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A detailed understanding of antibody-based SARS-CoV-2 immunity has critical implications for overcoming the COVID-19 pandemic and informing vaccination strategies. We evaluated SARS-CoV-2 antibody response dynamics in a cohort of 963 individuals over 10 months. Investigating 2,146 samples, we initially detected SARS-CoV-2 antibodies in 94.4% individuals, with 82% and 79% exhibiting serum and IgG neutralization, respectively. Approximately 3% of patients demonstrated exceptional SARS-CoV-2-neutralization, with these ‘elite neutralizers’ also possessing cross-neutralizing IgG to SARS-CoV-1. Multivariate statistical modeling revealed sero-reactivity, age and fever as key factors predicting SARS-CoV-2 neutralizing activity. A loss of anti-spike reactivity in 13% individuals was detected 10 months after infection. Neutralizing activity had half-lives of 14.7 weeks in serum versus 31.4 weeks in purified IgG, indicating a stable long-term memory IgG B-cell repertoire. Our results demonstrate a broad spectrum in the initial SARS-CoV-2-neutralizing antibody response, with sustained antibodies in majority of individuals for 10 months after mild COVID-19. Funding: This work was funded by grants to Florian Kleinfrom the German Center for Infection Research (DZIF), the German Research Foundation (DFG) CRC1279 and CRC1310, European Research Council (ERC) ERC-stG639961 and COVIM: „NaFoUniMedCovid19“ (FKZ: 01KX2021). Ethical Approval: Blood samples were collected from donors who gave their written consent under the protocols 20-1187 and 16-054, approved by the Institutional Review Board (IRB) of the University Hospital Cologne.

Background: Meningitis and spinal infections with Gram-negative bacteria after local injections for treatment of chronic back pain are rare. We investigated an outbreak of Pseudomonas aeruginosa infections following CT-guided spinal injections (SI). Methods: A case was defined as a spinal infection or meningitis with P. aeruginosa after SI between January 10th and March 1st, 2019 in the same outpatient clinic. Patients without microbiological evidence of P. aeruginosa, but with a favorable response to antimicrobial therapy active against P. aeruginosa were defined as probable cases. Findings: 28 out of 297 patients who had received CT-guided SI during the study period developed meningitis or spinal infections. Medical records were available for 19 patients. In 15 patients there was microbiological evidence of P. aeruginosa and four patients were defined as probable cases. Two out of 19 patients developed meningitis, while 17 developed spinal infections. Median time from injection to hospital admission was 8 days (IQR 2-23). Patients mostly presented with back pain (n=18; 95%) but rarely developed fever (n=3; 16%). Most patients required surgery (n=16; 84%). Seven patients (37%) developed a relapse and one patient died. Although the source of infection has not been identified microbiologically, documented failures in asepsis performing SI probably contributed to these infections. Interpretation: SI are generally considered safe, but non-adherence to asepsis can lead to deleterious effects. Spinal infections caused by P. aeruginosa are difficult to treat and show a high relapse rate. Funding Statement: No funding to declare. Declaration of Interests: In the last three years NJ has received lecture fees from Gilead, Infectopharm, MSD and Bayer and travel grants from Gilead, Basilea, Correvio and Pfizer and grants for an observational study from Infectopharm. HS reports grants from German Centre for Infection Research (DZIF) and Accekerate, personal fees from Basilea Pharmaceuticals, Gilead, MSD, Entasis, Shionogi, ThermoFisher, bioMerieux, Becton Dickinson, Shionogi outside the submitted work. GF discloses advisory board fees from Gilead Sciences, Janssen, Merck Sharp & Dohme and ViiV Healthcare, lecture fees from Janssen, travel support from Gilead Sciences and Janssen and research support from Gilead Sciences, Janssen, ViiV Healthcare and Merck Sharp & Dohme. All other authors declare no conflicts of interest. Ethics Approval Statement: The study was approved by the local ethics committee.

Background: Germany is among the countries with the highest numbers of SARS-CoV-2 infections in Europe To slow the spread of SARS-CoV-2 a combination of measur