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. 2021 Jan:102:577-583.
doi: 10.1016/j.ijid.2020.10.104. Epub 2020 Nov 8.

High prevalence of pre-existing serological cross-reactivity against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in sub-Saharan Africa

For Yue Tso  1 , Salum J Lidenge  2 , Phoebe B Peña  1 , Ashley A Clegg  1 , John R Ngowi  3 , Julius Mwaiselage  4 , Owen Ngalamika  5 , Peter Julius  6 , John T West  7 , Charles Wood  8
Affiliations

High prevalence of pre-existing serological cross-reactivity against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in sub-Saharan Africa

For Yue Tso et al. Int J Infect Dis. 2021 Jan.

Abstract

Objective: Significant morbidity and mortality have occurred in the USA, Europe, and Asia due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), whereas the numbers of infections and deaths in sub-Saharan Africa (SSA) have remained comparatively low. It has been hypothesized that exposure of the population in SSA to other coronaviruses prior to the COVID-19 pandemic resulted in some degree of cross-protection against SARS-CoV-2 infection and pathogenesis. We evaluated this hypothesis by comparing SARS-CoV-2 cross-reactive antibodies in pre-pandemic plasma samples collected from SSA and the USA.

Method: Pre-COVID-19 pandemic plasma samples from SSA and the USA were collected and tested by immunofluorescence assay against the spike and nucleocapsid proteins of all known human coronaviruses (HCoVs).

Results: The prevalence of SARS-CoV-2 serological cross-reactivity was significantly higher in samples from SSA compared with the USA. Most of these cross-reactive samples cross-recognized the SARS-CoV-2 nucleocapsid protein and the spike proteins of other HCoVs. Nucleocapsid proteins from HCoV-NL63 and HCoV-229E were detected in most samples, thereby implicating prior exposure to these two HCoVs as the likely source of cross-reactive antibodies against SARS-CoV-2.

Conclusion: The low incidences of SARS-CoV-2 infection and disease in SSA appear to be correlated with the pre-pandemic serological cross-recognition of HCoVs, which are substantially more prevalent in SSA than the USA.

Keywords: COVID-19; Cross-reactivity; HCoV-229E; HCoV-NL63; Human coronavirus; SARS-CoV-2; Serology; Sub-Saharan Africa.

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Figures

Figure 1
Figure 1
IFA against either mock, SARS-CoV-2 spike, or nucleocapsid expressing cells. Representative images are shown for IFA with negative control plasma, COVID-19 convalescence plasma (positive control), and pre-COVID-19 pandemic cross-reactive plasma samples 21928 and 21933. Sample 21928 exhibited cross-reactivity against SARS-CoV-2 spike, but not its respective mock and SARS-CoV-2 nucleocapsid. Sample 21933 exhibited cross-reactivity against SARS-CoV-2 nucleocapsid, but not its respective mock and SARS-CoV-2 spike. White arrows indicate positive cells. Scale bar represent 50 μm.
Figure 2
Figure 2
Percentage prevalence of serological cross-reactivity against SARS-CoV-2 in Tanzania, Zambia, and the USA. (A) Combined serological cross-reactivity against SARS-CoV-2 spike and nucleocapsid. (B) Serological cross-reactivity against SARS-CoV-2 nucleocapsid. (C) Serological cross-reactivity against SARS-CoV-2 spike.
Figure 3
Figure 3
IFA against SARS, MERS, HCoV-OC43, HCoV-HKU-1, HCoV-NL63, and HCoV-229E spike or nucleocapsid expressing cells. Representative images are shown of IFA with pre-COVID-19 pandemic cross-reactive plasma sample 21854. Sample 21854 strongly recognized the spike proteins of HCoV-OC43, HCoV-HKU-1, HCoV-NL63, and HCoV-229E, but not those of SARS and MERS. Sample 21854 only recognized the nucleocapsid of HCoV-NL63 but not those of the other human coronaviruses. White arrows indicate positive cells. Scale bar represent 50 μm.
Figure 4
Figure 4
Percentage prevalence of serological cross-reactivity against SARS, MERS, HCoV-OC43, HCoV-HKU-1, HCoV-NL63, and HCoV-229E. (A) Spike. (B) Nucleocapsid.
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