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Alemán GV, Cerpas C, Juarez JG, Moreira H, Arguello S, Coloma J, Harris E, Gordon A, Bennett SN, Balmaseda Á. Tracking the genetic diversity of SARS-CoV-2 variants in Nicaragua throughout the COVID-19 Pandemic. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.03.596876. [PMID: 38895444 PMCID: PMC11185506 DOI: 10.1101/2024.06.03.596876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
The global circulation of SARS-CoV-2 has been extensively documented, yet the dynamics within Central America, particularly Nicaragua, remain underexplored. This study characterizes the genomic diversity of SARS-CoV-2 in Nicaragua from March 2020 through December 2022, utilizing 1064 genomes obtained via next-generation sequencing. These sequences were selected nationwide and analyzed for variant classification, lineage predominance, and phylogenetic diversity. We employed both Illumina and Oxford Nanopore Technologies for all sequencing procedures. Results indicated a temporal and spatial shift in dominant lineages, initially from B.1 and A.2 in early 2020 to various Omicron subvariants towards the study's end. Significant lineage shifts correlated with changes in COVID-19 positivity rates, underscoring the epidemiological impact of variant dissemination. The comparative analysis with regional data underscored the low diversity of circulating lineages in Nicaragua and their delayed introduction compared to other countries in the Central American region. The study also linked specific viral mutations with hospitalization rates, emphasizing the clinical relevance of genomic surveillance. This research advances the understanding of SARS-CoV-2 evolution in Nicaragua and provide valuable information regarding its genetic diversity for public health officials in Central America. We highlight the critical role of ongoing genomic surveillance in identifying emergent lineages and informing public health strategies.
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Affiliation(s)
| | - Cristhiam Cerpas
- Sustainable Sciences Institute, Managua, Nicaragua
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia Ministerio de Salud, Managua, Nicaragua
| | | | | | | | - Josefina Coloma
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Eva Harris
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | | | | | - Ángel Balmaseda
- Sustainable Sciences Institute, Managua, Nicaragua
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia Ministerio de Salud, Managua, Nicaragua
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Cerpas C, Vásquez G, Moreira H, Juarez JG, Coloma J, Harris E, Bennett SN, Balmaseda Á. Introduction of New Dengue Virus Lineages of Multiple Serotypes after COVID-19 Pandemic, Nicaragua, 2022. Emerg Infect Dis 2024; 30:1203-1213. [PMID: 38782023 PMCID: PMC11138998 DOI: 10.3201/eid3006.231553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
Major dengue epidemics throughout Nicaragua's history have been dominated by 1 of 4 dengue virus serotypes (DENV-1-4). To examine serotypes during the dengue epidemic in Nicaragua in 2022, we performed real-time genomic surveillance in-country and documented cocirculation of all 4 serotypes. We observed a shift toward co-dominance of DENV-1 and DENV-4 over previously dominant DENV-2. By analyzing 135 new full-length DENV sequences, we found that introductions underlay the resurgence: DENV-1 clustered with viruses from Ecuador in 2014 rather than those previously seen in Nicaragua; DENV-3, which last circulated locally in 2014, grouped instead with Southeast Asia strains expanding into Florida and Cuba in 2022; and new DENV-4 strains clustered within a South America lineage spreading to Florida in 2022. In contrast, DENV-2 persisted from the formerly dominant Nicaragua clade. We posit that the resurgence emerged from travel after the COVID-19 pandemic and that the resultant intensifying hyperendemicity could affect future dengue immunity and severity.
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Affiliation(s)
- Cristhiam Cerpas
- Sustainable Sciences Institute, Managua, Nicaragua (C. Cerpas, G. Vásquez, H. Moreira, J.G. Juarez, Á. Balmaseda)
- Laboratorio Nacional de Virologia, Centro Nacional de Diagnóstico y Referencia Ministerio de Salud, Managua (C. Cerpas, Á. Balmaseda)
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California Berkeley, Berkeley, California, USA (J. Coloma, E. Harris)
- California Academy of Sciences, San Francisco, California, USA (S.N. Bennett)
| | - Gerald Vásquez
- Sustainable Sciences Institute, Managua, Nicaragua (C. Cerpas, G. Vásquez, H. Moreira, J.G. Juarez, Á. Balmaseda)
- Laboratorio Nacional de Virologia, Centro Nacional de Diagnóstico y Referencia Ministerio de Salud, Managua (C. Cerpas, Á. Balmaseda)
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California Berkeley, Berkeley, California, USA (J. Coloma, E. Harris)
- California Academy of Sciences, San Francisco, California, USA (S.N. Bennett)
| | - Hanny Moreira
- Sustainable Sciences Institute, Managua, Nicaragua (C. Cerpas, G. Vásquez, H. Moreira, J.G. Juarez, Á. Balmaseda)
- Laboratorio Nacional de Virologia, Centro Nacional de Diagnóstico y Referencia Ministerio de Salud, Managua (C. Cerpas, Á. Balmaseda)
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California Berkeley, Berkeley, California, USA (J. Coloma, E. Harris)
- California Academy of Sciences, San Francisco, California, USA (S.N. Bennett)
| | - Jose G. Juarez
- Sustainable Sciences Institute, Managua, Nicaragua (C. Cerpas, G. Vásquez, H. Moreira, J.G. Juarez, Á. Balmaseda)
- Laboratorio Nacional de Virologia, Centro Nacional de Diagnóstico y Referencia Ministerio de Salud, Managua (C. Cerpas, Á. Balmaseda)
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California Berkeley, Berkeley, California, USA (J. Coloma, E. Harris)
- California Academy of Sciences, San Francisco, California, USA (S.N. Bennett)
| | - Josefina Coloma
- Sustainable Sciences Institute, Managua, Nicaragua (C. Cerpas, G. Vásquez, H. Moreira, J.G. Juarez, Á. Balmaseda)
- Laboratorio Nacional de Virologia, Centro Nacional de Diagnóstico y Referencia Ministerio de Salud, Managua (C. Cerpas, Á. Balmaseda)
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California Berkeley, Berkeley, California, USA (J. Coloma, E. Harris)
- California Academy of Sciences, San Francisco, California, USA (S.N. Bennett)
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Yang MC, Su YT, Chen PH, Tsai CC, Lin TI, Wu JR. Changing patterns of infectious diseases in children during the COVID-19 pandemic. Front Cell Infect Microbiol 2023; 13:1200617. [PMID: 37457965 PMCID: PMC10339349 DOI: 10.3389/fcimb.2023.1200617] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/19/2023] [Indexed: 07/18/2023] Open
Abstract
Each infectious disease has had its own epidemic pattern and seasonality for decades. However, public health mitigation measures during the coronavirus disease 2019 (COVID-19) pandemic have resulted in changing epidemic patterns of infectious diseases. Stringent measures resulted in low incidences of various infectious diseases during the outbreak of COVID-19, including influenza, respiratory syncytial virus, pneumococcus, enterovirus, and parainfluenza. Owing to the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and subsequent immunity development, decreasing virulence of SARS-CoV-2, and worldwide immunization against SARS-CoV-2 in children beyond 6 months of age, mitigation measures are lifted country by country. Consequently, the immunity debt to infectious respiratory viruses other than SARS-CoV-2 contributed to the "off-season," "see-saw," and "upsurge" patterns of various infectious diseases in children. Moreover, apart from the persistence of SARS-CoV-2, the coexistence of other circulating viruses or bacterial outbreaks may lead to twindemics or tripledemics during the following years. Therefore, it is necessary to maintain hand hygiene and immunization policies against various pathogens to alleviate the ongoing impact of infectious diseases on children.
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Affiliation(s)
- Ming-Chun Yang
- Department of Pediatrics, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Yu-Tsun Su
- Department of Pediatrics, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Ping-Hong Chen
- Department of Pediatrics, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Ching-Chung Tsai
- Department of Pediatrics, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Ting-I Lin
- Department of Pediatrics, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Jiunn-Ren Wu
- Department of Pediatrics, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
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Frutos AM, Kuan G, Lopez R, Ojeda S, Shotwell A, Sanchez N, Saborio S, Plazaola M, Barilla C, Kenah E, Balmaseda A, Gordon A. Infection-Induced Immunity Is Associated With Protection Against Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Decreased Infectivity. Clin Infect Dis 2023; 76:2126-2133. [PMID: 36774538 PMCID: PMC10273383 DOI: 10.1093/cid/ciad074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/24/2023] [Accepted: 02/08/2023] [Indexed: 02/13/2023] Open
Abstract
BACKGROUND The impact of infection-induced immunity on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission has not been well established. Here we estimate the effects of prior infection induced immunity in adults and children on SARS-CoV-2 transmission in households. METHODS We conducted a household cohort study from March 2020-November 2022 in Managua, Nicaragua; following a housheold SARS-CoV-2 infection, household members are closely monitored for infection. We estimate the association of time period, age, symptoms, and prior infection with secondary attack risk. RESULTS Overall, transmission occurred in 70.2% of households, 40.9% of household contacts were infected, and the secondary attack risk ranged from 8.1% to 13.9% depending on the time period. Symptomatic infected individuals were more infectious (rate ratio [RR] 21.2, 95% confidence interval [CI]: 7.4-60.7) and participants with a prior infection were half as likely to be infected compared to naïve individuals (RR 0.52, 95% CI:.38-.70). In models stratified by age, prior infection was associated with decreased infectivity in adults and adolescents (secondary attack risk [SAR] 12.3, 95% CI: 10.3, 14.8 vs 17.5, 95% CI: 14.8, 20.7). However, although young children were less likely to transmit, neither prior infection nor symptom presentation was associated with infectivity. During the Omicron era, infection-induced immunity remained protective against infection. CONCLUSIONS Infection-induced immunity is associated with decreased infectivity for adults and adolescents. Although young children are less infectious, prior infection and asymptomatic presentation did not reduce their infectivity as was seen in adults. As SARS-CoV-2 transitions to endemicity, children may become more important in transmission dynamics.
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Affiliation(s)
- Aaron M Frutos
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Guillermina Kuan
- Health Center Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Roger Lopez
- Sustainable Sciences Institute, Managua, Nicaragua
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Sergio Ojeda
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Abigail Shotwell
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Nery Sanchez
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Saira Saborio
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
- Sustainable Sciences Institute, Managua, Nicaragua
| | | | | | - Eben Kenah
- Biostatistics Division, College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Angel Balmaseda
- Sustainable Sciences Institute, Managua, Nicaragua
- Laboratorio Nacional de Virología, Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Aubree Gordon
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
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Medić S, Anastassopoulou C, Lozanov-Crvenković Z, Dragnić N, Petrović V, Ristić M, Pustahija T, Tsakris A, Ioannidis JPA. Incidence, Risk, and Severity of SARS-CoV-2 Reinfections in Children and Adolescents Between March 2020 and July 2022 in Serbia. JAMA Netw Open 2023; 6:e2255779. [PMID: 36780157 PMCID: PMC9926322 DOI: 10.1001/jamanetworkopen.2022.55779] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
IMPORTANCE During the COVID-19 pandemic, children and adolescents were massively infected worldwide. In 2022, reinfections became a main feature of the endemic phase of SARS-CoV-2, so it is important to understand the epidemiology and clinical impact of reinfections. OBJECTIVE To assess the incidence, risk, and severity of pediatric SARS-CoV-2 reinfection. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study used epidemiologic data of documented SARS-CoV-2 infections from the surveillance database of the Institute for Public Health of Vojvodina. A total of 32 524 children and adolescents from Vojvodina, Serbia, with laboratory-confirmed SARS-CoV-2 infection between March 6, 2020, and April 30, 2022, were followed up for reinfection until July 31, 2022. MAIN OUTCOMES AND MEASURES Incidence rates of documented SARS-CoV-2 reinfection per 1000 person-months, estimated risk of documented reinfection 90 days or more after laboratory confirmation of primary infection, reinfection severity, hospitalizations, and deaths. RESULTS The study cohort included 32 524 children and adolescents with COVID-19 (mean [SD] age, 11.2 [4.9] years; 15 953 [49.1%] male), including 964 children (3.0%) who experienced documented reinfection. The incidence rate of documented reinfections was 3.2 (95% CI, 3.0-3.4) cases per 1000 person-months and was highest in adolescents aged 12 to 17 years (3.4; 95% CI, 3.2-3.7). Most reinfections (905 [93.9%]) were recorded in 2022. The cumulative reinfection risk was 1.3% at 6 months, 1.9% at 9 months, 4.0% at 12 months, 6.7% at 15 months, 7.2% at 18 months, and 7.9% after 21 months. Pediatric COVID-19 cases were generally mild. The proportion of severe clinical forms decreased from 14 (1.4%) in initial episodes to 3 (0.3%) in reinfections. Reinfected children were approximately 5 times less likely to have severe disease during reinfection compared with initial infection (McNemar odds ratio, 0.2; 95% CI, 0.0-0.8). Pediatric reinfections rarely led to hospitalization (0.5% vs 1.3% during primary infections), and none resulted in death. CONCLUSIONS AND RELEVANCE This cohort study found that the SARS-CoV-2 reinfection risk remained substantially lower for children and adolescents compared with adults as of July 2022. Pediatric infections were mild, and reinfections were even milder than primary infections.
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Affiliation(s)
- Snežana Medić
- Department of Epidemiology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Center for Disease Control and Prevention, Institute of Public Health of Vojvodina, Novi Sad, Serbia
| | - Cleo Anastassopoulou
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Nataša Dragnić
- Department of Social Medicine and Health Statistics With Informatics, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Center for Informatics and Biostatistics, Institute of Public Health of Vojvodina, Novi Sad, Serbia
| | - Vladimir Petrović
- Department of Epidemiology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Center for Disease Control and Prevention, Institute of Public Health of Vojvodina, Novi Sad, Serbia
| | - Mioljub Ristić
- Department of Epidemiology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Center for Disease Control and Prevention, Institute of Public Health of Vojvodina, Novi Sad, Serbia
| | - Tatjana Pustahija
- Department of Epidemiology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Center for Disease Control and Prevention, Institute of Public Health of Vojvodina, Novi Sad, Serbia
| | - Athanasios Tsakris
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - John P. A. Ioannidis
- Department of Medicine, Stanford University, Stanford, California
- Department of Epidemiology and Population Health, Stanford University, Stanford, California
- Department of Biomedical Data Science, Stanford University, Stanford, California
- Department of Statistics, Stanford University, Stanford, California
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6
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Frutos AM, Balmaseda A, Vydiswaran N, Patel M, Ojeda S, Brouwer A, Tutino R, Cai S, Bakker K, Sanchez N, Lopez R, Kuan G, Gordon A. Burden and seasonality of primary and secondary symptomatic common cold coronavirus infections in Nicaraguan children. Influenza Other Respir Viruses 2023; 17:e13078. [PMID: 36494188 PMCID: PMC9835451 DOI: 10.1111/irv.13086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 11/22/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The current SARS-CoV-2 pandemic highlights the need for an increased understanding of coronavirus epidemiology. In a pediatric cohort in Nicaragua, we evaluate the seasonality and burden of common cold coronavirus (ccCoV) infection and evaluate likelihood of symptoms in reinfections. METHODS Children presenting with symptoms of respiratory illness were tested for each of the four ccCoVs (NL63, 229E, OC43, and HKU1). Annual blood samples collected before ccCoV infection were tested for antibodies against each ccCoV. Seasonality was evaluated using wavelet and generalized additive model (GAM) analyses, and age-period effects were investigated using a Poisson model. We also evaluate the risk of symptom presentation between primary and secondary infections. RESULTS In our cohort of 2576 children from 2011 to 2016, we observed 595 ccCoV infections and 107 cases of ccCoV-associated lower respiratory infection (LRI). The overall incidence rate was 61.1 per 1000 person years (95% confidence interval (CI): 56.3, 66.2). Children under two had the highest incidence of ccCoV infections and associated LRI. ccCoV incidence rapidly decreases until about age 6. Each ccCoV circulated throughout the year and demonstrated annual periodicity. Peaks of NL63 typically occurred 3 months before 229E peaks and 6 months after OC43 peaks. Approximately 69% of symptomatic ccCoV infections were secondary infections. There was slightly lower risk (rate ratio (RR): 0.90, 95% CI: 0.83, 0.97) of LRI between secondary and primary ccCoV infections among participants under the age of 5. CONCLUSIONS ccCoV spreads annually among children with the greatest burden among ages 0-1. Reinfection is common; prior infection is associated with slight protection against LRI among the youngest children.
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Affiliation(s)
- Aaron M. Frutos
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMichiganUSA
| | - Angel Balmaseda
- Health Center Sócrates Flores VivasMinistry of HealthManaguaNicaragua
- Laboratorio Nacional de Virología, Centro Nacional de Diagnósticoy ReferenciaMinistry of HealthManaguaNicaragua
| | - Nivea Vydiswaran
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMichiganUSA
| | - Mayuri Patel
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMichiganUSA
| | | | - Andrew Brouwer
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMichiganUSA
| | - Rebecca Tutino
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMichiganUSA
| | - Shuwei Cai
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMichiganUSA
| | - Kevin Bakker
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMichiganUSA
| | | | - Roger Lopez
- Laboratorio Nacional de Virología, Centro Nacional de Diagnósticoy ReferenciaMinistry of HealthManaguaNicaragua
- Sustainable Sciences InstituteManaguaNicaragua
| | - Guillermina Kuan
- Health Center Sócrates Flores VivasMinistry of HealthManaguaNicaragua
- Sustainable Sciences InstituteManaguaNicaragua
| | - Aubree Gordon
- Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborMichiganUSA
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Lima K, Fontoura JC, de Souza PO, Fazolo T, Hilario G, Zorzetto R, Rodrigues Junior LC, Coimbra LD, Borin A, Bispo-dos-Santos K, Granja F, Marques RE, Zavaglia GO, Fernandes IR, Varela FH, Polese-Bonatto M, Tonini ML, Ikeda do Carmo GM, de Almeida WAF, Borges TJ, Nakaya HI, Proenca-Modena JL, Callegari-Jacques SM, Scotta MC, Stein RT, Bonorino C. SARS-CoV-2 infected children form early immune memory responses dominated by nucleocapsid-specific CD8+ T cells and antibodies. Front Immunol 2022; 13:1033364. [PMID: 36405692 PMCID: PMC9667737 DOI: 10.3389/fimmu.2022.1033364] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/03/2022] [Indexed: 08/13/2023] Open
Abstract
This is the third year of the SARS-CoV-2 pandemic, and yet most children remain unvaccinated. COVID-19 in children manifests as mostly mild or asymptomatic, however high viral titers and strong cellular and humoral responses are observed upon acute infection. It is still unclear how long these responses persist, and if they can protect from re-infection and/or disease severity. Here, we analyzed immune memory responses in a cohort of children and adults with COVID-19. Important differences between children and adults are evident in kinetics and profile of memory responses. Children develop early N-specific cytotoxic T cell responses, that rapidly expand and dominate their immune memory to the virus. Children's anti-N, but not anti-S, antibody titers increase over time. Neutralization titers correlate with N-specific antibodies and CD8+T cells. However, antibodies generated by infection do not efficiently cross-neutralize variants Gamma or Delta. Our results indicate that mechanisms that protect from disease severity are possibly different from those that protect from reinfection, bringing novel insights for pediatric vaccine design. They also underline the importance of vaccination in children, who remain at risk for COVID-19 despite having been previously infected.
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Affiliation(s)
- Karina Lima
- Departamento de Ciências Básicas da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre – UFCSPA, Porto Alegre, Brazil
| | - Julia C. Fontoura
- Departamento de Ciências Básicas da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre – UFCSPA, Porto Alegre, Brazil
| | - Priscila Oliveira de Souza
- Departamento de Ciências Básicas da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre – UFCSPA, Porto Alegre, Brazil
| | - Tiago Fazolo
- Departamento de Ciências Básicas da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre – UFCSPA, Porto Alegre, Brazil
| | - Gabriel Hilario
- Departamento de Ciências Básicas da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre – UFCSPA, Porto Alegre, Brazil
| | - Renata Zorzetto
- Departamento de Ciências Básicas da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre – UFCSPA, Porto Alegre, Brazil
| | - Luiz C Rodrigues Junior
- Departamento de Ciências Básicas da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre – UFCSPA, Porto Alegre, Brazil
| | - Lais D. Coimbra
- Brazilian Biosciences National Laboratory, Brazilian Center for Research in Energy and Materials (CNPEM), Campinas, Brazil
| | - Alexandre Borin
- Brazilian Biosciences National Laboratory, Brazilian Center for Research in Energy and Materials (CNPEM), Campinas, Brazil
| | - Karina Bispo-dos-Santos
- Laboratory of Emerging Viruses (LEVE), Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas (Unicamp), Campinas, Brazil
| | - Fabiana Granja
- Laboratory of Emerging Viruses (LEVE), Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas (Unicamp), Campinas, Brazil
- Biodiversity Research Centre, Federal University of Roraima (UFRR), Boa Vista, Brazil
| | - Rafael Elias Marques
- Brazilian Biosciences National Laboratory, Brazilian Center for Research in Energy and Materials (CNPEM), Campinas, Brazil
| | - Gabriela Oliveira Zavaglia
- Social Responsibility – Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (PROADI-SUS ), Hospital Moinhos de Vento, Porto Alegre, Brazil
| | - Ingrid Rodrigues Fernandes
- Social Responsibility – Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (PROADI-SUS ), Hospital Moinhos de Vento, Porto Alegre, Brazil
| | - Fernanda Hammes Varela
- Social Responsibility – Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (PROADI-SUS ), Hospital Moinhos de Vento, Porto Alegre, Brazil
| | - Marcia Polese-Bonatto
- Social Responsibility – Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (PROADI-SUS ), Hospital Moinhos de Vento, Porto Alegre, Brazil
| | - Maiko Luís Tonini
- Coordenação-Geral de Vigilância das Doenças de Transmissão Respiratória de Condições Crônicas, Departamento de Doenças de Condições Crônicas e IST, Secretaria de Vigilância em Saúde – Ministério da Saúde (CGDR/DCCI/SVS/MS)., Brasília, Brazil
| | - Greice Madeleine Ikeda do Carmo
- Departamento de Imunizações e doenças transmissíveis, Secretaria de Vigilância em Saúde - Ministério da Saúde (DEIDT/SVS/MS), Brasília, Brazil
| | | | - Thiago J. Borges
- Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Helder I. Nakaya
- Computational System Biology Laboratory (CSBL), Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - José Luiz Proenca-Modena
- Laboratory of Emerging Viruses (LEVE), Department of Genetics, Microbiology and Immunology, Institute of Biology, University of Campinas (Unicamp), Campinas, Brazil
- Hub of Global Health (HGH), University of Campinas (Unicamp), Campinas, Brazil
| | | | - Marcelo Comerlato Scotta
- Social Responsibility – Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (PROADI-SUS ), Hospital Moinhos de Vento, Porto Alegre, Brazil
- Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul – PUCRS, Porto Alegre, Brazil
| | - Renato T. Stein
- Social Responsibility – Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (PROADI-SUS ), Hospital Moinhos de Vento, Porto Alegre, Brazil
- Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul – PUCRS, Porto Alegre, Brazil
| | - Cristina Bonorino
- Departamento de Ciências Básicas da Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre – UFCSPA, Porto Alegre, Brazil
- Department of Surgery, University of California at San Diego – UCSD, La Jolla, CA, United States
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Infection-induced immunity is associated with protection against SARS-CoV-2 infection, but not decreased infectivity during household transmission. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.10.10.22280915. [PMID: 36263069 PMCID: PMC9580390 DOI: 10.1101/2022.10.10.22280915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Background Understanding the impact of infection-induced immunity on SARS-CoV-2 transmission will provide insight into the transition of SARS-CoV-2 to endemicity. Here we estimate the effects of prior infection induced immunity and children on SARS-CoV-2 transmission in households. Methods We conducted a household cohort study between March 2020-June 2022 in Managua, Nicaragua where when one household member tests positive for SARS-CoV-2, household members are closely monitored for SARS-CoV-2 infection. Using a pairwise survival model, we estimate the association of infection period, age, symptoms, and infection-induced immunity with secondary attack risk. Results Overall transmission occurred in 72.4% of households, 42% of household contacts were infected and the secondary attack risk was 13.0% (95% CI: 11.7, 14.6). Prior immunity did not impact the probability of transmitting SARS-CoV-2. However, participants with pre-existing infection-induced immunity were half as likely to be infected compared to naïve individuals (RR 0.53, 95% CI: 0.39, 0.72), but this reduction was not observed in children. Likewise, symptomatic infected individuals were more likely to transmit (RR 24.4, 95% CI: 7.8, 76.1); however, symptom presentation was not associated with infectivity of young children. Young children were less likely to transmit SARS-CoV-2 than adults. During the omicron era, infection-induced immunity remained protective against infection. Conclusions Infection-induced immunity is associated with protection against infection for adults and adolescents. While young children are less infectious, prior infection and asymptomatic presentation did not reduce their infectivity as was seen in adults. As SARS-CoV-2 transitions to endemicity, children may become more important in transmission dynamics. Article summary Infection-induced immunity protects against SARS-CoV-2 infection for adolescents and adults; however, there was no protection in children. Prior immunity in an infected individual did not impact the probability they will spread SARS-CoV-2 in a household setting.
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