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. 2023 Jan 12:10:1040012.
doi: 10.3389/fpubh.2022.1040012. eCollection 2022.

SARS-CoV-2 breakthrough infections during the second wave of COVID-19 at Pune, India

Prakash P Doke  1 , Suhas T Mhaske  2 , Gauri Oka  1 , Ruta Kulkarni  2 , Vrishali Muley  3 , Akhilesh Chandra Mishra  2 , Vidya A Arankalle  2
Affiliations

SARS-CoV-2 breakthrough infections during the second wave of COVID-19 at Pune, India

Prakash P Doke et al. Front Public Health. .

Abstract

Breakthrough infections following SARS-CoV-2 vaccination remain the global concern. The current study was conducted during the second wave of COVID-19 (1st March-7th July 2021) in Pune, India, at two tertiary care hospitals. Of the 6,159 patients diagnosed as COVID-19, 372/2,210 (16.8%) were breakthrough infections. Of these, 81.1 and 18.8% received one or two doses of Covishield or Covaxin, respectively. Of note, 30.7% patients were with comorbidities, hypertension being the commonest (12.44%). The majority of infections were mild (81.2%). Forty-three patients with breakthrough infections were hospitalized with severe (n = 27, 62.8%) or moderate (n = 16, 37.2%) disease. The receptor binding domain (RBD) sequences from vaccinated (n = 126) and non-vaccinated (n = 168) samples were used for variant analysis. The delta variant was predominant followed by kappa in both vaccinated and non-vaccinated groups. Viral load (qRT-PCR) was not different among these categories. Full-genome comparisons of sequences in relation to vaccination status did not identify any mutation characteristic of the vaccinated group. Irrespective of the number of doses, neutralizing antibody titers (PRNT50) during the first week of clinical disease were higher in the vaccinated patients than the unvaccinated category. In conclusion, though not completely, SARS-CoV-2 vaccines used for country-wide immunization did reduce disease severity among the individuals without any comorbidity by inducing rapid immune response against distinctly different delta and kappa variants. The utility against emerging variants with further mutations need to be carefully examined.

Keywords: COVID-19; SARS-CoV-2; breakthrough infection; neutralizing antibodies; vaccination; variants.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Comparison of Ct values for (A) E gene and (B) RdRp gene of SARS-CoV-2 in vaccinated and non-vaccinated COVID-19 patients. NS, non significant.
Figure 2
Figure 2
PRNT50 titer in breakthrough infection (1 or 2 doses of vaccine) and non-vaccinated individual. ***Denotes high statistical significance with P value < 0.0001, NS denotes statistically non significant.
See this image and copyright information in PMC

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