Longevity of Middle East Respiratory Syndrome Coronavirus Antibody Responses in Humans, Saudi Arabia

Alshukairi, Abeer N.; Zhao, Jincun; Al-Mozaini, Maha; Wang, Yanqun; Dada, Ashraf; Baharoon, Salim; Alfaraj, Sara N.; Ahmed, Waleed; Enani, Mushira; Elzein, Fatehi; Eltayeb, Nazik; Layqah, Laila; El-Saed, Aiman; Bahaudden, Husam A.; Haseeb, Abdul; El-Kafrawy, Sherif A.; Hassan, Ahmed M.; Siddiq, Najlaa; Alsharif, Ibtihaj; Qushmaq, Isamel; Azhar, Esam I.; Perlman, Stanley; Memish, Ziad A.

doi:10.3201/eid2705.204056

Cited by 12 publications

(7 citation statements)

References 13 publications

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“…We found a robust and long-lived MERS-CoV-specific memory B cells as well as CD4 + and CD8 + T cells responses in these individuals, which could confer prolonged and efficient immune protection. In general, these findings are consistent with previous studies conducted on smaller sample sizes and after shorter periods after initial MERS infection [ 7 , 13–19 ].…”

Section: Discussionsupporting

confidence: 93%

“…These studies have shown persistence of T-cell and antibody responses in patients recovered from SARS-CoV-1 infection up to 17 years [ 7–10 ], although other studies suggested potential waning of antibodies and B cells overtime to low or undetectable levels [ 11 , 12 ]. Although limited number of studies have evaluated the longevity of immunity in MERS survivors, most of these studies have mainly focused on evaluating antibody responses which were found to last for up to 6 years post-recovery in most survivors [ 13 ]. Interestingly, such response was associated with disease severity and could wane over time especially in mild and asymptomatic cases [ 13–17 ].…”

mentioning

confidence: 99%

“…Although limited number of studies have evaluated the longevity of immunity in MERS survivors, most of these studies have mainly focused on evaluating antibody responses which were found to last for up to 6 years post-recovery in most survivors [ 13 ]. Interestingly, such response was associated with disease severity and could wane over time especially in mild and asymptomatic cases [ 13–17 ]. On the other hand, T cells were only investigated during acute phase or after few months post-infection and found to be strong in severe and moderate cases [ 7 , 18 , 19 ].…”

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confidence: 99%

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Middle East Respiratory Syndrome Coronavirus Infection Elicits Long-lasting Specific Antibody, T and B Cell Immune Responses in Recovered Individuals

Alhabbab

Algaissi

Mahmoud

et al. 2022

Clinical Infectious Diseases

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Background The Middle East respiratory syndrome coronavirus (MERS-CoV) is a highly pathogenic zoonotic betacoronavirus and a global public health concern. Better undersetting of the immune responses to MERS-CoV is needed to characterize the correlates of protection and durability of the immunity and to aid in developing preventative and therapeutic interventions. Although MERS-CoV–specific circulating antibodies could persist for several years post-recovery, their waning raises concerns about their durability and role in protection. Nonetheless, memory B and T cells could provide long-lasting protective immunity despite the serum antibodies levels. Methods Serological and flow cytometric analysis of MERS-CoV–specific immune responses were performed on samples collected from a cohort of recovered individuals who required intensive care unit (ICU) admission as well as hospital or home isolation several years after infection to characterize the longevity and quality of humoral and cellular immune responses. Results Our data showed that MERS-CoV infection could elicit robust long-lasting virus-specific binding and neutralizing antibodies as well as T- and B-cell responses up to 6.9 years postinfection regardless of disease severity or need for ICU admission. Apart from the persistent high antibody titers, this response was characterized by B-cell subsets with antibody-independent functions as demonstrated by their ability to produce tumor necrosis factor α (TNF-α), interleukin (IL)-6, and interferon γ (IFN-γ) cytokines in response to antigen stimulation. Furthermore, virus-specific activation of memory CD8+ and CD4+ T cell subsets from MERS-recovered patients resulted in secretion of high levels of TNF-α, IL-17, and IFN-γ. Conclusions MERS-CoV infection could elicit robust long-lasting virus-specific humoral and cellular responses.

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Section: Discussionsupporting

confidence: 93%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Middle East Respiratory Syndrome Coronavirus Infection Elicits Long-lasting Specific Antibody, T and B Cell Immune Responses in Recovered Individuals

Alhabbab

Algaissi

Mahmoud

et al. 2022

Clinical Infectious Diseases

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“…Although long-term increases were observed in qualitative spline models, biexponential fitted models confirm a flat slope and therefore predict longer stability, as has also been described for SARS-CoV and MERS-CoV. [33][34][35][36][37][38] This raises an optimistic scenario, as neutralizing antibody levels are highly predictive of immune protection, 5,7,39,40 although sporadic cases of reinfection have been reported even in the presence of neutralizing antibodies. 41,42 Our results complement previous studies that evaluated midterm immunity 2,17,18,43,44 and are in line with current evidence showing a long-lasting neutralizing response for at least 1 year [45][46][47] and the presence of receptor-binding domain (RBD)specific memory B cells 3,48 and long-lived bone marrow plasma cells.…”

Section: Discussionmentioning

confidence: 71%

Clinical course impacts early kinetics,magnitude, and amplitude of SARS-CoV-2 neutralizing antibodies beyond 1 year after infection

Pradenas

Trinité

Urrea

et al. 2022

Cell Reports Medicine

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To understand the determinants of long-term immune responses to SARS-CoV-2 and the concurrent impact of vaccination and emerging variants, we follow a prospective cohort of 332 COVID-19 patients over more than a year after symptom onset. We evaluate plasma neutralizing activity using HIV-based pseudoviruses, expressing the spike of different SARS-CoV-2 variants, and analyze longitudinally using mixed-effects models. Long-term neutralizing activity is stable beyond one year after infection in mild/asymptomatic and hospitalized participants. However, longitudinal models suggest that hospitalized individuals generate both short- and long-lived memory B cells, while responses of non-hospitalized are dominated by long-lived B cells. In both groups, vaccination boosts responses to natural infection. Long-term (>300 days from infection) responses in unvaccinated participants show reduced efficacy against beta, but not alpha nor delta variants. Multivariate analysis identifies severity of primary infection as an independent determinant of higher magnitude and lower relative cross-neutralization activity of long-term neutralizing responses.

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“…According to a large-scale Korean study, serum antibodies against the spike antigen of MERS-CoV persist for three years after infection (48). A more recent report detected MERS-CoV-specific neutralizing antibodies for six years post-infection in 48 patients with previous MERS-CoV infection (20), which is significantly longer than the reported duration for serum antibodies against the spike antigen of SARS-COV-2 (nearly eight months) (49). In the present study, the median duration from MERS-CoV infection and SARS-CoV-2 infection was 3.4 years.…”

Section: Discussionmentioning

confidence: 99%

Potential Cross-Reactive Immunity to COVID-19 Infection in Individuals With Laboratory-Confirmed MERS-CoV Infection: A National Retrospective Cohort Study From Saudi Arabia

et al. 2021

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BackgroundA growing number of experiments have suggested potential cross-reactive immunity between severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and previous human coronaviruses. We conducted the present retrospective cohort study to investigate the relationship between previous Middle East respiratory syndrome-coronavirus (MERS-CoV) infection and the risk of SARS-CoV-2 infection as well as the relationship between previous MERS-CoV and COVID-19-related hospitalization and mortality.MethodsStarting in March 2020, we prospectively followed two groups of individuals who tested negative for COVID-19 infection. The first group had a previously confirmed MERS-CoV infection, which was compared to a control group of MERS-negative individuals. The studied cohort was then followed until November 2020 to track evidence of contracting COVID-19 infection.FindingsA total of 82 (24%) MERS-positive and 260 (31%) MERS-negative individuals had COVID-19 infection. Patients in the MERS-positive group had a lower risk of COVID-19 infection than those in the MERS-negative group (Risk ratio [RR] 0.696, 95% confidence interval [CI] 0.522-0.929; p =0.014). The risk of COVID-19-related hospitalization in the MERS-positive group was significantly higher (RR 4.036, 95% CI 1.705-9.555; p =0.002). The case fatality rate (CFR) from COVID-19 was 4.9% in the MERS-positive group and 1.2% in the MERS-negative group (p =0.038). The MERS-positive group had a higher risk of death than the MERS-negative group (RR 6.222, 95% CI 1.342-28.839; p =0.019). However, the risk of mortality was similar between the two groups when death was adjusted for age (p =0.068) and age and sex (p =0.057). After controlling for all the independent variables, only healthcare worker occupation and >1 comorbidity were independent predictors of SARS-CoV-2 infection.InterpretationIndividuals with previous MERS-CoV infection can exhibit a cross-reactive immune response to SARS-CoV-2 infection. Our study demonstrated that patients with MERS-CoV infection had higher risks of COVID-19-related hospitalization and death than MERS-negative individuals.

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Longevity of Middle East Respiratory Syndrome Coronavirus Antibody Responses in Humans, Saudi Arabia

Cited by 12 publications

References 13 publications

Middle East Respiratory Syndrome Coronavirus Infection Elicits Long-lasting Specific Antibody, T and B Cell Immune Responses in Recovered Individuals

Middle East Respiratory Syndrome Coronavirus Infection Elicits Long-lasting Specific Antibody, T and B Cell Immune Responses in Recovered Individuals

Clinical course impacts early kinetics,magnitude, and amplitude of SARS-CoV-2 neutralizing antibodies beyond 1 year after infection

Potential Cross-Reactive Immunity to COVID-19 Infection in Individuals With Laboratory-Confirmed MERS-CoV Infection: A National Retrospective Cohort Study From Saudi Arabia

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