Abstract Antibodies are critical for protection against a range of viral respiratory diseases including SARS-CoV-2, but the induction of durable and potent antibody responses continues to be a challenge. Beyond neutralization, there is growing appreciation for the potential protective role of Fc-mediated functions, especially against immune-evasive variants. Induction of polyfunctional antibody responses is a complex multifactorial process that is shaped by interactions between various antibody features, viral properties and host factors. Here we review lessons learnt from the COVID-19 pandemic regarding how prior infection and different vaccination strategies can modulate plasma and mucosal antibody profiles, including isotypes, IgG subclasses, Fc glycosylation and consequently functions. Additionally, we discuss the challenges of immune imprinting and its effects upon antibody responses to viral variants. This review provides insights into optimising antibody-based strategies for COVID-19 prevention and treatment emphasising the need for further research to understand the mechanisms behind effective antibody responses and their impact upon clinical outcomes.
Aurelia et al. (Thu,) studied this question.