Immunity to SARS-CoV-2: What Do We Know and Should We Be Testing for It?

Misra, Anisha; Theel, Elitza S.

doi:10.1128/jcm.00482-21

Cited by 27 publications

(25 citation statements)

References 65 publications

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“…SARS-CoV-2 vaccines have been shown to protect solid organ transplant recipients against severe COVID-19 [ 19 ], but it remains to be determined to what degree serologic response correlates with clinical protection in solid organ transplant recipients. Even for the general population, clinically relevant cut-off values for antibody levels that associate with clinical protection are not yet available [ 20 ]. In some solid organ transplant recipients a cellular immune response to SARS-CoV-2 vaccination has been observed even in the absence of a serologic response [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Serologic response to a third dose of an mRNA-based SARS-CoV-2 vaccine in lung transplant recipients

Hoffman

Meek

Rijkers

et al. 2022

Transplant Immunology

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Section: Discussionmentioning

confidence: 99%

Serologic response to a third dose of an mRNA-based SARS-CoV-2 vaccine in lung transplant recipients

Hoffman

Meek

Rijkers

et al. 2022

Transplant Immunology

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“…Humoral responses to SARS-CoV-2 do not fully reflect protective immunity against the virus. 11 – 13 Ig levels are not the sole determinants of protective immunity, but easily accessible serologic tests ( e.g. , enzyme-linked immunosorbent assays [ELISAs]) are often the only tests used to assess antiviral immunity.…”

Section: Immune Responses To Covid-19mentioning

confidence: 99%

T cell responses to COVID-19 infection and vaccination in patients with multiple sclerosis receiving disease-modifying therapy

et al. 2022

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Background: Multiple sclerosis (MS) is a neurological disorder marked by accumulating immune-mediated damage to the central nervous system. The dysregulated immune system in MS combined with immune effects of disease-modifying therapies (DMTs) used in MS treatment could alter responses to infections, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19). Most of the literature on immune response to SARS-CoV-2 infection and COVID-19 vaccination, in both the general population and patients with MS on DMTs, has focused on humoral immunity. However, immune response to COVID-19 involves multiple lines of defense, including T cells. Objective and Methods: We review innate and adaptive immunity to COVID-19 and expand on the role of T cells in mediating protective immunity against SARS-CoV-2 infection and in responses to COVID-19 vaccination in MS. Results: Innate, humoral, and T cell immune responses combat COVID-19 and generate protective immunity. Assays detecting cytokine expression by T cells show an association between SARS-CoV-2-specific T cell responses and milder/asymptomatic COVID-19 and protective immune memory. Conclusion: Studies of COVID-19 immunity in people with MS on DMTs should ideally include comprehensive assessment of innate, humoral, and T cell responses.

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“…Yet, weak or waning humoral response in tandem with the emergence of new viral variants, capable of potentially escaping immune response, lead to a continued risk of reinfection with heterologous SARS-CoV-2 strains [1,11,12]. This is particularly true for the Omicron variant [13], which is the predominant viral strain globally as of October 2022 [14], causing mostly milder infections compared to preceding strains [15][16][17]. Available evidence from adult and pediatric populations points towards good effectiveness of prior mRNA vaccination against severe COVID-19 and hospitalisation due to Omicron variants, but less so against asymptomatic and symptomatic, mild breakthrough infections [11,[18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

Risk and symptoms of COVID-19 in health professionals according to baseline immune status and booster vaccination during the Delta and Omicron waves in Switzerland—A multicentre cohort study

et al. 2022

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Background Knowledge about protection conferred by previous Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and/or vaccination against emerging viral variants allows clinicians, epidemiologists, and health authorities to predict and reduce the future Coronavirus Disease 2019 (COVID-19) burden. We investigated the risk and symptoms of SARS-CoV-2 (re)infection and vaccine breakthrough infection during the Delta and Omicron waves, depending on baseline immune status and subsequent vaccinations. Methods and findings In this prospective, multicentre cohort performed between August 2020 and March 2022, we recruited hospital employees from ten acute/nonacute healthcare networks in Eastern/Northern Switzerland. We determined immune status in September 2021 based on serology and previous SARS-CoV-2 infections/vaccinations: Group N (no immunity); Group V (twice vaccinated, uninfected); Group I (infected, unvaccinated); Group H (hybrid: infected and ≥1 vaccination). Date and symptoms of (re)infections and subsequent (booster) vaccinations were recorded until March 2022. We compared the time to positive SARS-CoV-2 swab and number of symptoms according to immune status, viral variant (i.e., Delta-dominant before December 27, 2021; Omicron-dominant on/after this date), and subsequent vaccinations, adjusting for exposure/behavior variables. Among 2,595 participants (median follow-up 171 days), we observed 764 (29%) (re)infections, thereof 591 during the Omicron period. Compared to group N, the hazard ratio (HR) for (re)infection was 0.33 (95% confidence interval [CI] 0.22 to 0.50, p < 0.001) for V, 0.25 (95% CI 0.11 to 0.57, p = 0.001) for I, and 0.04 (95% CI 0.02 to 0.10, p < 0.001) for H in the Delta period. HRs substantially increased during the Omicron period for all groups; in multivariable analyses, only belonging to group H was associated with protection (adjusted HR [aHR] 0.52, 95% CI 0.35 to 0.77, p = 0.001); booster vaccination was associated with reduction of breakthrough infection risk in groups V (aHR 0.68, 95% CI 0.54 to 0.85, p = 0.001) and H (aHR 0.67, 95% CI 0.45 to 1.00, p = 0.048), largely observed in the early Omicron period. Group H (versus N, risk ratio (RR) 0.80, 95% CI 0.66 to 0.97, p = 0.021) and participants with booster vaccination (versus nonboosted, RR 0.79, 95% CI 0.71 to 0.88, p < 0.001) reported less symptoms during infection. Important limitations are that SARS-CoV-2 swab results were self-reported and that results on viral variants were inferred from the predominating strain circulating in the community at that time, rather than sequencing. Conclusions Our data suggest that hybrid immunity and booster vaccination are associated with a reduced risk and reduced symptom number of SARS-CoV-2 infection during Delta- and Omicron-dominant periods. For previously noninfected individuals, booster vaccination might reduce the risk of symptomatic Omicron infection, although this benefit seems to wane over time.

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Immunity to SARS-CoV-2: What Do We Know and Should We Be Testing for It?

Cited by 27 publications

References 65 publications

Serologic response to a third dose of an mRNA-based SARS-CoV-2 vaccine in lung transplant recipients

Serologic response to a third dose of an mRNA-based SARS-CoV-2 vaccine in lung transplant recipients

T cell responses to COVID-19 infection and vaccination in patients with multiple sclerosis receiving disease-modifying therapy

Risk and symptoms of COVID-19 in health professionals according to baseline immune status and booster vaccination during the Delta and Omicron waves in Switzerland—A multicentre cohort study

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