COVID-19 Infection, and Reinfection, and Vaccine Effectiveness Against Symptomatic Infection Among Health Care Workers in the Setting of Omicron Variant Transmission in New Delhi, India

Malhotra, Dr Sumit; Mani, Kalaivani; Lodha, Rakesh; Bakhshi, Sameer; Mathur, Vijay Prakash; Gupta, P.; Kedia, Saurabh; Sankar, Jhuma; Iyer, Kumar; Kumar, Arvind; Vikas, H; Ahuja, Vineet; Sinha, Subrata; Guleria, Randeep; Dua, Aman; Ahmad, S Rehan; Upadhyay, Ashish Datt; Sati, Hem Chandra; Mani, Kiruba; Lokade, Amol Kumar; Devi, K. Pavithra; Johnson, Riya Marie; Gowthaman, K.; Kumari, Mamta; Singh, Ritika; Kalra, Devanshi; Swetambri, Swetambri; Vasudha, Vasudha; Sharma, Shubhangi; Singh, Amit; Sharma, Vikas; Kanswal, Sunita; Sharma, Rohini; Giri, Tanika; Rajput, Simple; Mehra, Geeta; Sharma, Amit; Madan, Divya; Singh, Mukesh; Gupta, Anvita; Sharma, Smily; Sachdeva, Surbhi; Kumar, Mayank; Singh, Sachin; Singh, Ajay K.; Gohar, Naveen; Kumar, Ramu; Kanojia, Nitin; Singhania, Jyoti; Dubey, Ritu; Shukla, Sagrika; Abishek, G; Sarkar, Sujoy; Gupta, Ishan; Rai, Sabin; Tummala, Snikitha; Reddy, Thrisha; Vadodaria, Vishwa; Sharma, Ajay P.; Gupta, Amit; Vats, Manish; Deori, Trideep Jyoti; Jaiswal, Abhishek; Pandit, Sabitri

doi:10.2139/ssrn.4063803

Cited by 4 publications

(4 citation statements)

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“…[37][38][39][40] Milder infections could be a result of other factors apart from omicron variants, such as effects of previous infection and vaccination protection. 41 However, multiple studies have indicated a reduced or no effect of different COVID-19 vaccines against omicron variants. [42][43][44] Using point-of-care technologies such as thromboelastography (TEG) poses an opportunity to improve early management of severe COVID-19-associated coagulopathy.…”

mentioning

confidence: 99%

Relative Hypercoagulopathy of the SARS-CoV-2 Beta and Delta Variants when Compared to the Less Severe Omicron Variants Is Related to TEG Parameters, the Extent of Fibrin Amyloid Microclots, and the Severity of Clinical Illness

Grobbelaar

Kruger

Venter

et al. 2022

Semin Thromb Hemost

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Earlier variants of SARS-CoV-2 have been associated with plasma hypercoagulability (as judged by thromboelastography) and an extensive formation of fibrin amyloid microclots, which are considered to contribute to the pathology of the coronavirus 2019 disease (COVID-19). The newer Omicron variants appear to be far more transmissible, but less virulent, even when taking immunity acquired from previous infections or vaccination into account. We here show that while the clotting parameters associated with Omicron variants are significantly raised over those of healthy, matched controls, they are only raised to levels significantly lower than those seen with more severe variants such as beta and delta. We also observed that individuals infected with omicron variants manifested less extensive microclot formation in platelet-poor plasma compared with those harboring the more virulent variants. The measurement of clotting effects between the different variants acts as a kind of “internal control” that demonstrates the relationship between the extent of coagulopathies and the virulence of the variant of interest. This adds to the evidence that microclots may play an important role in reflecting the severity of symptoms observed in COVID-19.

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mentioning

confidence: 99%

Relative Hypercoagulopathy of the SARS-CoV-2 Beta and Delta Variants when Compared to the Less Severe Omicron Variants Is Related to TEG Parameters, the Extent of Fibrin Amyloid Microclots, and the Severity of Clinical Illness

Grobbelaar

Kruger

Venter

et al. 2022

Semin Thromb Hemost

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“…~40% Nab negativity against major VOCs at PD2-1 when an optimum response is expected and ~100% negativity at 6 months indeed is a matter of great concern. This did result in a large number of breakthrough infections with Delta and Omicron VOCs (36)(37)(38). During the explosive Delta wave, the efficacy of the COVISHIELD vaccine against clinical disease was shown to be 61.3% in Chennai, India (39).…”

Section: Discussionmentioning

confidence: 99%

“…The Omicron (BA.1/BA.2) variants detected in Botswana and South Africa were transmitted globally in a short time span (7,8). Additionally, several variants were reported without significant spread (B.1.1.318, Theta (C. 36 During clinical trials of COVID-19 vaccines, in vitro neutralization assays such as plaque reduction neutralization test (PRNT) and microneutralization test (MNT) were developed and used employing the Wuhan (wild type, lineage B) virus. These tests required a BSL-3 facility and hence could be performed by limited laboratories.…”

Section: Introductionmentioning

confidence: 99%

Variable neutralizing antibody responses to 10 SARS-CoV-2 variants in natural infection with wild- type (B.1) virus, Kappa (B.1.617.1), and Delta (B.1.617.2) variants and COVISHIELD vaccine immunization in India: utility of the MSD platform

et al. 2023

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For the efficacy of COVID-19 vaccines, emergence of variants accumulating immune-escape mutations remains a major concern. We analyzed the anti-variant (n = 10) neutralization activity of sera from COVID-19 patients infected with Wuhan (B.1), Kappa, and Delta variants and COVISHIELD vaccine recipients with (prepositives) or without (prenegatives) prior antibody positivity using V- PLEX ACE2 Neutralization Kit from MSD. MSD and PRNT50 correlated well (r = 0.76–0.83, p < 0.0001). Despite the least antibody positivity in Kappa patients, anti-variant neutralizing antibody (Nab) levels in the responders were comparable with Delta patients. Vaccinees sampled at 1 month (PD2-1) and 6 months (PD2-6) post-second dose showed the highest seropositivity and Nab levels against the Wuhan strain. At PD2-1, the responder rate was variant-dependent and 100% respectively in prenegatives and prepositives. Nab levels against B.1.135.1, B.1.620, B.1.1.7+E484K (both groups), AY.2 (prenegatives), and B.1.618 (prepositives) were lower than that of Wuhan. At PD2-6, positivity decreased to 15.6%–68.8% in the prenegatives; 3.5%–10.7% of prepositives turned negative for the same four variants. As against the decline in Nab levels in 9/10 variants (prenegatives), a further reduction was seen against the same four variants in the prepositives. These variants possess immune-evasion-associated mutations in the RBD/S region. In conclusion, our data show that the Nab response of patients to multiple variants depends on the infecting variant. We confirm superiority of hybrid immunity in neutralizing multiple variants. Depending on the infecting variant pre- or postvaccination, immune response to different vaccines in different populations will vary and impact protection against emerging variants. The MSD platform provides an excellent alternative to live virus/pseudovirus neutralization tests.

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“…Furthermore, infection with SARS-CoV-2 induces strong cellular and humoral immunity, with the magnitude of response possibly correlating with disease severity (8)(9)(10). However, reinfections have raised questions pertaining to protective immunity after infection and vaccination, especially with Omicron variants (11)(12)(13)(14). Current primary vaccines for SARS-CoV-2 target the wild-type (WT) spike protein, and studies have documented reduced viral neutralization titers to Omicron as compared to other variants (13).…”

Section: Introductionmentioning

confidence: 99%

Wild-type SARS-CoV-2 neutralizing immunity decreases across variants and over time but correlates well with diagnostic testing

O’Shea

Schuler²,

Chen³

et al. 2023

Front. Immunol.

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ImportanceThe degree of immune protection against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) variants provided by infection versus vaccination with wild-type virus remains unresolved, which could influence future vaccine strategies. The gold-standard for assessing immune protection is viral neutralization; however, few studies involve a large-scale analysis of viral neutralization against the Omicron variant by sera from individuals infected with wild-type virus.Objectives1) To define the degree to which infection versus vaccination with wild-type SARS-CoV-2 induced neutralizing antibodies against Delta and Omicron variants.2) To determine whether clinically available data, such as infection/vaccination timing or antibody status, can predict variant neutralization.MethodsWe examined a longitudinal cohort of 653 subjects with sera collected three times at 3-to-6-month intervals from April 2020 to June 2021. Individuals were categorized according to SARS-CoV-2 infection and vaccination status. Spike and nucleocapsid antibodies were detected via ADVIA Centaur® (Siemens) and Elecsys® (Roche) assays, respectively. The Healgen Scientific® lateral flow assay was used to detect IgG and IgM spike antibody responses. Pseudoviral neutralization assays were performed on all samples using human ACE2 receptor-expressing HEK-293T cells infected with SARS-CoV-2 spike protein pseudotyped lentiviral particles for wild-type (WT), B.1.617.2 (Delta), and B.1.1.529 (Omicron) variants.ResultsVaccination after infection led to the highest neutralization titers at all timepoints for all variants. Neutralization was also more durable in the setting of prior infection versus vaccination alone. Spike antibody clinical testing effectively predicted neutralization for wild-type and Delta. However, nucleocapsid antibody presence was the best independent predictor of Omicron neutralization. Neutralization of Omicron was lower than neutralization of either wild-type or Delta virus across all groups and timepoints, with significant activity only present in patients that were first infected and later immunized.ConclusionsParticipants having both infection and vaccination with wild-type virus had the highest neutralizing antibody levels against all variants and had persistence of activity. Neutralization of WT and Delta virus correlated with spike antibody levels against wild-type and Delta variants, but Omicron neutralization was better correlated with evidence of prior infection. These data help explain why ‘breakthrough’ Omicron infections occurred in previously vaccinated individuals and suggest better protection is observed in those with both vaccination and previous infection. This study also supports the concept of future SARS-CoV-2 Omicron-specific vaccine boosters.

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COVID-19 Infection, and Reinfection, and Vaccine Effectiveness Against Symptomatic Infection Among Health Care Workers in the Setting of Omicron Variant Transmission in New Delhi, India

Cited by 4 publications

References 0 publications

Relative Hypercoagulopathy of the SARS-CoV-2 Beta and Delta Variants when Compared to the Less Severe Omicron Variants Is Related to TEG Parameters, the Extent of Fibrin Amyloid Microclots, and the Severity of Clinical Illness

Relative Hypercoagulopathy of the SARS-CoV-2 Beta and Delta Variants when Compared to the Less Severe Omicron Variants Is Related to TEG Parameters, the Extent of Fibrin Amyloid Microclots, and the Severity of Clinical Illness

Variable neutralizing antibody responses to 10 SARS-CoV-2 variants in natural infection with wild- type (B.1) virus, Kappa (B.1.617.1), and Delta (B.1.617.2) variants and COVISHIELD vaccine immunization in India: utility of the MSD platform

Wild-type SARS-CoV-2 neutralizing immunity decreases across variants and over time but correlates well with diagnostic testing

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