous monitoring and updating vaccination strategies to maintain effective protection against emerging SARS-CoV-2 variants.