COVID-19 reinfection in the presence of neutralizing antibodies

Zhang, Ju; Ding, Nan; Ren, Lili; Song, Rui; Chen, Danying; Zhao, Xiongyan; Chen, Budong; Han, Junyan; Li, Jiarui; Song, Yangzi; Lin, Dachuan; Han, Kai; Yu, Fang; Xie, Ruming; Chen, Zhihai; Xie, Wen; Liu, Jingyuan; Cen, Shan; Bi, Yang; Wu, Angela Ruohao; Zhang, Fujie; Chen, Chen; Zeng, Hui

doi:10.1093/nsr/nwab006

Cited by 29 publications

(31 citation statements)

References 20 publications

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“…However, it was not sterizing immunity, and the virus still moderately replicated in nasal turbinates of prior infected hamsters, indicating that prior infected hamsters can be artificially re-infected after a short recovery period, even with a high level of neutralization antibodies. The conclusion is consistent with recent reports showing that recovered COVID-19 patients were re-infected in the presence of neutralizing antibodies 24,25 . A large study of a recovered cohort of 175 COVID-19 patients revealed that 6% of COVID-19 patients did not show any antibody response at all, and about 30% COVID-19 patients showed very low neutralizing antibodies 26 .…”

Section: Discussionsupporting

confidence: 93%

Impact of Prior Infection on Protection and Transmission of SARS-CoV-2 in Golden Hamsters

Zhang

Guo²,

Li³

et al. 2021

Preprint

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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused over 100 million confirmed human infections, and 2 million more deaths globally since its emergence in the end of 2019. Several studies have shown that prior infection provided protective immunity against SARS-CoV-2 in non-human primate models. However, the effect of prior infection on blocking SARS-CoV-2 transmission is not clear. Here, we evaluated the impact of prior infection on protection and transmission of the SARS-CoV-2 virus in golden hamsters. Our results showed that prior infection provided protective immunity against SARS-CoV-2 re-challenge, but it was not sterizing immunity. The transmission experiment results showed that SARS-CoV-2 was efficiently transmitted from naive hamsters to prior infected hamsters by direct contact and airborne route, but not by indirect contact. Further, the virus was efficiently transmitted from prior infected hamsters to naive hamsters by direct contact, but not by airborne route and indirect contact. Surprisingly, the virus can be transmitted between prior infected hamsters by direct contact during a short period of early infection. Taken together, our study demonstrated that prior infected hamsters with good immunity can still be naturally re-infected, and the virus can be transmitted between prior infected hamsters and the naive through different transmission routes, implying the potential possibility of human re-infection and the risk of virus transmission between prior infected population and the healthy. Our study will help to calculate the herd immunity threshold more accurately, make more reasonable public health decisions, formulate an optimized population vaccination program, as well as aid the implementation of appropriate public health and social measures to control COVID-19.

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Section: Discussionsupporting

confidence: 93%

Impact of Prior Infection on Protection and Transmission of SARS-CoV-2 in Golden Hamsters

Zhang

Guo²,

Li³

et al. 2021

Preprint

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“…Moreover, we first showed that previously infected Syrian hamsters can be naturally reinfected by direct contact or the airborne route in an intense reexposure setting, but with lower viral titers in upper respiratory tract. This conclusion is consistent with recent reports showing that recovered COVID-19 patients were reinfected in the presence of neutralizing antibodies ( Selhorst et al, 2020 ; Zhang et al, 2021 ), and low levels of subgenomic RNA was detected in the nasal swabs of previously infected rhesus macaques when rechallenge ( Chandrashekar et al, 2020 ). Different from our results, several recent studies reported that prior infection in COVID-19 patients was highly protective against SARS-CoV-2 reinfection, with protective efficiency from 81.4 to 95.2% ( Abu-Raddad et al, 2020 , 2021b ; Rennert and McMahan, 2021 ; Sheehan et al, 2021 ).…”

Section: Discussionsupporting

confidence: 93%

“…SARS-CoV-2 transmission study between prior infected rhesus macaques and the naïve animals was not found. Several human COVID-19 reinfection cases have been reported 1 year before ( To et al, 2020 ; Van Elslande et al, 2020 ), even in the presence of neutralizing antibodies ( Selhorst et al, 2020 ; Zhang et al, 2021 ). Hence, the recovered COVID-19 patients still need to follow public health measures and keep on personal protection.…”

Section: Introductionmentioning

confidence: 99%

Impact of Prior Infection on Severe Acute Respiratory Syndrome Coronavirus 2 Transmission in Syrian Hamsters

Zhang

Guo

et al. 2021

Front. Microbiol.

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Prior infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) provides protective immunity against reinfection. However, whether prior infection blocks SARS-CoV-2 transmission is not yet clear. Here, we evaluated the impact of prior infection on SARS-CoV-2 transmission in Syrian hamsters. Our results showed that prior infection significantly reduced SARS-CoV-2 replication in Syrian hamsters, but sterilizing immunity was not achieved. Prior infection blocked the airborne transmission of SARS-CoV-2 from previously infected Syrian hamsters to naïve Syrian hamsters and previously infected Syrian hamsters. Moreover, prior infection substantially reduced the efficiency of direct contact transmission between previously infected Syrian hamsters. However, prior infection had limited impact on SARS-CoV-2 transmission from previously infected Syrian hamsters to naïve Syrian hamsters via direct contact in the early course of infection. Human reinfection and SARS-CoV-2 transmission between a previously infected population and a healthy population would be likely, and a higher vaccination coverage rate was needed to reach herd immunity. Our work will aid the implementation of appropriate public health and social measures to control coronavirus infectious disease 2019 (COVID-19) pandemic.

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“…The conducted analysis confirms the hypothesis that the likelihood of experiencing SARS-CoV-2 symptomatic infection is greatly reduced in individuals already infected in the previous 8-10 months 11 . In line with what observed elsewhere [7][8][9]13,14 , our findings suggest that the relative risk of symptomatic infection for individuals who previously tested positive to IgG antibodies compared to seronegative subjects is less than 6%.…”

Section: Mainsupporting

confidence: 92%

The risk of symptomatic reinfection during the second COVID-19 wave in individuals previously exposed to SARS-CoV-2

Manica

Pancheri

Poletti

et al. 2021

Preprint

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To what extent infection with SARS-CoV-2 protects against subsequent reinfection or symptomatic reinfection is still unclear. In this cohort study, we analyzed surveillance records of COVID-19 cases identified between June 2020 and January 2021 in five Italian municipalities, where 77.7% of the entire population was screened for IgG antibodies in May 2020. We compared the risk of observing symptomatic infections in two mutually exclusive groups defined by the initial serological response. We estimated that the cumulative incidence of identified symptomatic infections in the IgG negative and positive cohorts was 2.67% (95%CI: 2.12%-3.37%) and 0.14% (95%CI: 0.04%-0.58%), respectively. The adjusted odd ratio of developing symptomatic infection in individuals previously exposed to SARS-CoV-2 was estimated at 0.054 (95%CI: 0.009-0.169). Quantifying protective immunity against COVID-19 disease elicited by natural infection with SARS-CoV-2 is essential to inform strategies for controlling the pandemic in the forthcoming months.

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COVID-19 reinfection in the presence of neutralizing antibodies

Cited by 29 publications

References 20 publications

Impact of Prior Infection on Protection and Transmission of SARS-CoV-2 in Golden Hamsters

Impact of Prior Infection on Protection and Transmission of SARS-CoV-2 in Golden Hamsters

Impact of Prior Infection on Severe Acute Respiratory Syndrome Coronavirus 2 Transmission in Syrian Hamsters

The risk of symptomatic reinfection during the second COVID-19 wave in individuals previously exposed to SARS-CoV-2

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