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Yamamoto S, Matsuda K, Maeda K, Horii K, Okudera K, Oshiro Y, Inamura N, Nemoto T, Takeuchi JS, Li Y, Konishi M, Tsuchiya K, Gatanaga H, Oka S, Mizoue T, Sugiyama H, Aoyanagi N, Mitsuya H, Sugiura W, Ohmagari N. Preinfection Neutralizing Antibodies, Omicron BA.5 Breakthrough Infection, and Long COVID: A Propensity Score-Matched Analysis. J Infect Dis 2023; 228:1652-1661. [PMID: 37756608 DOI: 10.1093/infdis/jiad317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/04/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Data are limited on the role of preinfection humoral immunity protection against Omicron BA.5 infection and long coronavirus disease (COVID) development. METHODS We conducted nested case-control analysis among tertiary hospital staff in Tokyo who donated blood samples in June 2022 (1 month before Omicron BA.5 wave), approximately 6 months after receiving a third dose of COVID-19 mRNA vaccine. We measured live virus-neutralizing antibody titers against wild type and Omicron BA.5, and anti-receptor-binding domain (RBD) antibody titers at preinfection, and compared them between cases and propensity-matched controls. Among the breakthrough cases, we examined association between preinfection antibody titers and incidence of long COVID. RESULTS Preinfection anti-RBD and neutralizing antibody titers were lower in cases than controls. Neutralizing titers against wild type and Omicron BA.5 were 64% (95% confidence interval [CI], 42%-77%) and 72% (95% CI, 53%-83%) lower, respectively, in cases than controls. Individuals with previous Omicron BA.1/BA.2 infections were more frequent among controls than cases (10.3% vs 0.8%), and their Omicron BA.5 neutralizing titers were 12.8-fold higher than infection-naive individuals. Among cases, preinfection antibody titers were not associated with incidence of long COVID. CONCLUSIONS Preinfection immunogenicity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may play a role in protecting against the Omicron BA.5 infection but not preventing long COVID.
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Affiliation(s)
- Shohei Yamamoto
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kouki Matsuda
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
- Japan Foundation for AIDS Prevention, Tokyo, Japan
- Division of Antiviral Therapy, Joint Research Center for Human Retrovirus Infection, Kagoshima University, Kagoshima, Japan
| | - Kenji Maeda
- Division of Antiviral Therapy, Joint Research Center for Human Retrovirus Infection, Kagoshima University, Kagoshima, Japan
- Department of Refractory Viral Infection, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kumi Horii
- Infection Control Office, Center Hospital of the National Center for the Global Health and Medicine, Tokyo, Japan
| | - Kaori Okudera
- Infection Control Office, Kohnodai Hospital of the National Center for the Global Health and Medicine, Chiba, Japan
| | - Yusuke Oshiro
- Department of Laboratory Testing, Center Hospital of the National Center for the Global Health and Medicine, Tokyo, Japan
| | - Natsumi Inamura
- Department of Laboratory Testing, Center Hospital of the National Center for the Global Health and Medicine, Tokyo, Japan
| | - Takashi Nemoto
- Department of Laboratory Testing, Center Hospital of the National Center for the Global Health and Medicine, Tokyo, Japan
| | - Junko S Takeuchi
- Department of Academic-Industrial Partnerships Promotion, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yunfei Li
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Maki Konishi
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kiyoto Tsuchiya
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hiroyuki Gatanaga
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Shinichi Oka
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Haruhito Sugiyama
- Center Hospital of the National Center for the Global Health and Medicine, Tokyo, Japan
| | - Nobuyoshi Aoyanagi
- Kohnodai Hospital of the National Center for the Global Health and Medicine, Chiba, Japan
| | - Hiroaki Mitsuya
- Department of Refractory Viral Infection, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Wataru Sugiura
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
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Davies MA, Morden E, Rosseau P, Arendse J, Bam JL, Boloko L, Cloete K, Cohen C, Chetty N, Dane P, Heekes A, Hsiao NY, Hunter M, Hussey H, Jacobs T, Jassat W, Kariem S, Kassanjee R, Laenen I, Le Roux S, Lessells R, Mahomed H, Maughan D, Meintjes G, Mendelson M, Mnguni A, Moodley M, Murie K, Naude J, Ntusi NAB, Paleker M, Parker A, Pienaar D, Preiser W, Prozesky H, Raubenheimer P, Rossouw L, Schrueder N, Smith B, Smith M, Solomon W, Symons G, Taljaard J, Wasserman S, Wilkinson RJ, Wolmarans M, Wolter N, Boulle A. Outcomes of laboratory-confirmed SARS-CoV-2 infection during resurgence driven by Omicron lineages BA.4 and BA.5 compared with previous waves in the Western Cape Province, South Africa. medRxiv 2022:2022.06.28.22276983. [PMID: 35794899 PMCID: PMC9258293 DOI: 10.1101/2022.06.28.22276983] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Objective We aimed to compare clinical severity of Omicron BA.4/BA.5 infection with BA.1 and earlier variant infections among laboratory-confirmed SARS-CoV-2 cases in the Western Cape, South Africa, using timing of infection to infer the lineage/variant causing infection. Methods We included public sector patients aged ≥20 years with laboratory-confirmed COVID-19 between 1-21 May 2022 (BA.4/BA.5 wave) and equivalent prior wave periods. We compared the risk between waves of (i) death and (ii) severe hospitalization/death (all within 21 days of diagnosis) using Cox regression adjusted for demographics, comorbidities, admission pressure, vaccination and prior infection. Results Among 3,793 patients from the BA.4/BA.5 wave and 190,836 patients from previous waves the risk of severe hospitalization/death was similar in the BA.4/BA.5 and BA.1 waves (adjusted hazard ratio [aHR] 1.12; 95% confidence interval [CI] 0.93; 1.34). Both Omicron waves had lower risk of severe outcomes than previous waves. Prior infection (aHR 0.29, 95% CI 0.24; 0.36) and vaccination (aHR 0.17; 95% CI 0.07; 0.40 for boosted vs. no vaccine) were protective. Conclusion Disease severity was similar amongst diagnosed COVID-19 cases in the BA.4/BA.5 and BA.1 periods in the context of growing immunity against SARS-CoV-2 due to prior infection and vaccination, both of which were strongly protective.
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Affiliation(s)
- Mary-Ann Davies
- Health Intelligence, Western Cape Government: Health and Wellness, South Africa
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, South Africa
- Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, South Africa
| | - Erna Morden
- Health Intelligence, Western Cape Government: Health and Wellness, South Africa
- Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, South Africa
| | | | | | - Jamy-Lee Bam
- Health Intelligence, Western Cape Government: Health and Wellness, South Africa
| | - Linda Boloko
- Groote Schuur Hospital, Western Cape Government: Health and Wellness, South Africa
- Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, South Africa
| | - Keith Cloete
- Western Cape Government: Health and Wellness, South Africa
| | - Cheryl Cohen
- National Institute for Communicable Diseases, National Health Laboratory Service, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nicole Chetty
- Health Intelligence, Western Cape Government: Health and Wellness, South Africa
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, South Africa
| | - Pierre Dane
- Health Intelligence, Western Cape Government: Health and Wellness, South Africa
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, South Africa
| | - Alexa Heekes
- Health Intelligence, Western Cape Government: Health and Wellness, South Africa
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, South Africa
| | - Nei-Yuan Hsiao
- Division of Medical Virology, University of Cape Town, Cape Town, Western Cape, South Africa
- National Health Laboratory Service, South Africa
| | - Mehreen Hunter
- Health Intelligence, Western Cape Government: Health and Wellness, South Africa
- Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, South Africa
| | - Hannah Hussey
- Health Intelligence, Western Cape Government: Health and Wellness, South Africa
- Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, South Africa
- Metro Health Services, Western Cape Government: Health and Wellness
| | - Theuns Jacobs
- Health Intelligence, Western Cape Government: Health and Wellness, South Africa
| | - Waasila Jassat
- National Institute for Communicable Diseases, National Health Laboratory Service, South Africa
| | - Saadiq Kariem
- Western Cape Government: Health and Wellness, South Africa
| | - Reshma Kassanjee
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, South Africa
| | - Inneke Laenen
- Health Intelligence, Western Cape Government: Health and Wellness, South Africa
- Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University
| | - Sue Le Roux
- Western Cape Government: Health and Wellness, South Africa
- Karl Bremer Hospital, Western Cape Government: Health and Wellness
| | - Richard Lessells
- KwaZulu-Natal Research, Innovation & Sequencing Platform, University of KwaZulu-Natal, Durban, South Africa
| | - Hassan Mahomed
- Metro Health Services, Western Cape Government: Health and Wellness
- Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University
| | - Deborah Maughan
- Groote Schuur Hospital, Western Cape Government: Health and Wellness, South Africa
- Department of Medicine, University of Cape Town, South Africa
| | - Graeme Meintjes
- Groote Schuur Hospital, Western Cape Government: Health and Wellness, South Africa
- Department of Medicine, University of Cape Town, South Africa
| | - Marc Mendelson
- Groote Schuur Hospital, Western Cape Government: Health and Wellness, South Africa
- Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, South Africa
| | - Ayanda Mnguni
- Khayelitsha District Hospital, Western Cape Government: Health and Wellness
| | - Melvin Moodley
- Health Intelligence, Western Cape Government: Health and Wellness, South Africa
| | - Katy Murie
- Western Cape Government: Health and Wellness, South Africa
- Metro Health Services, Western Cape Government: Health and Wellness
| | - Jonathan Naude
- Mitchells Plain Hospital, Western Cape Government: Health and Wellness
| | - Ntobeko A. B. Ntusi
- Groote Schuur Hospital, Western Cape Government: Health and Wellness, South Africa
- Department of Medicine, University of Cape Town, South Africa
- South African Medical Research Council Extramural Unit on Intersection of Noncommunicable Diseases and Infectious Diseases
| | - Masudah Paleker
- Health Intelligence, Western Cape Government: Health and Wellness, South Africa
- Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University
| | - Arifa Parker
- Tygerberg Hospital, Western Cape Government: Health and Wellness
- Division of Infectious Diseases, Department of Medicine, Stellenbosch University, South Africa
| | - David Pienaar
- Rural Health Services, Western Cape Government: Health and Wellness
| | - Wolfgang Preiser
- National Health Laboratory Service, South Africa
- Division of Medical Virology, University of Stellenbosch, South Africa
| | - Hans Prozesky
- Tygerberg Hospital, Western Cape Government: Health and Wellness
- Division of Infectious Diseases, Department of Medicine, Stellenbosch University, South Africa
| | - Peter Raubenheimer
- Groote Schuur Hospital, Western Cape Government: Health and Wellness, South Africa
- Department of Medicine, University of Cape Town, South Africa
| | - Liezel Rossouw
- Western Cape Government: Health and Wellness, South Africa
| | - Neshaad Schrueder
- Tygerberg Hospital, Western Cape Government: Health and Wellness
- Division of General Medicine, Department of Medicine, Stellenbosch University, South Africa
| | - Barry Smith
- Western Cape Government: Health and Wellness, South Africa
- Karl Bremer Hospital, Western Cape Government: Health and Wellness
| | - Mariette Smith
- Health Intelligence, Western Cape Government: Health and Wellness, South Africa
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, South Africa
| | | | - Greg Symons
- Groote Schuur Hospital, Western Cape Government: Health and Wellness, South Africa
- Department of Medicine, University of Cape Town, South Africa
| | - Jantjie Taljaard
- Tygerberg Hospital, Western Cape Government: Health and Wellness
- Division of Infectious Diseases, Department of Medicine, Stellenbosch University, South Africa
| | - Sean Wasserman
- Groote Schuur Hospital, Western Cape Government: Health and Wellness, South Africa
- Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town, South Africa
| | - Robert J. Wilkinson
- The Francis Crick Institute, Midland Road, London, NW1 1AT, UK
- Department of Infectious Diseases, Imperial College London, W12 0NN, UK
- Wellcome Centre for Infectious Disease Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, South Africa
| | | | - Nicole Wolter
- National Institute for Communicable Diseases, National Health Laboratory Service, South Africa
- School of Pathology, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Andrew Boulle
- Health Intelligence, Western Cape Government: Health and Wellness, South Africa
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, South Africa
- Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, South Africa
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3
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Davies M, Kassanjee R, Rousseau P, Morden E, Johnson L, Solomon W, Hsiao N, Hussey H, Meintjes G, Paleker M, Jacobs T, Raubenheimer P, Heekes A, Dane P, Bam J, Smith M, Preiser W, Pienaar D, Mendelson M, Naude J, Schrueder N, Mnguni A, Le Roux S, Murie K, Prozesky H, Mahomed H, Rossouw L, Wasserman S, Maughan D, Boloko L, Smith B, Taljaard J, Symons G, Ntusi NAB, Parker A, Wolter N, Jassat W, Cohen C, Lessells R, Wilkinson RJ, Arendse J, Kariem S, Moodley M, Wolmarans M, Cloete K, Boulle A. Outcomes of laboratory-confirmed SARS-CoV-2 infection in the Omicron-driven fourth wave compared with previous waves in the Western Cape Province, South Africa. Trop Med Int Health 2022; 27:564-573. [PMID: 35411997 PMCID: PMC9115442 DOI: 10.1111/tmi.13752] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVES The objective was to compare COVID-19 outcomes in the Omicron-driven fourth wave with prior waves in the Western Cape, assess the contribution of undiagnosed prior infection to differences in outcomes in a context of high seroprevalence due to prior infection and determine whether protection against severe disease conferred by prior infection and/or vaccination was maintained. METHODS In this cohort study, we included public sector patients aged ≥20 years with a laboratory-confirmed COVID-19 diagnosis between 14 November and 11 December 2021 (wave four) and equivalent prior wave periods. We compared the risk between waves of the following outcomes using Cox regression: death, severe hospitalisation or death and any hospitalisation or death (all ≤14 days after diagnosis) adjusted for age, sex, comorbidities, geography, vaccination and prior infection. RESULTS We included 5144 patients from wave four and 11,609 from prior waves. The risk of all outcomes was lower in wave four compared to the Delta-driven wave three (adjusted hazard ratio (aHR) [95% confidence interval (CI)] for death 0.27 [0.19; 0.38]. Risk reduction was lower when adjusting for vaccination and prior diagnosed infection (aHR: 0.41, 95% CI: 0.29; 0.59) and reduced further when accounting for unascertained prior infections (aHR: 0.72). Vaccine protection was maintained in wave four (aHR for outcome of death: 0.24; 95% CI: 0.10; 0.58). CONCLUSIONS In the Omicron-driven wave, severe COVID-19 outcomes were reduced mostly due to protection conferred by prior infection and/or vaccination, but intrinsically reduced virulence may account for a modest reduction in risk of severe hospitalisation or death compared to the Delta-driven wave.
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Affiliation(s)
- Mary‐Ann Davies
- Health Intelligence, Western Cape Government: HealthCape TownSouth Africa
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape TownCape TownSouth Africa
- Division of Public Health MedicineSchool of Public Health and Family Medicine, University of Cape TownCape TownSouth Africa
| | - Reshma Kassanjee
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape TownCape TownSouth Africa
| | | | - Erna Morden
- Health Intelligence, Western Cape Government: HealthCape TownSouth Africa
- Division of Public Health MedicineSchool of Public Health and Family Medicine, University of Cape TownCape TownSouth Africa
| | - Leigh Johnson
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape TownCape TownSouth Africa
| | | | - Nei‐Yuan Hsiao
- Division of Medical VirologyUniversity of Cape TownCape TownSouth Africa
- National Health Laboratory ServiceCape TownSouth Africa
| | - Hannah Hussey
- Health Intelligence, Western Cape Government: HealthCape TownSouth Africa
- Division of Public Health MedicineSchool of Public Health and Family Medicine, University of Cape TownCape TownSouth Africa
| | - Graeme Meintjes
- Groote Schuur Hospital, Western Cape Government: HealthCape TownSouth Africa
- Department of MedicineUniversity of Cape TownCape TownSouth Africa
- Wellcome Centre for Infectious Disease Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape TownCape TownSouth Africa
| | - Masudah Paleker
- Health Intelligence, Western Cape Government: HealthCape TownSouth Africa
- Division of Health Systems and Public Health, Department of Global HealthStellenbosch UniversityTygerbergSouth Africa
| | - Theuns Jacobs
- Health Intelligence, Western Cape Government: HealthCape TownSouth Africa
| | - Peter Raubenheimer
- Groote Schuur Hospital, Western Cape Government: HealthCape TownSouth Africa
- Department of MedicineUniversity of Cape TownCape TownSouth Africa
| | - Alexa Heekes
- Health Intelligence, Western Cape Government: HealthCape TownSouth Africa
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape TownCape TownSouth Africa
| | - Pierre Dane
- Health Intelligence, Western Cape Government: HealthCape TownSouth Africa
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape TownCape TownSouth Africa
| | - Jamy‐Lee Bam
- Health Intelligence, Western Cape Government: HealthCape TownSouth Africa
| | - Mariette Smith
- Health Intelligence, Western Cape Government: HealthCape TownSouth Africa
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape TownCape TownSouth Africa
| | - Wolfgang Preiser
- National Health Laboratory ServiceCape TownSouth Africa
- Division of Medical VirologyStellenbosch UniversityStellenboschSouth Africa
| | - David Pienaar
- Rural Health Services, Western Cape Government: HealthCape TownSouth Africa
| | - Marc Mendelson
- Groote Schuur Hospital, Western Cape Government: HealthCape TownSouth Africa
- Division of Infectious Diseases and HIV Medicine, Department of MedicineUniversity of Cape TownCape TownSouth Africa
| | - Jonathan Naude
- Mitchells Plain Hospital, Western Cape Government: HealthCape TownSouth Africa
| | - Neshaad Schrueder
- Tygerberg Hospital, Western Cape Government: HealthParowSouth Africa
- Department of MedicineStellenbosch UniversityStellenboschSouth Africa
| | - Ayanda Mnguni
- Khayelitsha District Hospital, Western Cape Government: HealthKhayelitshaSouth Africa
| | - Sue Le Roux
- Karl Bremer Hospital, Western Cape Government: HealthBellvilleSouth Africa
- Western Cape Government: HealthCape TownSouth Africa
| | - Kathleen Murie
- Western Cape Government: HealthCape TownSouth Africa
- Metro Health Services, Western Cape Government: HealthCape TownSouth Africa
| | - Hans Prozesky
- Tygerberg Hospital, Western Cape Government: HealthParowSouth Africa
- Division of Infectious Diseases, Department of MedicineStellenbosch UniversityTygerbergSouth Africa
| | - Hassan Mahomed
- Division of Health Systems and Public Health, Department of Global HealthStellenbosch UniversityTygerbergSouth Africa
- Metro Health Services, Western Cape Government: HealthCape TownSouth Africa
| | | | - Sean Wasserman
- Groote Schuur Hospital, Western Cape Government: HealthCape TownSouth Africa
- Wellcome Centre for Infectious Disease Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape TownCape TownSouth Africa
- Division of Infectious Diseases and HIV Medicine, Department of MedicineUniversity of Cape TownCape TownSouth Africa
| | - Deborah Maughan
- Groote Schuur Hospital, Western Cape Government: HealthCape TownSouth Africa
- Department of MedicineUniversity of Cape TownCape TownSouth Africa
| | - Linda Boloko
- Groote Schuur Hospital, Western Cape Government: HealthCape TownSouth Africa
- Division of Infectious Diseases and HIV Medicine, Department of MedicineUniversity of Cape TownCape TownSouth Africa
| | - Barry Smith
- Karl Bremer Hospital, Western Cape Government: HealthBellvilleSouth Africa
- Western Cape Government: HealthCape TownSouth Africa
| | - Jantjie Taljaard
- Tygerberg Hospital, Western Cape Government: HealthParowSouth Africa
- Division of Infectious Diseases, Department of MedicineStellenbosch UniversityTygerbergSouth Africa
| | - Greg Symons
- Groote Schuur Hospital, Western Cape Government: HealthCape TownSouth Africa
- Department of MedicineUniversity of Cape TownCape TownSouth Africa
| | - Ntobeko A. B. Ntusi
- Groote Schuur Hospital, Western Cape Government: HealthCape TownSouth Africa
- Department of MedicineUniversity of Cape TownCape TownSouth Africa
| | - Arifa Parker
- Tygerberg Hospital, Western Cape Government: HealthParowSouth Africa
- Division of Infectious Diseases, Department of MedicineStellenbosch UniversityTygerbergSouth Africa
| | - Nicole Wolter
- National Institute for Communicable Diseases, National Health Laboratory ServiceJohannesburgSouth Africa
| | - Waasila Jassat
- National Institute for Communicable Diseases, National Health Laboratory ServiceJohannesburgSouth Africa
| | - Cheryl Cohen
- National Institute for Communicable Diseases, National Health Laboratory ServiceJohannesburgSouth Africa
- Faculty of Health Sciences, School of Public Health, University of the WitwatersrandJohannesburgSouth Africa
| | - Richard Lessells
- KwaZulu‐Natal Research, Innovation & Sequencing Platform, University of KwaZulu‐NatalDurbanSouth Africa
| | - Robert J. Wilkinson
- Wellcome Centre for Infectious Disease Research in Africa, Institute of Infectious Disease and Molecular Medicine, University of Cape TownCape TownSouth Africa
- Francis Crick InstituteLondonUK
- Department of Infectious DiseasesImperial College LondonLondonUK
| | | | - Saadiq Kariem
- Western Cape Government: HealthCape TownSouth Africa
| | - Melvin Moodley
- Health Intelligence, Western Cape Government: HealthCape TownSouth Africa
| | | | - Keith Cloete
- Western Cape Government: HealthCape TownSouth Africa
| | - Andrew Boulle
- Health Intelligence, Western Cape Government: HealthCape TownSouth Africa
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape TownCape TownSouth Africa
- Division of Public Health MedicineSchool of Public Health and Family Medicine, University of Cape TownCape TownSouth Africa
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Yang W, Shaman J. COVID-19 pandemic dynamics in India, the SARS-CoV-2 Delta variant and implications for vaccination. J R Soc Interface 2022; 19:20210900. [PMID: 35670221 PMCID: PMC9169547 DOI: 10.1098/rsif.2021.0900] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 05/20/2022] [Indexed: 12/11/2022] Open
Abstract
The Delta variant is a major SARS-CoV-2 variant of concern first identified in India. To better understand COVID-19 pandemic dynamics and Delta, we use multiple datasets and model-inference to reconstruct COVID-19 pandemic dynamics in India during March 2020-June 2021. We further use the large discrepancy in one- and two-dose vaccination coverage in India (53% versus 23% by end of October 2021) to examine the impact of vaccination and whether prior non-Delta infection can boost vaccine effectiveness (VE). We estimate that Delta escaped immunity in 34.6% (95% CI: 0-64.2%) of individuals with prior wild-type infection and was 57.0% (95% CI: 37.9-75.6%) more infectious than wild-type SARS-CoV-2. Models assuming higher VE among non-Delta infection recoverees, particularly after the first dose, generated more accurate predictions than those assuming no such increases (best-performing VE setting: 90/95% versus 30/67% baseline for the first/second dose). Counterfactual modelling indicates that high vaccination coverage for first vaccine dose in India combined with the boosting of VE among recoverees averted around 60% of infections during July-mid-October 2021. These findings provide support to prioritizing first-dose vaccination in regions with high underlying infection rates, given continued vaccine shortages and new variant emergence.
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Affiliation(s)
- Wan Yang
- Department of Epidemiology, Columbia University, New York, NY, USA
| | - Jeffrey Shaman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
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Gelanew T, Mulu A, Abebe M, Bates TA, Wassie L, Teferi M, Fentahun D, Alemu A, Tamiru F, Assefa G, Bayih AG, Tafesse FG, Mihret A, Abdissa A. A Single Dose of ChAdOx1 nCoV-19 Vaccine Elicits High Antibody Responses in Individuals with Prior SARS-CoV-2 Infection Comparable to That of Two-Dose-Vaccinated, SARS-CoV-2-Infection-Naïve Individuals: A Longitudinal Study in Ethiopian Health Workers. Vaccines (Basel) 2022; 10. [PMID: 35746467 DOI: 10.3390/vaccines10060859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/13/2022] [Accepted: 05/19/2022] [Indexed: 12/10/2022] Open
Abstract
Single-dose COVID-19 vaccines, mostly mRNA-based vaccines, are shown to induce robust antibody responses in individuals who were previously infected with SARS-CoV-2, suggesting the sufficiency of a single dose for those individuals in countries with limited vaccine supply. However, these important data are limited to developed nations. We conducted a prospective longitudinal study among Ethiopian healthcare workers who received a ChAdOx1 nCoV-19 vaccine. We compared the geometric mean titers (GMTs) of the SARS-CoV-2 receptor-binding domain (RBD)-specific IgG antibodies in 39 SARS-CoV-2 naïve participants and 24 participants previously infected with SARS-CoV-2 (P.I.), who received two doses of ChAdOx1 nCoV-19 vaccine across the two post-vaccination time points (at 8 to 12 weeks post single dose and two dose vaccinations). We noted that the GMT (1632.16) in naïve participants at 8-12 weeks post first dose were comparable to the GMT (1674.94) observed in P.I. participants prior to vaccination. Interestingly, P.I. participants had significantly higher antibody titers compared to naïve participants, after both the first (GMT, 4913.50 vs. 1632.16) and second doses (GMT, 9804.60 vs. 6607.30). Taken together, our findings show that a single ChAdOx1 nCoV-19 dose in previously SARS-CoV-2 infected individuals elicits similar, if not higher, antibody responses to those of two-dose-vaccinated naïve individuals.
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Congrave-Wilson Z, Cheng WA, Lee Y, Perez S, Turner L, Marentes Ruiz CJ, Mendieta S, Skura A, Jumarang J, Del Valle J, Kubale J, Allen EK, Thomas PG, Gordon A, Pannaraj PS. Twelve-Month Longitudinal Serology in SARS-CoV-2 Naïve and Experienced Vaccine Recipients and Unvaccinated COVID-19-Infected Individuals. Vaccines (Basel) 2022; 10:813. [PMID: 35632569 PMCID: PMC9143304 DOI: 10.3390/vaccines10050813] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 11/16/2022] Open
Abstract
Longitudinal data comparing SARS-CoV-2 serology in individuals following infection and vaccination over 12 months are limited. This study compared the magnitude, decay, and variability in serum IgG, IgA, and neutralizing activity induced by natural infection (n = 218) or mRNA vaccination in SARS-CoV-2 naïve (n = 143) or experienced (n = 122) individuals over time using enzyme-linked immunosorbent assays and an in vitro virus neutralization assay. Serological responses were found to be highly variable after natural infection compared with vaccination but durable through 12 months. Antibody levels in vaccinated, SARS-CoV-2 naïve individuals peaked by 1 month then declined through 9 months, culminating in non-detectable SARS-CoV-2-specific serum IgA. Individuals with both infection and vaccination showed SARS-CoV-2-specific IgG and IgA levels that were more robust and slower to decline than the other groups; neutralizing activity remained highest in this group at 9 months past vaccination. These data reinforce the benefit of vaccination after SARS-CoV-2 recovery.
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Affiliation(s)
- Zion Congrave-Wilson
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (Z.C.-W.); (W.A.C.); (Y.L.); (S.P.); (L.T.); (C.J.M.R.); (S.M.); (A.S.); (J.J.); (J.D.V.)
| | - Wesley A. Cheng
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (Z.C.-W.); (W.A.C.); (Y.L.); (S.P.); (L.T.); (C.J.M.R.); (S.M.); (A.S.); (J.J.); (J.D.V.)
| | - Yesun Lee
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (Z.C.-W.); (W.A.C.); (Y.L.); (S.P.); (L.T.); (C.J.M.R.); (S.M.); (A.S.); (J.J.); (J.D.V.)
| | - Stephanie Perez
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (Z.C.-W.); (W.A.C.); (Y.L.); (S.P.); (L.T.); (C.J.M.R.); (S.M.); (A.S.); (J.J.); (J.D.V.)
| | - Lauren Turner
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (Z.C.-W.); (W.A.C.); (Y.L.); (S.P.); (L.T.); (C.J.M.R.); (S.M.); (A.S.); (J.J.); (J.D.V.)
| | - Carolyn Jennifer Marentes Ruiz
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (Z.C.-W.); (W.A.C.); (Y.L.); (S.P.); (L.T.); (C.J.M.R.); (S.M.); (A.S.); (J.J.); (J.D.V.)
| | - Shirley Mendieta
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (Z.C.-W.); (W.A.C.); (Y.L.); (S.P.); (L.T.); (C.J.M.R.); (S.M.); (A.S.); (J.J.); (J.D.V.)
| | - Adam Skura
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (Z.C.-W.); (W.A.C.); (Y.L.); (S.P.); (L.T.); (C.J.M.R.); (S.M.); (A.S.); (J.J.); (J.D.V.)
| | - Jaycee Jumarang
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (Z.C.-W.); (W.A.C.); (Y.L.); (S.P.); (L.T.); (C.J.M.R.); (S.M.); (A.S.); (J.J.); (J.D.V.)
| | - Jennifer Del Valle
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (Z.C.-W.); (W.A.C.); (Y.L.); (S.P.); (L.T.); (C.J.M.R.); (S.M.); (A.S.); (J.J.); (J.D.V.)
| | - John Kubale
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (J.K.); (A.G.)
| | - Emma Kaitlynn Allen
- Department of Immunology, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA; (E.K.A.); (P.G.T.)
| | - Paul G. Thomas
- Department of Immunology, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA; (E.K.A.); (P.G.T.)
| | - Aubree Gordon
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (J.K.); (A.G.)
| | - Pia S. Pannaraj
- Division of Infectious Diseases, Children’s Hospital Los Angeles, Los Angeles, CA 90027, USA; (Z.C.-W.); (W.A.C.); (Y.L.); (S.P.); (L.T.); (C.J.M.R.); (S.M.); (A.S.); (J.J.); (J.D.V.)
- Department of Pediatrics and Molecular Microbiology and Immunology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
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7
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Goldberg Y, Mandel M, Woodbridge Y, Fluss R, Novikov I, Yaari R, Ziv A, Freedman L, Huppert A. Similarity of Protection Conferred by Previous SARS-CoV-2 Infection and by BNT162b2 Vaccine: A 3-Month Nationwide Experience From Israel. Am J Epidemiol 2022; 191:1420-1428. [PMID: 35355048 PMCID: PMC8992290 DOI: 10.1093/aje/kwac060] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 03/01/2022] [Accepted: 03/25/2022] [Indexed: 01/28/2023] Open
Abstract
The worldwide shortage of vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection while the pandemic still remains uncontrolled has led many countries to the dilemma of whether or not to vaccinate previously infected persons. Understanding the level of protection conferred by previous infection compared with that of vaccination is important for policy-making. We analyzed an updated individual-level database of the entire population of Israel to assess the protection provided by both prior infection and vaccination in preventing subsequent SARS-CoV-2 infection, hospitalization with coronavirus disease 2019 (COVID-19), severe disease, and death due to COVID-19. Outcome data were collected from December 20, 2020, to March 20, 2021. Vaccination was highly protective, with overall estimated effectiveness of 94.5% (95% confidence interval (CI): 94.3, 94.7) for documented infection, 95.8% (95% CI: 95.2, 96.2) for hospitalization, 96.3% (95% CI: 95.7, 96.9) for severe illness, and 96.0% (95% CI: 94.9, 96.9) for death. Similarly, the overall estimated level of protection provided by prior SARS-CoV-2 infection was 94.8% (95% CI: 94.4, 95.1) for documented infection, 94.1% (95% CI: 91.9, 95.7) for hospitalization, and 96.4% (95% CI: 92.5, 98.3) for severe illness. Our results should be considered by policy-makers when deciding whether or not to prioritize vaccination of previously infected adults.
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Affiliation(s)
- Yair Goldberg
- Correspondence Address: Correspondence to Dr. Yair Goldberg, Faculty of Industrial Engineering and Management, Technion - Israel Institute of Technology, Haifa, Israel 3200003. (E-mail: )
| | | | - Yonatan Woodbridge
- The Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Israel
| | - Ronen Fluss
- The Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Israel
| | - Ilya Novikov
- The Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Israel
| | - Rami Yaari
- The Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Israel
| | - Arnona Ziv
- The Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Israel
| | - Laurence Freedman
- The Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Israel
| | - Amit Huppert
- The Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Israel,The Sackler Faculty of Medicine, Tel Aviv University, Israel
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8
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Davies MA, Kassanjee R, Rosseau P, Morden E, Johnson L, Solomon W, Hsiao NY, Hussey H, Meintjes G, Paleker M, Jacobs T, Raubenheimer P, Heekes A, Dane P, Bam JL, Smith M, Preiser W, Pienaar D, Mendelson M, Naude J, Schrueder N, Mnguni A, Roux SL, Murie K, Prozesky H, Mahomed H, Rossouw L, Wasserman S, Maughan D, Boloko L, Smith B, Taljaard J, Symons G, Ntusi N, Parker A, Wolter N, Jassat W, Cohen C, Lessells R, Wilkinson RJ, Arendse J, Kariem S, Moodley M, Vallabhjee K, Wolmarans M, Cloete K, Boulle A. Outcomes of laboratory-confirmed SARS-CoV-2 infection in the Omicron-driven fourth wave compared with previous waves in the Western Cape Province, South Africa. medRxiv 2022:2022.01.12.22269148. [PMID: 35043121 PMCID: PMC8764730 DOI: 10.1101/2022.01.12.22269148] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES We aimed to compare COVID-19 outcomes in the Omicron-driven fourth wave with prior waves in the Western Cape, the contribution of undiagnosed prior infection to differences in outcomes in a context of high seroprevalence due to prior infection, and whether protection against severe disease conferred by prior infection and/or vaccination was maintained. METHODS In this cohort study, we included public sector patients aged ≥20 years with a laboratory confirmed COVID-19 diagnosis between 14 November-11 December 2021 (wave four) and equivalent prior wave periods. We compared the risk between waves of the following outcomes using Cox regression: death, severe hospitalization or death and any hospitalization or death (all ≤14 days after diagnosis) adjusted for age, sex, comorbidities, geography, vaccination and prior infection. RESULTS We included 5,144 patients from wave four and 11,609 from prior waves. Risk of all outcomes was lower in wave four compared to the Delta-driven wave three (adjusted Hazard Ratio (aHR) [95% confidence interval (CI)] for death 0.27 [0.19; 0.38]. Risk reduction was lower when adjusting for vaccination and prior diagnosed infection (aHR:0.41, 95% CI: 0.29; 0.59) and reduced further when accounting for unascertained prior infections (aHR: 0.72). Vaccine protection was maintained in wave four (aHR for outcome of death: 0.24; 95% CI: 0.10; 0.58). CONCLUSIONS In the Omicron-driven wave, severe COVID-19 outcomes were reduced mostly due to protection conferred by prior infection and/or vaccination, but intrinsically reduced virulence may account for an approximately 25% reduced risk of severe hospitalization or death compared to Delta.
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Affiliation(s)
- Mary-Ann Davies
- Health Intelligence, Western Cape Government: Health, South Africa
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, South Africa
- Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town
| | - Reshma Kassanjee
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, South Africa
| | | | - Erna Morden
- Health Intelligence, Western Cape Government: Health, South Africa
- Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town
| | - Leigh Johnson
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, South Africa
| | | | - Nei-Yuan Hsiao
- Division of Medical Virology, University of Cape Town, Cape Town, Western Cape, South Africa
- National Health Laboratory Service, South Africa
| | - Hannah Hussey
- Health Intelligence, Western Cape Government: Health, South Africa
- Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town
| | - Graeme Meintjes
- Groote Schuur Hospital, Western Cape Government: Health
- Department of Medicine, University of Cape Town
| | - Masudah Paleker
- Health Intelligence, Western Cape Government: Health, South Africa
- Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University
| | - Theuns Jacobs
- Health Intelligence, Western Cape Government: Health, South Africa
| | - Peter Raubenheimer
- Groote Schuur Hospital, Western Cape Government: Health
- Department of Medicine, University of Cape Town
| | - Alexa Heekes
- Health Intelligence, Western Cape Government: Health, South Africa
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, South Africa
| | - Pierre Dane
- Health Intelligence, Western Cape Government: Health, South Africa
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, South Africa
| | - Jamy-Lee Bam
- Health Intelligence, Western Cape Government: Health, South Africa
| | - Mariette Smith
- Health Intelligence, Western Cape Government: Health, South Africa
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, South Africa
| | - Wolfgang Preiser
- National Health Laboratory Service, South Africa
- Division of Medical Virology, University of Stellenbosch, South Africa
| | - David Pienaar
- Rural Health Services, Western Cape Government: Health
| | - Marc Mendelson
- Groote Schuur Hospital, Western Cape Government: Health
- Department of Medicine, University of Cape Town
| | - Jonathan Naude
- Mitchells Plain Hospital, Western Cape Government: Health
| | - Neshaad Schrueder
- Tygerberg Hospital, Western Cape Government: Health
- Department of Medicine, Stellenbosch University, South Africa
| | - Ayanda Mnguni
- Khayelitsha District Hospital, Western Cape Government: Health
| | - Sue Le Roux
- Groote Schuur Hospital, Western Cape Government: Health
- Department of Medicine, University of Cape Town
| | - Katie Murie
- Western Cape Government: Health, South Africa
| | - Hans Prozesky
- Tygerberg Hospital, Western Cape Government: Health
- Department of Medicine, Stellenbosch University, South Africa
| | - Hassan Mahomed
- Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University
- Metro Health Services, Western Cape Government: Health
| | | | - Sean Wasserman
- Groote Schuur Hospital, Western Cape Government: Health
- Department of Medicine, University of Cape Town
| | - Deborah Maughan
- Groote Schuur Hospital, Western Cape Government: Health
- Department of Medicine, University of Cape Town
| | - Linda Boloko
- Groote Schuur Hospital, Western Cape Government: Health
- Department of Medicine, University of Cape Town
| | - Barry Smith
- Groote Schuur Hospital, Western Cape Government: Health
- Department of Medicine, University of Cape Town
| | - Jantjie Taljaard
- Tygerberg Hospital, Western Cape Government: Health
- Department of Medicine, Stellenbosch University, South Africa
| | - Greg Symons
- Groote Schuur Hospital, Western Cape Government: Health
- Department of Medicine, University of Cape Town
| | - Ntobeko Ntusi
- Groote Schuur Hospital, Western Cape Government: Health
- Department of Medicine, University of Cape Town
| | - Arifa Parker
- Tygerberg Hospital, Western Cape Government: Health
- Department of Medicine, Stellenbosch University, South Africa
| | - Nicole Wolter
- National Institute for Communicable Diseases, National Health Laboratory Service, South Africa
| | - Waasila Jassat
- National Institute for Communicable Diseases, National Health Laboratory Service, South Africa
| | - Cheryl Cohen
- National Institute for Communicable Diseases, National Health Laboratory Service, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Richard Lessells
- KwaZulu-Natal Research, Innovation & Sequencing Platform, University of KwaZulu-Natal, Durban, South Africa
| | - Robert J Wilkinson
- The Francis Crick Institute, Midland Road, London, NW1 1AT, UK
- Department of Infectious Diseases, Imperial College London, W12 0NN, UK
| | | | | | - Melvin Moodley
- Health Intelligence, Western Cape Government: Health, South Africa
| | | | | | | | - Andrew Boulle
- Health Intelligence, Western Cape Government: Health, South Africa
- Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, South Africa
- Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town
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9
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Gelanew T, Mulu A, Abebe M, Bates TA, Wassie L, Tefer M, Fentahun D, Alemu A, Tamiru F, Assefa G, Bayih AG, Taffesse FG, Mihret A, Abdissa A. A single dose ChAdOx1 nCoV-19 vaccine elicits high antibody responses in individuals with prior SARS-CoV-2 infection comparable to that of double dose vaccinated SARS-CoV-2 infection naïve individuals. Res Sq 2022:rs.3.rs-1250175. [PMID: 35043108 PMCID: PMC8764722 DOI: 10.21203/rs.3.rs-1250175/v1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Background A single dose COVID-19 vaccines, mostly mRNA-based vaccines, are shown to induce robust antibody responses in individuals who were previously infected with SARS-CoV-2, suggesting the sufficiency of a single dose to those individuals. However, these important data are limited to developed nations and lacking in resource-limited countries, like Ethiopia. Methods We compared receptor-binding domain (RBD)-specific IgG antibodies in 40 SARS-CoV-2 naïve participants and 25 participants previously infected with SARS-CoV-2, who received two doses of ChAdOx1 nCoV-19 vaccine. We measured the antibody response in post-vaccination blood samples from both groups of participants collected at four different post-vaccination time points: 8- and 12-weeks after each dose of the vaccine administration using an in-house developed ELISA. Results We observed a high level of anti-RBD IgG antibodies titers 8-weeks after a single dose administration (16/27; 59.3%) among naïve participants, albeit dropped significantly (p<0.05) two months later, suggesting the protective immunity elicited by the first dose ChAdOx1 nCoV-19 vaccine will likely last for a minimum of three months. However, as expected, a significant (p<0.001) increase in the level of anti-RBD IgG antibodies titers was observed after the second dose administration in all naïve participants. By contrast, the ChAdOx1 nCoV-19 vaccine-induced anti-RBD IgG antibody titers produced by the P.I participants at 8- to 12-weeks post-single dose vaccination were found to be similar to the antibody titers seen after a two-dose vaccination course among infection- naïve participants and showed no significant (p>0.05) increment following the second dose administration. Conclusion Taken together, our findings show that a single ChAdOx1 nCoV-19 dose in previously SARS-CoV-2 infected individuals elicits similar antibody responses to that of double dose vaccinated naïve individuals. Age and sex were not associated with the level of vaccine-elicited immune responses in both individuals with and without prior SARS-CoV-2 infection. Further studies are required to assess the need for a booster dose to extend the duration and amplitude of the specific protective immune response in Ethiopia settings, especially following the Omicron pandemic.
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Affiliation(s)
- Tesfaye Gelanew
- Armauer Hansen Research Institute, P.O. Box: 1005, Jimma Road, ALERT campus, Addis Ababa, Ethiopia
| | - Andargachew Mulu
- Armauer Hansen Research Institute, P.O. Box: 1005, Jimma Road, ALERT campus, Addis Ababa, Ethiopia
| | - Markos Abebe
- Armauer Hansen Research Institute, P.O. Box: 1005, Jimma Road, ALERT campus, Addis Ababa, Ethiopia
| | - Timothy A Bates
- Department of Molecular Microbiology & Immunology, Oregon Health & Sciences University, OR, USA
| | - Liya Wassie
- Armauer Hansen Research Institute, P.O. Box: 1005, Jimma Road, ALERT campus, Addis Ababa, Ethiopia
| | - Mekonnen Tefer
- Armauer Hansen Research Institute, P.O. Box: 1005, Jimma Road, ALERT campus, Addis Ababa, Ethiopia
| | - Desalegn Fentahun
- Armauer Hansen Research Institute, P.O. Box: 1005, Jimma Road, ALERT campus, Addis Ababa, Ethiopia
| | - Aynalem Alemu
- Armauer Hansen Research Institute, P.O. Box: 1005, Jimma Road, ALERT campus, Addis Ababa, Ethiopia
| | - Frehiwot Tamiru
- Armauer Hansen Research Institute, P.O. Box: 1005, Jimma Road, ALERT campus, Addis Ababa, Ethiopia
| | - Gebeyehu Assefa
- Armauer Hansen Research Institute, P.O. Box: 1005, Jimma Road, ALERT campus, Addis Ababa, Ethiopia
| | - Abebe Genetu Bayih
- Armauer Hansen Research Institute, P.O. Box: 1005, Jimma Road, ALERT campus, Addis Ababa, Ethiopia
| | - Fikadu G Taffesse
- Department of Molecular Microbiology & Immunology, Oregon Health & Sciences University, OR, USA
| | - Adane Mihret
- Armauer Hansen Research Institute, P.O. Box: 1005, Jimma Road, ALERT campus, Addis Ababa, Ethiopia
| | - Alemseged Abdissa
- Armauer Hansen Research Institute, P.O. Box: 1005, Jimma Road, ALERT campus, Addis Ababa, Ethiopia
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10
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Abstract
We systematically reviewed studies to estimate the risk of SARS-CoV-2 reinfection among those previously infected with SARS-CoV-2. For this systematic review, we searched scientific publications on PubMed and MedRxiv, a pre-print server, through August 18, 2021. Eligible studies were retrieved on August 18, 2021. The following search term was used on PubMed: ((("Cohort Studies"[Majr]) AND ("COVID-19"[Mesh] OR "SARS-CoV-2"[Mesh])) OR "Reinfection"[Majr]) OR "Reinfection"[Mesh]. The following search term was used on MedRxiv: "Cohort Studies" AND "COVID-19" OR "SARS-CoV-2" AND "Reinfection". The search terms were broad to encompass all applicable studies. There were no restrictions on the date of publication. Studies that did not describe cohorts with estimates of the risk of SARS-CoV-2 reinfection among those with previous infection were excluded. Studies that included vaccinated participants were either excluded or limited to sub-groups of non-vaccinated individuals. To identify relevant studies with appropriate control groups, we developed the following criteria for studies to be included in the systematic analysis: (1) baseline polymerase chain reaction (PCR) testing, (2) a uninfected comparison group, (3) longitudinal follow-up, (4) a cohort of human participants, i.e. not a case report or case series, and (5) outcome determined by PCR. The review was conducted following PRISMA guidelines. We assessed for selection, information, and analysis bias, per PRISMA guidelines. We identified 1,392 reports. Of those, 10 studies were eligible for our systematic review. The weighted average risk reduction against reinfection was 90.4% with a standard deviation of 7.7% (p-value: <0.01). Protection against SARS-CoV-2 reinfection was observed for up to 10 months. Studies had potential information, selection, and analysis biases. The protective effect of prior SARS-CoV-2 infection on re-infection is high and similar to the protective effect of vaccination. More research is needed to characterize the duration of protection and the impact of different SARS-CoV-2 variants.
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Affiliation(s)
- N. Kojima
- Department of Medicine, University of California Los
Angeles, CA, USA
| | - N. K. Shrestha
- Department of Infectious Diseases, Cleveland Clinic, OH,
USA
| | - J. D. Klausner
- Departments of Medicine and Population and Public Health
Sciences and the COVID-19 Pandemic Research Center, USC, Keck School of
Medicine, University Southern California, Los Angeles, CA, USA
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11
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Zhang C, Guo Z, Li N, Cui H, Meng K, Liu L, Zhao L, Zhang S, Qin C, Liu J, Gao Y, Zhang C. Impact of Prior Infection on Severe Acute Respiratory Syndrome Coronavirus 2 Transmission in Syrian Hamsters. Front Microbiol 2021; 12:722178. [PMID: 34447364 PMCID: PMC8383181 DOI: 10.3389/fmicb.2021.722178] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 07/16/2021] [Indexed: 11/16/2022] Open
Abstract
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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Affiliation(s)
- Cheng Zhang
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
- College of Veterinary Medicine, Hebei Agricultural University, Baoding, China
| | - Zhendong Guo
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
| | - Nan Li
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
| | - Huan Cui
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
- College of Veterinary Medicine, Jilin University, Changchun, China
| | - Keyin Meng
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
| | - Lina Liu
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
| | - Li Zhao
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
| | - Shanshan Zhang
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
| | - Chengfeng Qin
- Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Juxiang Liu
- College of Veterinary Medicine, Hebei Agricultural University, Baoding, China
| | - Yuwei Gao
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
| | - Chunmao Zhang
- Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, China
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