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. 2023 Nov 3;23(1):757.
doi: 10.1186/s12879-023-08763-2.

Symptomatic MERS-CoV infection reduces the risk of future COVID-19 disease; a retrospective cohort study

Aiman El-Saed  1   2   3 , Fatmah Othman  3   4 , Henry Baffoe-Bonnie  1 , Rawabi Almulhem  1 , Muayed Matalqah  1 , Latifah Alshammari  5 , Majid M Alshamrani  6   7   8
Affiliations

Symptomatic MERS-CoV infection reduces the risk of future COVID-19 disease; a retrospective cohort study

Aiman El-Saed et al. BMC Infect Dis. .

Abstract

Background: The general human immune responses similarity against different coronaviruses may reflect some degree of cross-immunity, whereby exposure to one coronavirus may confer partial immunity to another. The aim was to determine whether previous MERS-CoV infection was associated with a lower risk of subsequent COVID-19 disease and its related outcomes.

Methods: We conducted a retrospective cohort study among all patients screened for MERS-CoV at a tertiary care hospital in Saudi Arabia between 2012 and early 2020. Both MERS-CoV positive and negative patients were followed up from early 2020 to September 2021 for developing COVID-19 infection confirmed by RT-PCR testing.

Results: A total of 397 participants followed for an average 15 months during COVID-19 pandemic (4.9 years from MERS-CoV infection). Of the 397 participants, 93 (23.4%) were positive for MERS-CoV at baseline; 61 (65.6%) of the positive cases were symptomatic. Out of 397, 48 (12.1%) participants developed COVID-19 by the end of the follow-up period. Cox regression analysis adjusted for age, gender, and major comorbidity showed a marginally significant lower risk of COVID-19 disease (hazard ratio = 0.533, p = 0.085) and hospital admission (hazard ratio = 0.411, p = 0.061) in patients with positive MERS-CoV. Additionally, the risk of COVID-19 disease was further reduced and became significant in patients with symptomatic MERS-CoV infection (hazard ratio = 0.324, p = 0.034) and hospital admission (hazard ratio = 0.317, p = 0.042).

Conclusions: The current findings may indicate a partial cross-immunity, where patients with symptomatic MERS-CoV have a lower risk of future COVID-19 infection and related hospitalization. The present results may need further examination nationally using immunity markers.

Keywords: COVID-19; Cross-immunity; Cross-protection; MERS-CoV; Saudi Arabia.

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Conflict of interest statement

All authors have no known competing financial interests or personal relationships that could have influenced the work reported in this paper.

Figures

Fig. 1
Fig. 1
Diagram of developing COVID-19 infection by MERS-CoV status
Fig. 2
Fig. 2
Incidence of the study outcomes per 1000 patient years at the end of follow up period by baseline MERS-CoV status
Fig. 3
Fig. 3
Adjusted Cox regression analysis of COVID-19 free survival at the end of follow up period by baseline MERS-CoV status*Adjusted for age at COVID, gender, and major comorbidity (hypertension, diabetes, heart diseases, lung diseases, and renal disease/hemodialysis)
See this image and copyright information in PMC

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