Multiple studies published over the past few months highlight a pattern of
decline in the IgG antibodies of recovered COVID-19 patients. This new research
suggests patients infected with SARS-CoV-2—the virus that causes
COVID-19—retain their IgG antibodies for only a few months after recovery,
raising concerns about long-term immunity.
IgM vs. IgG Antibodes
When a virus such as SARS-CoV-2 enters the body, the immune system begins
to produce its first round of antibodies. These are known as IgM antibodies,
and they are usually detectable three to six days after infection.1 These antibodies serve as the body’s initial
attempt at neutralizing the virus, but they fade rather quickly. As IgM
antibodies dwindle, IgG antibodies start to develop and spike; they are
typically detectable eight days after infection. IgG antibodies tend to provide
long-term protection against reinfection.2
One of these studies, published on June 16, focused on two hospitals in
Wuhan, China, the initial epicenter of COVID-19. Researchers analyzed IgG and
IgM antibody levels in four groups of the population: 3,800 medical workers who
were initially exposed to the virus, 20,000 members of the general population,
1,600 hospitalized patients (who were not hospitalized for COVID-19), and 1,500
patients with a confirmed case of COVID-19.3
Although 90% of COVID-19 patients tested positive for antibodies while the
virus was still active in their body, only 4% of previously-exposed healthcare
workers presented with these IgG antibodies. This finding led the researches to
conclude that protective antibodies would not endure in the long-term after the
SARS-CoV-2 virus is shed.
“The most shocking part of our study, to me, is the extremely low viral
levels in the blood serum of healthcare providers, most of whom had exposure to
the virus in a highly-contagious environment without the appropriate personal
protective equipment in the early days of the outbreak,” Fangijan Guo, MD, an assistant professor at the University of Texas
Medical Branch and one of the authors of this study, tells Verywell. “The
plausible explanation is that those healthcare providers did not produce
long-lasting protective antibodies to SARS-CoV-2.”
Another study, published on July 21 by the David Geffen School of Medicine
at the University of California, Los Angeles (UCLA), screened for antibodies in
30 confirmed COVID-19 patients and four suspected COVID-19 patients.4 Results built on the Wuhan study’s findings,
suggesting that immunity is short-lived.
While UCLA researchers are still gathering data from COVID-19 patients,
they believe IgG antibodies remain in the body for an average of 60 days.
The Implication for Recovered Patients
The fact that antibodies may not last long is nerve-wracking for people
like Chiara DiGiallorenzo, 25, who is currently enrolled in the UCLA antibody
study.
DiGiallorenzo, who is based in Los Angeles, is immunocompromised and tested
positive for COVID-19 on March 6. She tells Verywell that this diagnosis was
especially difficult for her because there were very few cases in California at
the time, and local doctors were unfamiliar with testing and treatment
protocols.
DiGiallorenzo publicly documented her experience with COVID-19 on her Instagram
stories, sharing detailed
snapshots of her struggles to encourage her followers to take the virus
seriously. After her symptoms faded, she continued to test positive for a month
and a half.
“It was a very frustrating and isolating experience,” DiGiallorenzo says.
“The doctors were uncertain as to why this was happening—it was unclear if I
was shedding the virus or if I was still infectious.”
After finally getting a negative test result, she had an antibody screening
in May. Results showed she had a "high antibody count." Her antibody
levels will be retested during the UCLA study.
DiGiallorenzo says she fears reinfection, since the doctor she's been
working with throughout the study is seeing a drop-off in antibodies among most
participants.
"He has alerted us that most people are losing antibodies at an
alarmingly fast rate in comparison to other coronaviruses," she says. "He had a patient lose them
completely in three weeks."
What This Means For You ;
These studies show immunity is not guaranteed after you’ve been infected
with SARS-CoV-2. Given that IgG antibodies shed in around three months, the
chance of reinfection is possible. This research applies to both symptomatic
and asymptomatic patients.
What This Research Means for Herd Immunity ;
Herd immunity, which was initially proposed as a solution to COVID-19 in
the UK, occurs when a significant portion of a population obtains immunity to a
specific virus.5 This reduces
the chances of person-to-person transmission, essentially wiping a virus off a
map. Herd immunity can be achieved through vaccines or through actually
acquiring—and recovering from—a virus. Either way, herd immunity relies on the
effectiveness of neutralizing antibodies.
Alexander Marchetti, a microbiology and immunology PhD candidate at
the Indiana University School of Medicine, tells Verywell that if the discoveries about
short-lived SARS-CoV-2 antibodies are further tested and confirmed, then herd
immunity would prove futile.
Because there isn't a vaccine at this time, developing herd immunity to
COVID-19 would involve a large number of people getting infected. Marchetti
says this would come at the cost of an excessive amount of lives lost from
COVID-19, given the pathogenicity of this disease.
According to Marchetti, earlier coronaviruses—such as SARS—had symptoms
that manifested boldly and loudly in those afflicted, making it easier to
separate the infected portion of the population from the non-infected portion.
Additionally, SARS was only spread through symptomatic patients, while
SARS-CoV-2 can be transmitted through asymptomatic people,6 increasing the chances of widespread
infection.
SARS killed about 10% of those infected, and the remaining part of the
infected population was left with immunity.7
That doesn’t seem to be the case for this current strain of coronavirus,
Marchetti says.
“What’s changed now is that this strain of coronavirus is less deadly than
SARS, and that’s what’s allowing it to spread undetected," he says.
"People can go for a week or two without symptoms and spread it. That has
made it more virulent, yet less deadly on a mirco-scale. But in the
macro-environment, if you zoom out, you get millions of people who are
infected and hundreds of thousands more who are killed.”
SARS antibodies also tend to last for a much longer duration, according to
Guo.
“It is reported that even 210 days after symptom onset, neutralizing viral
antibodies (anti-viral IgG) are still detectable in recovered SARS patients,”
he says. “Why people infected with SARS-CoV-2 do not produce long-lasting
protective antibodies is unknown. Further studies in this area are
needed.”
What This Research Means for Vaccines ;
The goal of a COVID-19 vaccine is to create an immune response against the SARS-CoV-2
virus. In other words, a vaccine should trigger antibody production. But
because of the decrease in antibodies over time, scientists and doctors like
Guo have their doubts about the efficiency of a potential vaccine.
When Will We Have a COVID-19 Vaccine?
This finding would put a big question
mark on the success of an effective vaccine against SARS-CoV-2.
—
FANGIJAN GUO, MD
"This makes developing an effective vaccine more difficult, as
long-lasting protective antibodies seem to be not produced,” Guo says. “What is
worse, some reports demonstrate that people with severe COVID-19 have high
antibody titers and people with mild diseases quickly lose their antibodies to
SARS-CoV-2."
While research regarding antibodies continues, it’s important to maintain
social distancing, wear masks, and properly isolate when infected. If you’re
looking to test for antibodies, the Centers for Disease Control and Prevention
(CDC) recommends you follow the testing and diagnosing protocols of your state,
and reach out to your local healthcare providers and laboratories.8
What to Know About the COVID-19 Antibody
Test
If you do choose to get an antibody test, it's important to remember what
the test can and can't tell you.
"A positive COVID-19 antibody test will not provide people an immune
passport to show that people are immune to SARS-CoV-2,” Guo says. “A positive
test result only shows that they were infected or are still infected with
SARS-CoV-2.”