TY - JOUR AU - Cagigi, Alberto AU - Yu, Meng AU - Österberg, Björn AU - Svensson, Julia AU - Falck-Jones, Sara AU - Vangeti, Sindhu AU - Åhlberg, Eric AU - Azizmohammadi, Lida AU - Warnqvist, Anna AU - Falck-Jones, Ryan AU - Gubisch, Pia C. AU - Ödemis, Mert AU - Ghafoor, Farangies AU - Eisele, Mona AU - Lenart, Klara AU - Bell, Max AU - Johansson, Niclas AU - Albert, Jan AU - Sälde, Jörgen AU - Pettie, Deleah D. AU - Murphy, Michael P. AU - Carter, Lauren AU - King, Neil P. AU - Ols, Sebastian AU - Normark, Johan AU - Ahlm, Clas AU - Forsell, Mattias N. AU - Färnert, Anna AU - Loré, Karin AU - Smed-Sörensen, Anna T1 - Airway antibodies emerge according to COVID-19 severity and wane rapidly but reappear after SARS-CoV-2 vaccination PY - 2021/11/22/ AB - Understanding the presence and durability of antibodies against SARS-CoV-2 in the airways is required to provide insights into the ability of individuals to neutralize the virus locally and prevent viral spread. Here, we longitudinally assessed both systemic and airway immune responses upon SARS-CoV-2 infection in a clinically well-characterized cohort of 147 infected individuals representing the full spectrum of COVID-19 severity, from asymptomatic infection to fatal disease. In addition, we evaluated how SARS-CoV-2 vaccination influenced the antibody responses in a subset of these individuals during convalescence as compared with naive individuals. Not only systemic but also airway antibody responses correlated with the degree of COVID-19 disease severity. However, although systemic IgG levels were durable for up to 8 months, airway IgG and IgA declined significantly within 3 months. After vaccination, there was an increase in both systemic and airway antibodies, in particular IgG, often exceeding the levels found during acute disease. In contrast, naive individuals showed low airway antibodies after vaccination. In the former COVID-19 patients, airway antibody levels were significantly elevated after the boost vaccination, highlighting the importance of prime and boost vaccinations for previously infected individuals to obtain optimal mucosal protection. JF - JCI Insight JA - JCI Insight SN - 2379-3708 DO - 10.1172/jci.insight.151463 VL - 6 IS - 22 UR - https://doi.org/10.1172/jci.insight.151463 PB - The American Society for Clinical Investigation ER -