Antibody correlates of protection from SARS-CoV-2 reinfection prior to vaccination: A nested case-control within the SIREN study. Issue 5 (November 2022)

• Record Type: Journal Article
• Authors: Atti, Ana; Insalata, Ferdinando; Carr, Edward J; Otter, Ashley D; Castillo-Olivares, Javier; Wu, Mary; Harvey, Ruth; Howell, Michael; Chan, Andrew; Lyall, Jonathan; Temperton, Nigel; Cantoni, Diego; da Costa, Kelly; Nadesalingam, Angalee; Taylor-Kerr, Andrew; Hettiarachchi, Nipunadi; Tranquillini, Caio; Hewson, Jacqueline; Cole, Michelle J; Foulkes, Sarah; Munro, Katie; Monk, Edward J M; Milligan, Iain D; Linley, Ezra; Chand, Meera A; Brown, Colin S; Islam, Jasmin; Semper, Amanda; Charlett, Andre; Heeney, Jonathan L; Beale, Rupert; Zambon, Maria; Hopkins, Susan; Brooks, Tim; Hall, Victoria;
• Is Part Of: Journal of infection. Volume 85:Issue 5(2022)
• Page Start: 545
• Page End: 556
• Publication Date: 2022-11
• Subjects: SARS-CoV-2 -- Neutralising antibodies -- SARS-CoV-2 serology -- Reinfection -- Immunity; Infection -- Periodicals; Bacterial Infections -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.905
• DOI: 10.1016/j.jinf.2022.09.004
• Languages: English
• ISSNs: 0163-4453

Abstract

Summary: Objectives: To investigate serological differences between SARS-CoV-2 reinfection cases and contemporary controls, to identify antibody correlates of protection against reinfection. Methods: We performed a case-control study, comparing reinfection cases with singly infected individuals pre-vaccination, matched by gender, age, region and timing of first infection. Serum samples were tested for anti-SARS-CoV-2 spike (anti-S), anti-SARS-CoV-2 nucleocapsid (anti-N), live virus microneutralisation (LV-N) and pseudovirus microneutralisation (PV-N). Results were analysed using fixed effect linear regression and fitted into conditional logistic regression models. Results: We identified 23 cases and 92 controls. First infections occurred before November 2020; reinfections occurred before February 2021, pre-vaccination. Anti-S levels, LV-N and PV-N titres were significantly lower among cases; no difference was found for anti-N levels. Increasing anti-S levels were associated with reduced risk of reinfection (OR 0·63, CI 0·47-0·85), but no association for anti-N levels (OR 0·88, CI 0·73-1·05). Titres >40 were correlated with protection against reinfection for LV-N Wuhan (OR 0·02, CI 0·001–0·31) and LV-N Alpha (OR 0·07, CI 0·009–0·62). For PV-N, titres >100 were associated with protection against Wuhan (OR 0·14, CI 0·03–0·64) and Alpha (0·06, CI 0·008–0·40). Conclusions: Before vaccination, protection against SARS-CoV-2 reinfection was directly correlated with anti-S levels, PV-N and LV-N titres, but not with anti-N levels. Detectable LV-N titres were sufficient for protection, whilst PV-N titres >100 were required for a protective effect. Trial registration number: ISRCTN11041050