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Comment
. 2023 Feb;23(2):153-154.
doi: 10.1016/S1473-3099(23)00001-4. Epub 2023 Jan 11.

Tracking immune correlates of protection for emerging SARS-CoV-2 variants

Eric J Nilles  1 , Cecilia Then Paulino  2 , Michael de St Aubin  3 , William Duke  4 , Petr Jarolim  5 , Isaac Miguel Sanchez  2 , Kristy O Murray  6 , Colleen L Lau  7 , Emily Zielinski Gutiérrez  8 , Ronald Skewes Ramm  2 , Marietta Vasquez  9 , Adam Kucharski  10
Affiliations
Comment

Tracking immune correlates of protection for emerging SARS-CoV-2 variants

Eric J Nilles et al. Lancet Infect Dis. 2023 Feb.
No abstract available

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Conflict of interest statement

EJN is the Principal Investigator on a US Centers for Disease Control and Prevention (CDC)-funded U01 award that funded the study, and CLL, AK, MdSA, WD, and MV have received salary support, consultancy fees, or travel paid through this award. EZG is an employee of the US CDC. CTP, IMS, and RSR are employees of the Ministry of Health and Social Assistance, Dominican Republic, that was subcontracted with funds from the US CDC award. AK is supported by the Wellcome Trust, UK. PJ and KOM declare no competing interests. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US CDC.

Figures

Figure
Figure
Correlates of protection for symptomatic SARS-CoV-2 infection by variants of concern The plots show binomial generalised additive model covariate adjusted relative risk for real-time PCR (rtPCR) positive test by antibody marker level and stratified by variant of concern. (A) Relative risk of infection scaled to a reference value of 0·79 BAU/mL (manufacturer-defined positive cutoff index of 0·80 BAU/mL). The blue line indicates the regression point estimate with gray shading representing the 95% CI. The horizontal black dashed line indicates 0·25 relative risk and vertical black arrow the total anti-spike value at the 0·25 relative risk intercept, corresponding to an estimated 75% protection against the respective variant. To control for variable risk of pathogen exposure across the study population, covariates that are or might be associated with exposure were included in the model, including age, sex, month of sample collection, number of COVID-19 vaccine doses, days since last vaccine dose, urban versus rural setting, study site, and number of household residents. Given the non-linear relationship between log transformed antibody titre and risk of infection, the antibody titre covariate was modelled using two degrees of freedom. Case samples used in the models were all collected <5 days after symptom onset and were sequence-confirmed except BA.1, which includes all rtPCR-positive cases during the clearly delineated phase of BA.1 transmission. The number of rtPCR-positive/negative study participants per plot are 42/394 (mu), 84/474 (delta), 54/423 (BA.1), 17/288 (BA.2), and 19/288 (BA.4/5). (B) Plots represent the same generalised additive models, but risk of infection is referenced to a total anti-spike antibody titre of 500 BAU/mL. Unadjusted anti-spike antibody levels by rtPCR result and variant are shown in the appendix (p 3). BAU=binding antibody units.
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References

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Supplementary concepts