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. 2023 Jun:131:100-110.
doi: 10.1016/j.ijid.2023.01.006. Epub 2023 Jan 24.

Susceptibility to reinfection with SARS-CoV-2 virus relative to existing antibody concentrations and T cell response

Shereen Atef  1 , Farida Al Hosani  2 , Laila AbdelWareth  3 , Rami H Al-Rifai  4 , Rowan Abuyadek  5 , Andrea Jabari  6 , Raghib Ali  7 , Basel Altrabulsi  3 , Susanna Dunachie  8 , Adnan Alatoom  3 , James G Donnelly  9
Affiliations

Susceptibility to reinfection with SARS-CoV-2 virus relative to existing antibody concentrations and T cell response

Shereen Atef et al. Int J Infect Dis. 2023 Jun.

Abstract

Objectives: We investigated the reinfection rate of vaccinated or convalescent immunized SARS-CoV-2 in 952 expatriate workers with SARS-CoV-2 serological antibody (Ab) patterns and surrogate T cell memory at recruitment and follow-up.

Methods: Trimeric spike, nucleocapsid, and neutralizing Abs were measured, along with a T cell stimulation assay, targeting SARS-CoV-2 memory in clusters of differentiation (CD) 4+ and CD8+ T cells. The subjects were then followed up for reinfection for up to 6 months.

Results: The seroprevalence positivity at enrollment was greater than 99%. The T cell reactivity in this population was 38.2%. Of the 149 (15.9%) participants that were reinfected during the follow-up period (74.3%) had nonreactive T cells at enrollment. Those who had greater than 100 binding Ab units/ml increase from the median concentration of antispike immunoglobulin G Abs had a 6% reduction in the risk of infection. Those who were below the median concentration had a 78% greater risk of infection.

Conclusion: Significant immune protection from reinfection was observed in those who retained T cell activation memory. Additional protection was observed when the antispike was greater than the median value.

Keywords: Neutralizing antibodies; Reinfection; SARS-CoV-2 immunocompetence; Seroprevalence; Spike and receptor binding protein antibodies; T cell response.

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Conflict of interest statement

Declaration of competing interest The authors have no competing interests to declare.

Figures

Figure 1
Figure 1
Flowchart of study population included in this study a Either left the country, moved to different camps, or possibly were deceased or where on annual leave, offsite, or on-duty during the scheduled survey date (n = 63). b Eleven cases had no information on their PCR testing results during the follow-up, possibly they just left their workplace after the survey. PCR, polymerase chain reaction.
Figures 2
Figures 2
Matrix scatterplot - correlation between the three measured sero-biomarkers (anti-S IgG, anti-N IgG, and neutralizing IgG antibodies) (a) and by T cells reactivity (b): with reactive T cells, (c): with no reactive T cells) at enrollment. Ig, immunoglobulin; N, nucleocapsid; S, spike.
Figure 3
Figure 3
Survival probability for not contracting SARS-CoV-2 during the follow-up. PCR, polymerase chain reaction.
Figure 4
Figure 4
Distribution of antispike IgG, anti-N IgG, and neutralizing IgG antibodies at enrollment by infection with SARS-CoV-2 during the follow-up. P-values retrieved from the non-parametric Mann-Whitney U test. Ig, immunoglobulin; N, nucleocapsid; PCR, polymerase chain reaction.
See this image and copyright information in PMC

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