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Reinfection with SARS-CoV-2 and Failure of Humoral Immunity: a case report.

ABSTRACT: Recovery from COVID-19 is associated with production of anti-SARS-CoV-2 antibodies, but it is uncertain whether these confer immunity. We describe viral RNA shedding duration in hospitalized patients and identify patients with recurrent shedding. We sequenced viruses from two distinct episodes of symptomatic COVID-19 separated by 144 days in a single patient, to conclusively describe reinfection with a new strain harboring the spike variant D614G. With antibody and B cell analytics, we show correlates of adaptive immunity, including a differential response to D614G. Finally, we discuss implications for vaccine programs and begin to define benchmarks for protection against reinfection from SARS-CoV-2.

SUBMITTER: Goldman JD

PROVIDER: S-EPMC7523175 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Reinfection with SARS-CoV-2 and Failure of Humoral Immunity: a case report.

Goldman Jason D JD Wang Kai K Röltgen Katharina K Nielsen Sandra C A SCA Roach Jared C JC Naccache Samia N SN Yang Fan F Wirz Oliver F OF Yost Kathryn E KE Lee Ji-Yeun JY Chun Kelly K Wrin Terri T Petropoulos Christos J CJ Lee Inyoul I Fallen Shannon S Manner Paula M PM Wallick Julie A JA Algren Heather A HA Murray Kim M KM Su Yapeng Y Hadlock Jennifer J Jeharajah Joshua J Berrington William R WR Pappas George P GP Nyatsatsang Sonam T ST Greninger Alexander L AL Satpathy Ansuman T AT Pauk John S JS Boyd Scott D SD Heath James R JR

medRxiv : the preprint server for health sciences 20200925

Recovery from COVID-19 is associated with production of anti-SARS-CoV-2 antibodies, but it is uncertain whether these confer immunity. We describe viral RNA shedding duration in hospitalized patients and identify patients with recurrent shedding. We sequenced viruses from two distinct episodes of symptomatic COVID-19 separated by 144 days in a single patient, to conclusively describe reinfection with a new strain harboring the spike variant D614G. With antibody and B cell analytics, we show corr ...[more]

PMID: 32995830

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Project description:IntroductionThere is robust evidence indicating that the SARS-CoV-2-specific humoral response is associated with protection against severe disease. However, relatively little data exist regarding how the humoral immune response at the time of hospital admission correlates with disease severity in unimmunized patients. Our goal was toidentify variables of the humoral response that could potentially serve as prognostic markers for COVID-19 progressionin unvaccinated SARS-CoV-2 patients.MethodsA prospective cross-sectional study was carried out in a cohort of 160 unimmunized, adult COVID-19 patients from the Hospital Universitario 12Octubre. Participants were classified into four clinical groups based on disease severity: non-survivors with respiratory failure (RF), RF survivors, patients requiring oxygen therapy and those not receiving oxygen therapy. Serum samples were taken on admission and IgM, IgG, IgG subclass antibody titers were determined by ELISA, and neutralizing antibody titersusing a surrogate neutralization assay. The differences in the antibody titers between groups and the association between the clinical and analytical characteristics of the patients and the antibody titers were analyzed.ResultsPatients that developed RF and survived had IgM titers that were 2-fold higher than non-survivors (p = 0.001), higher levels of total IgG than those who developed RF and succumbed to infection (p< 0.001), and than patients who required oxygen therapy (p< 0.05), and had 5-fold higher IgG1 titers than RF non-survivors (p< 0.001) and those who needed oxygen therapy (p< 0.001), and 2-fold higher than patients that did not require oxygen therapy during admission (p< 0.05). In contrast, RF non-survivorshad the lowest neutralizing antibodylevels, which were significantly lower compared those with RF that survived (p = 0.03). A positive correlation was found between IgM, total IgG, IgG1 and IgG3 titers and neutralizing antibody titers in the total cohort (p ≤ 0.0036).ConclusionsWe demonstrate that patients with RF that survived infection had significantly higher IgM, IgG, IgG1 and neutralizing titers compared to patients with RF that succumb to infection, suggesting that using humoral response variables could be used as a prognostic marker for guiding the clinical management of unimmunized patients admitted to the hospital for SARS-CoV-2 infection.

Dataset Information

Reinfection with SARS-CoV-2 and Failure of Humoral Immunity: a case report.

Publications

Reinfection with SARS-CoV-2 and Failure of Humoral Immunity: a case report.

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