An immune correlate of SARS-CoV-2 infection and severity of reinfections

Maier, Hannah E.; Balmaseda, Ángel; Ojeda, Sergio; Cerpas, Cristiam; Sánchez, Nery; Plazaola, Miguel; Bakel, Harm van; Kubale, John; López, Roger; Saborío, Saira; Barilla, Carlos; Harris, Eva; Kuan, Guillermina; Gordon, Aubree

doi:10.1101/2021.11.23.21266767

Cited by 20 publications

(14 citation statements)

References 39 publications

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“…All second infections occurred in 2021, when variants of concern, particularly Gamma and Delta, began actively circulating in Nicaragua. 31 The relative rate (RR) of symptomatic second infection followed a similar pattern to that observed with all COVID-19 cases and associated severe presentations, such as hospitalization. Children 6 months to 4 years of age displayed slightly higher protection from symptomatic second infection at 61% (RR, 0.39; 95% CI, 0.18-0.77) as did children 5 to 9 years of age at 64% (RR, 0.36; 0.17-0.69) compared with 49% (RR, 0.51; 0.28-0.92) among children 10 to 14 years of age, although these differences were not statistically significant ( Table 3 and Figure 1 C).…”

Section: Resultscontrasting

confidence: 75%

Association of SARS-CoV-2 Seropositivity and Symptomatic Reinfection in Children in Nicaragua

Kubale

Balmaseda²,

Frutos

et al. 2022

JAMA Netw Open

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IMPORTANCEThe impact of the SARS-CoV-2 pandemic on children remains unclear. Better understanding of the burden of COVID-19 among children and their risk of reinfection is crucial, as they will be among the last groups vaccinated. OBJECTIVETo characterize the burden of COVID-19 and assess how risk of symptomatic reinfection may vary by age among children. DESIGN, SETTING, AND PARTICIPANTS In this prospective, community-based pediatric cohort study conducted from March 1, 2020, to October 15, 2021, 1964 nonimmunocompromised children aged 0 to 14 years were enrolled by random selection from the Nicaraguan Pediatric Influenza Cohort, a community-based cohort in District 2 of Managua, Nicaragua. Additional newborn infants aged 4 weeks or younger were randomly selected and enrolled monthly via home visits. EXPOSURES Prior COVID-19 infection as confirmed by positive anti-SARS-CoV-2 antibodies (receptor binding domain and spike protein) or real-time reverse transcriptase-polymerase chain reaction (RT-PCR)-confirmed COVID-19 infection at least 60 days before current COVID-19 infection. MAIN OUTCOMES AND MEASURES Symptomatic COVID-19 cases confirmed by real-time RT-PCR and hospitalization within 28 days of symptom onset of a confirmed COVID-19 case. RESULTS This cohort study assessed 1964 children (mean [SD] age, 6.9 [4.4] years; 985 [50.2%]male). Of 1824 children who were tested, 908 (49.8%; 95% CI, 47.5%-52.1%) were seropositive during the study. There were also 207 PCR-confirmed COVID-19 cases, 12 (5.8%) of which were severe enough to require hospitalization. Incidence of COVID-19 was highest among children younger than 2 years (16.1 cases per 100 person-years; 95% CI, 12.5-20.5 cases per 100 person-years), which was approximately 3 times the incidence rate in any other child age group assessed. In addition, 41 symptomatic SARS-CoV-2 episodes (19.8%; 95% CI, 14.4%-25.2%) were reinfections. CONCLUSIONS AND RELEVANCEIn this prospective, community-based pediatric cohort study, rates of symptomatic and severe COVID-19 were highest among the youngest participants, with rates stabilizing at approximately 5 years of age. In addition, symptomatic reinfections represented a large proportion of symptomatic COVID-19 cases.

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Section: Resultscontrasting

confidence: 75%

Association of SARS-CoV-2 Seropositivity and Symptomatic Reinfection in Children in Nicaragua

Kubale

Balmaseda²,

Frutos

et al. 2022

JAMA Netw Open

Self Cite

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“…According to manufacturer's specifications, results are positive when the serum total anti-SARS-CoV-2 antibodies concentration is ≥0.8 kBAU/L. A total anti-SARS-CoV-2 antibodies titer of 656 kBAU/L was considered as predictive of ≥80% protection against modest or severe COVID-19 illness, in keeping with previously published data [15,16].…”

Section: Methodssupporting

confidence: 56%

Variation of total anti-SARS-CoV-2 antibodies after primary BNT162b2 vaccination and homologous booster

Salvagno¹,

Henry²,

Pighi³

et al. 2022

Preprint

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Background: In this serosurveillance study, we investigated the variation of total anti-SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) antibodies in healthcare workers receiving primary BNT162b2 vaccination and homologous booster.Methods: A total number of 524 subjects (median age, 46 years; 65.3% females), were studied. All received primary BNT162b2 vaccination (two doses) and homologous booster (one dose) >8 months after completing the primary cycle. Blood samples were collected before the first and second vaccine doses, at 1, 3 and 6 months after the second dose, as well as before and 1 month after booster. Total anti-SARS-CoV-2 neutralizing antibodies were assayed with Roche Elecsys Anti-SARS-CoV-2 S chemiluminescent immunoassay.Results: Overall, 65.1% subjects were baseline (i.e., prevaccination) SARS-CoV-2 seronegative and always tested SARS-CoV-2 negative (“N/N”), 16.2% were baseline SARS-CoV-2 seronegative but tested SARS-CoV-2 positive after receiving the vaccine booster dose (“N/P”), whilst 18.7% were baseline SARS-CoV-2 seropositive and always tested SARS-CoV-2 negative afterwards (“P/N”). All groups displayed a similar trend of total anti-SARS-CoV-2 S antibodies throughout the study period, though the P/N cohort exhibited higher values compared to the other two groups until receiving the booster, after which the levels become similar in all cohorts. Significant differences in total anti-SARS-CoV-2 S antibodies values were not found between N/N and N/P groups, neither 1 month after booster. The rate of subjects with protective antibodies values become 100% in all groups after booster.Conclusions: Although baseline seropositivity is associated with more pronounced humoral immune response following primary vaccination compared to never infected subjects, SARS-CoV-2 infection after booster does not significantly foster antibody titers.

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“…30 Additionally, in a pre-print of a cohort study on the immune correlates of natural infection, seropositivity was associated with 69·2% protection from symptomatic infection mostly against Gamma and Delta variants with higher protection against moderate or severe infection and reinfections were less severe than first infections. 31…”

Section: Discussionmentioning

confidence: 99%

“…30 Additionally, in a pre-print of a cohort study on the immune correlates of natural infection, seropositivity was associated with 69•2% protection from symptomatic infection mostly against Gamma and Delta variants with higher protection against moderate or severe infection and reinfections were less severe than first infections. 31 The frequency and timeliness of required vaccination doses (typically for protection against severe have not yet been determined with certainty. The third dose should probably be seen as the final dose of the original vaccination scheme.…”

Section: Discussionmentioning

confidence: 99%

Risk and severity of SARS-CoV-2 reinfections during 2020-2022 in Vojvodina, Serbia: a population-level study

Medić

Anastassopoulou

Lozanov-Crvenković

et al. 2022

Preprint

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BackgroundData on the rate and severity of reinfections with SARS-CoV-2 in real-world settings are scarce and the effects of booster vaccination on reinfection risk are unknown.MethodsIn a retrospective cohort study, all SARS-CoV-2 laboratory-confirmed residents of Vojvodina, registered in the database of the Institute of Public Health of Vojvodina, between March 6, 2020 and October 31, 2021, were followed for reinfection ≥90 days after primary infection. Data were censored at the end of follow-up (January 31, 2022) or death. The risk of reinfection was visualized with Kaplan-Meier plots. To examine whether vaccination protected from reinfection, the subset of Vojvodina residents with primary infection in 2020 (March 6–December 31) were matched (1:2) with controls without reinfection.ResultsUntil January 31, 2022, 13,792 reinfections were recorded among 251,104 COVID-19 primary infections (5·49%). Most reinfections (86·8%) were recorded in January 2022. Reinfections were mostly mild (99·2%). Hospitalizations were uncommon (1·08% vs. 3·70% in primary infection) and COVID-19 deaths were very rare (n=20, case fatality rate 0·15%). The overall incidence rate of SARS-CoV-2 reinfections was 5·99 (95% CI 5·89-6·09) per 1,000 person-months for those who survived the first three months after primary infection. The reinfection risk was estimated as 0·76% at six months, 1·36% at nine months, 4·96% at 12 months, 16·7% at 15 months, and 18·9% at 18 months. Among 34 second reinfections, none resulted in hospitalization or death. Unvaccinated (OR=1·23; 95%CI=1·14–1·33), incompletely (OR=1·33; 95%CI=1·08–1·64) or completely vaccinated (OR=1·50; 95%CI=1·37–1·63), were modestly more likely to be reinfected compared with those who received a third (booster) vaccine dose.ConclusionsSARS-CoV-2 reinfections were exceptionally uncommon until the end of 2021 but became common with the advent of the Omicron variant. Very few reinfections were severe. A vaccination booster dose may modestly reduce reinfection risk.

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An immune correlate of SARS-CoV-2 infection and severity of reinfections

Cited by 20 publications

References 39 publications

Association of SARS-CoV-2 Seropositivity and Symptomatic Reinfection in Children in Nicaragua

Association of SARS-CoV-2 Seropositivity and Symptomatic Reinfection in Children in Nicaragua

Variation of total anti-SARS-CoV-2 antibodies after primary BNT162b2 vaccination and homologous booster

Risk and severity of SARS-CoV-2 reinfections during 2020-2022 in Vojvodina, Serbia: a population-level study

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