Fig. 2

The surrogate virus neutralization test (sVNT) detects neutralizing antibodies interfering with SARS-CoV-2 S RBD binding to human ACE2. Binding of SARS-CoV-2 S RBD to human ACE2 from commercial vendor (A) and produced in-house (B). Plates were coated with ACE2 as indicated. His-tagged SARS-CoV-2 S RBD was titrated as indicated and detected with an anti-His peroxidase-labeled mAb. Representative assays performed in duplicate are presented as the mean ± SD. C Inhibition of the interaction of SARS-CoV-2 S RBD with ACE2 by the addition of sera from convalescent patients with mild (blue lines) or severe (red lines) COVID-19 and healthy controls (HC; black lines). Assay performed in duplicate; mean percentages of neutralization ± SD. D–G Inhibition of the interaction of SARS-CoV-2 S RBD with ACE2 at the serum dilutions indicated. Individual values (dots) and means (line). Shaded areas represent the mean ± 2SD of values from sera of healthy controls. *P < 0.05; ***P < 0.001, Welch’s ANOVA followed by Dunnett’s T3 multiple comparisons test. H Relative distributions of SARS-CoV-2 neutralizing serum titers determined as the dilution retaining binding reduction > mean + 2SD of HC. ***P < 0.001; Fisher’s exact test (HC vs. mild or severe) or the Chi-squared test was used to assess the trend (mild vs. severe)