An outbreak of SARS-CoV-2 reinfection in a long-term care facility in South Korea

Kim, Il-Hwan; Shin, Minjoung; Park, Ae Kyung; Song, Jin Su; Kim, Miyoung; Park, Yoojin; Cho, Hee Sook; Jeong, Hye Myung; Kim, Jeong‐Min; Oh, Sae Jin; Kim, Jeong Ah; Lee, Chae young; Lee, Ji Joo; Wang, Seongjin; Rhee, Jee Eun; Park, Young-Joon; Kim, Eun Jin

doi:10.1016/j.jiph.2022.07.011

Cited by 11 publications

(11 citation statements)

References 12 publications

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“…In addition, after breakthrough infections, the neutralizing activities against BA.1 and BA.5 were enhanced in the heterologously boosted participants. Most cases of breakthrough infections in the present study developed in early 2022 when Omicron BA.1 was the predominant strain, explaining the remarkable cross-reactive neutralizing activities between Omicron subvariants BA.1 and BA.5, contrary to previous reports (19)(20)(21)(22)(23)(24). Immune responses after vaccination and natural infection may vary depending on age, sex, race, vaccine type/dose, and SARS-CoV-2 strain (25,26).…”

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confidence: 78%

“…The majority of the participants were male (90%) under the age of 40 years (median age, 34 years; interquartile range [IQR], 32-37). The median intervals between the primary and booster doses of the participants from the BNT162b2-, mRNA-1273-, and Ad26.COV2.S-boosted groups were 27 weeks (IQR, 25-28), 25 weeks (IQR, 24-27), and 23 weeks (IQR, [15][16][17][18][19][20][21][22][23][24], respectively. During the study period, the rate of laboratoryconfirmed breakthrough infections did not differ among the three groups (42.9-62.5%; Table 1).…”

Section: Study Participantsmentioning

confidence: 99%

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Humoral and cellular immunogenicity of homologous and heterologous booster vaccination in Ad26.COV2.S-primed individuals: Comparison by breakthrough infection

Hyun

Jang²,

Park³

et al. 2023

Front. Immunol.

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BackgroundWhether or not a single-dose Ad26.COV2.S prime and boost vaccination induces sufficient immunity is unclear. Concerns about the increased risk of breakthrough infections in the Ad26.COV2.S-primed population have also been raised.MethodsA prospective cohort study was conducted. Participants included healthy adults who were Ad26.COV2.S primed and scheduled to receive a booster vaccination with BNT162b2, mRNA-1273, or Ad26.COV2.S. The IgG anti-receptor binding domain (RBD) antibody titers, neutralizing antibody (NAb) titers (against wild type [WT] and Omicron [BA.1 and BA.5]), and Spike-specific interferon-γ responses of the participants were estimated at baseline, 3–4 weeks, 3 months, and 6 months after booster vaccination.ResultsA total of 89 participants were recruited (26 boosted with BNT162b2, 57 with mRNA-1273, and 7 with Ad26.COV2.S). The IgG anti-RBD antibody titers of all participants were significantly higher at 6 months post-vaccination than at baseline. The NAb titers against WT at 3 months post-vaccination were 359, 258, and 166 in the participants from the BNT162b2-, mRNA-1273-, and Ad26.COV2.S-boosted groups, respectively. Compared with those against WT, the NAb titers against BA.1/BA.5 were lower by 23.9/10.9-, 16.6/7.4-, and 13.8/7.2-fold in the participants from the BNT162b2-, mRNA-1273-, and Ad26.COV2.S-boosted groups, respectively, at 3 months post-vaccination. Notably, the NAb titers against BA.1 were not boosted after Ad26.COV2.S vaccination. Breakthrough infections occurred in 53.8%, 62.5%, and 42.9% of the participants from the BNT162b2-, mRNA-1273-, and Ad26.COV2.S-boosted groups, respectively. No significant difference in humoral and cellular immunity was found between individuals with and without SARS-CoV-2 breakthrough infections.ConclusionBooster vaccination elicited acceptable humoral and cellular immune responses in Ad26.COV2.S-primed individuals. However, the neutralizing activities against Omicron subvariants were negligible, and breakthrough infection rates were remarkably high at 3 months post-booster vaccination, irrespective of the vaccine type. A booster dose of a vaccine containing the Omicron variant antigen would be required.

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contrasting

confidence: 78%

Section: Study Participantsmentioning

confidence: 99%

Humoral and cellular immunogenicity of homologous and heterologous booster vaccination in Ad26.COV2.S-primed individuals: Comparison by breakthrough infection

Hyun

Jang²,

Park³

et al. 2023

Front. Immunol.

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“…After that, confirmed cases of COVID-19 on Jeju Island increased from 468 to 870 from July to August 2021 ( Figure 1C and Supplementary Figure 3 ). In the Republic of Korea, the Delta variant was first confirmed on April 2021 and exceeded half of all cases by July 2021 ( Kim et al, 2021 , 2022 ). Globally, the Delta variant has been replaced by the Omicron variant by the end of 2021 ( Lista et al, 2022 ), while on Jeju Island, Delta variant has been dominant over half the year, only being replaced by Omicron in January 2022 ( Figure 2 ).…”

Section: Discussionmentioning

confidence: 99%

Genomic surveillance of genes encoding the SARS-CoV-2 spike protein to monitor for emerging variants on Jeju Island, Republic of Korea

Kim

Park

et al. 2023

Front. Microbiol.

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IntroductionThe severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has been fueled by new variants emerging from circulating strains. Here, we report results from a genomic surveillance study of SARS-CoV-2 on Jeju Island, Republic of Korea, from February 2021 to September 2022.MethodsA total of 3,585 SARS-CoV-2 positive samples were analyzed by Sanger sequencing of the gene encoding the spike protein before performing phylogenetic analyses.ResultsWe found that the Alpha variant (B.1.1.7) was dominant in May 2021 before being replaced by the Delta variant (B.1.617.2) in July 2021, which was dominant until December 2021 before being replaced by the Omicron variant. Mutations in the spike protein, including N440K and G446S, have been proposed to contribute to immune evasion, accelerating the spread of Omicron variants.DiscussionOur results from Juju Island, Republic of Korea, are consistent with and contribute to global surveillance efforts crucial for identifying new variants of concern of SARS-CoV-2 and for monitoring the transmission dynamics and characteristics of known strains.

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“…For example, An et al followed up 262 discharged COVID-19 patients in the cities of Shenzhen and finally found that 14.5% of the patients were positive for SARS-CoV-2 nucleic acids. Although repositive only reflected the detection of nucleic acid fragments, the detection of the full genome sequence of SARS-CoV-2, positive viral cultures, and serological analyses in reinfection samples tested in other studies indicate the possibility of reinfection . This could be explained by the neutralizing antibody titers of recovered patients being lower than the expected level, which would be insufficient to completely eliminate the virus in a secondary infection .…”

Section: Introductionmentioning

confidence: 95%

“…Although repositive only reflected the detection of nucleic acid fragments, 5 the detection of the full genome sequence of SARS-CoV-2, positive viral cultures, and serological analyses in reinfection samples tested in other studies indicate the possibility of reinfection. 6 This could be explained by the neutralizing antibody titers of recovered patients being lower than the expected level, which would be insufficient to completely eliminate the virus in a secondary infection. 7 Additionally, the number and function of immune cells in discharged patients, such as antigen presenting cells, were severely impaired.…”

Section: ■ Introductionmentioning

confidence: 99%

Engineered Nanovesicles Expressing Bispecific Single Chain Variable Fragments to Protect against SARS-CoV-2 Infection

Tang,

Ding,

Zeng

et al. 2023

ACS Biomater. Sci. Eng.

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Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in high morbidity and mortality rates worldwide. Although the epidemic has been controlled in many areas and numerous patients have been successfully treated, the risk of reinfection persists due to the low neutralizing antibody titers and weak immune response. To provide long-term immune protection for infected patients, novel bispecific CB6/dendritic cell (DC)-specific intercellular adhesion molecule 3-grabbing nonintegrin (SIGN) nanovesicles (NVs) were constructed to target both the SARS-CoV-2 spike protein (S) and the DC receptors for virus neutralization and immune activation. Herein, we designed NVs expressing both CB6 and DC-SIGN single chain variable fragments (scFvs) on the surface to block SARS-CoV-2 invasion and activate DC function. Monophosphoryl lipid A (MPLA) was loaded into the CB6/DC-SIGN NVs as an adjuvant to promote this process. The CB6/DC-SIGN NVs prevented a pseudovirus expressing the S protein from infecting the target cells expressing high levels of angiotensin-converting enzyme 2 in vitro. Additionally, CB6/DC-SIGN NVs admixed with Sexpressing pseudoviruses activated the DCs, which was promoted by the adjuvant MPLA loaded in the NVs. Using a mouse model, we also confirmed that the CB6/DC-SIGN NVs effectively improved the neutralizing antibody titer and inhibited the growth of tumors expressing the S protein after 3 weeks of treatment. This potential NV-based treatment not only exerts a blocking effect by binding the S protein in the short term but may also provide patients with long-term protection against secondary infections.

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An outbreak of SARS-CoV-2 reinfection in a long-term care facility in South Korea

Cited by 11 publications

References 12 publications

Humoral and cellular immunogenicity of homologous and heterologous booster vaccination in Ad26.COV2.S-primed individuals: Comparison by breakthrough infection

Humoral and cellular immunogenicity of homologous and heterologous booster vaccination in Ad26.COV2.S-primed individuals: Comparison by breakthrough infection

Genomic surveillance of genes encoding the SARS-CoV-2 spike protein to monitor for emerging variants on Jeju Island, Republic of Korea

Engineered Nanovesicles Expressing Bispecific Single Chain Variable Fragments to Protect against SARS-CoV-2 Infection

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