Antibody-dependent cellular cytotoxicity (ADCC) responses to viral infection are a form of antibody regulated immune responses mediated through the Fc fragment. Whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) triggered ADCC responses contributes to COVID-19 disease development is currently not well understood. To understand the potential correlation between ADCC responses and COVID-19 disease development, we analyzed the ADCC activity and neutralizing antibody response in 255 individuals ranging from asymptomatic to fatal infections over 1 year post disease. ADCC was elicited by 10 days post-infection, peaked by 11–20 days, and remained detectable until 400 days post-infection. In general, patients with severe disease had higher ADCC activities. Notably, patients who had severe disease and recovered had higher ADCC activities than patients who had severe disease and deceased. Importantly, ADCC activities were mediated by a diversity of epitopes in SARS-COV-2-infected mice and induced to comparable levels against SARS-CoV-2 variants of concern (VOCs) (B.1.1.7, B.1.351, and P.1) as that against the D614G mutant in human patients and vaccinated mice. Our study indicates anti-SARS-CoV-2 ADCC as a major trait of COVID-19 patients with various conditions, which can be applied to estimate the extra-neutralization level against COVID-19, especially lethal COVID-19.

对病毒感染的抗体依赖性细胞毒性 (ADCC) 反应是一种通过 Fc 片段介导的抗体调节免疫反应。目前尚不清楚严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 引发的 ADCC 反应是否会导致 COVID-19 疾病的发展。为了解 ADCC 反应与 COVID-19 疾病发展之间的潜在相关性，我们分析了 255 名个体的 ADCC 活性和中和抗体反应，范围从无症状到致命感染超过 1 年。ADCC 在感染后 10 天引发，在 11-20 天达到峰值，并且在感染后 400 天仍可检测到。一般而言，患有严重疾病的患者具有较高的 ADCC 活性。尤其，患有严重疾病和康复的患者比患有严重疾病和死亡的患者具有更高的 ADCC 活性。重要的是，ADCC 活性由感染 SARS-COV-2 的小鼠中的多种表位介导，并诱导至与 SARS-CoV-2 相关变异体 (VOC) 相当的水平（B.1.1.7、B.1.351 和 P .1) 在人类患者和接种疫苗的小鼠中对抗 D614G 突变体。我们的研究表明，抗 SARS-CoV-2 ADCC 是 COVID-19 不同病症患者的主要特征，可用于估计针对 COVID-19，尤其是致命性 COVID-19 的额外中和水平。和 P.1) 在人类患者和接种疫苗的小鼠中对抗 D614G 突变体。我们的研究表明，抗 SARS-CoV-2 ADCC 是 COVID-19 不同病症患者的主要特征，可用于估计针对 COVID-19，尤其是致命性 COVID-19 的额外中和水平。和 P.1) 在人类患者和接种疫苗的小鼠中对抗 D614G 突变体。我们的研究表明，抗 SARS-CoV-2 ADCC 是 COVID-19 不同病症患者的主要特征，可用于估计针对 COVID-19，尤其是致命性 COVID-19 的额外中和水平。