A case of breakthrough infection with SARS-CoV-2 Delta derivative and reinfection with Omicron variant in a fully vaccinated health care professional

Pandit, Priyanka; Bhatt, Puneet; Sahay, Rima R.; Joshi, Yash B.; Patil, Deepak Y.; Yadav, Pragya D

doi:10.1016/j.jinf.2022.04.023

Cited by 3 publications

(4 citation statements)

References 10 publications

(11 reference statements)

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“…Consistent with the reported intervals between infection and re-infection, 46 days to 6 months ( 39 ), VX24 experienced a symptomatic reinfection during the Omicron wave two and half months after the BTI, which was supported by a 5.1-fold increase in NT 50 titers against the Omicron variant ( Figure 2B ). A recent study reported a Delta variant BTI followed by reinfection with the Omicron variant in a fully vaccinated healthcare worker ( 40 ); our study reports a similar case of BTI followed by reinfection in the community, which may reflect what was happening in the real world. Notably, the confirmation of the BA.1.1 and BA.1.1.2 subvariants in two BTIs on 12/20/2021 by whole genome sequencing was in agreement with reports of these subvariants during the initial phase of Omicron wave ( 2 ).…”

Section: Discussionsupporting

confidence: 67%

Identification of severe acute respiratory syndrome coronavirus 2 breakthrough infections by anti-nucleocapsid antibody among fully vaccinated non-healthcare workers during the transition from the delta to omicron wave

et al. 2022

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Uncontrolled transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to the emergence of several variants of concern (VOC). As vaccine-induced neutralizing antibodies against VOC waned over time, breakthrough infections (BTIs) have been reported primarily among healthcare workers or in long-term care facilities. Most BTIs were identified by reverse transcription-polymerase chain reaction (RT-PCR) or antigen test for individuals experiencing symptoms, known as symptomatic BTIs. In this study, we detected seroconversion of anti-nucleocapsid (N) antibody to identify both symptomatic and asymptomatic BTIs in a cohort of COVID-19-naive university employees and students following two or three doses of mRNA vaccines. We reported 4 BTIs among 85 (4.7%) participants caused by the Omicron and Delta VOC during the transition from the Delta to Omicron wave of the pandemic; three were symptomatic and confirmed by RT-PCR test and one asymptomatic. A symptomatic reinfection two and half months after a BTI was found in one participant. Two of three symptomatic BTIs and the reinfection were confirmed by whole genome sequencing. All were supported by a >4-fold increase in neutralizing antibodies against the Delta or Omicron variant. Moreover, we found both symptomatic and asymptomatic BTIs can boost neutralizing antibodies against VOC with variable degrees ranging from 2.5- to 77.4-fold increase in neutralizing antibody titers. As BTIs continue, our findings highlight the application of anti-N antibody test to ongoing studies of immunity induced by spike-based vaccine, and provide new insights into the establishment of herd immunity in the community during the post-vaccination era.

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Section: Discussionsupporting

confidence: 67%

Identification of severe acute respiratory syndrome coronavirus 2 breakthrough infections by anti-nucleocapsid antibody among fully vaccinated non-healthcare workers during the transition from the delta to omicron wave

et al. 2022

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“…A recent study demonstrated that Omicron BA.2 variant is 30% and 17-fold more capable than BA.1 and Delta, respectively, to escape current vaccines ( 41 ). Recently, a case of a breakthrough infection was reported with Delta derivative (AY.112) despite the hybrid immunity followed by reinfection with Omicron derivative BA.2 post-breakthrough infection ( 42 ). Recently, a study by Wang et al found that Del69-70, L452R, F486V, and R493Q mutation sites in the spike protein of the Omicron variant accelerated the spread of the virus and enhanced pathogenicity ( 43 ).…”

Section: Discussionmentioning

confidence: 99%

Omicron BA.2 lineage predominance in severe acute respiratory syndrome coronavirus 2 positive cases during the third wave in North India

et al. 2022

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BackgroundRecent studies on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reveal that Omicron variant BA.1 and sub-lineages have revived the concern over resistance to antiviral drugs and vaccine-induced immunity. The present study aims to analyze the clinical profile and genome characterization of the SARS-CoV-2 variant in eastern Uttar Pradesh (UP), North India.MethodsWhole-genome sequencing (WGS) was conducted for 146 SARS-CoV-2 samples obtained from individuals who tested coronavirus disease 2019 (COVID-19) positive between the period of 1 January 2022 and 24 February 2022, from three districts of eastern UP. The details regarding clinical and hospitalized status were captured through telephonic interviews after obtaining verbal informed consent. A maximum-likelihood phylogenetic tree was created for evolutionary analysis using MEGA7.ResultsThe mean age of study participants was 33.9 ± 13.1 years, with 73.5% accounting for male patients. Of the 98 cases contacted by telephone, 30 (30.6%) had a travel history (domestic/international), 16 (16.3%) reported having been infected with COVID-19 in past, 79 (80.6%) had symptoms, and seven had at least one comorbidity. Most of the sequences belonged to the Omicron variant, with BA.1 (6.2%), BA.1.1 (2.7%), BA.1.1.1 (0.7%), BA.1.1.7 (5.5%), BA.1.17.2 (0.7%), BA.1.18 (0.7%), BA.2 (30.8%), BA.2.10 (50.7%), BA.2.12 (0.7%), and B.1.617.2 (1.3%) lineages. BA.1 and BA.1.1 strains possess signature spike mutations S:A67V, S:T95I, S:R346K, S:S371L, S:G446S, S:G496S, S:T547K, S:N856K, and S:L981F, and BA.2 contains S:V213G, S:T376A, and S:D405N. Notably, ins214EPE (S1- N-Terminal domain) mutation was found in a significant number of Omicron BA.1 and sub-lineages. The overall Omicron BA.2 lineage was observed in 79.5% of women and 83.2% of men.ConclusionThe current study showed a predominance of the Omicron BA.2 variant outcompeting the BA.1 over a period in eastern UP. Most of the cases had a breakthrough infection following the recommended two doses of vaccine with four in five cases being symptomatic. There is a need to further explore the immune evasion properties of the Omicron variant.

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“…A study conducted in India found that 99.3% of 1007 patients with Omicron reinfection were asymptomatic or experienced mild symptoms such as fever (76.2%), cough (64.0%), muscle pain (63.2%), and sore throat (59.3%) 28 . Case reports from India also showed that in patients with multiple episodes of infections with different variants, clinical symptoms gradually improved from fever, sore throat, limb pain, and fatigue to only headache in the last infection 39 . In addition to the protective effect of previous infections, the reduced pathogenicity of the Omicron variant may also contribute to the alleviation of symptoms.…”

Section: The Severity Of Reinfections Compared With Initial Infectionsmentioning

confidence: 99%

“… 28 Case reports from India also showed that in patients with multiple episodes of infections with different variants, clinical symptoms gradually improved from fever, sore throat, limb pain, and fatigue to only headache in the last infection. 39 In addition to the protective effect of previous infections, the reduced pathogenicity of the Omicron variant may also contribute to the alleviation of symptoms.…”

Section: The Severity Of Reinfections Compared With Initial Infectionsmentioning

confidence: 99%

A mini review of reinfection with the SARS‐CoV‐2 Omicron variant

Shen,

Chen,

et al. 2024

Health Science Reports

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BackgroundCOVID‐19 has caused severe morbidity and mortality worldwide. After the end of the dynamic zero‐COVID policy in China in December, 2022, concerns regarding reinfection were raised while little was known due to the lack of surveillance data in this country.AimsThis study reviews the probability, risk factors, and severity of severe acute respiratory syndrome coronavirus 2 Omicron variant reinfection, as well as the interval between infections, risk of onward transmission by reinfected cases, and the role of booster vaccination against reinfection.SourcesReferences for this review were identified through searches of PubMed and Web of Science up to September 24, 2023.ResultsThe rate of reinfection ranges from 3.1% to 13.0%. Factors associated with a higher risk of reinfection include being female, having comorbidities, and being unvaccinated. Reinfection with the BA.4 or BA.5 variant occurs approximately 180 days after the initial infection. Reinfections are less clinically severe than primary infections, and there is evidence of lower transmissibility. The debate surrounding the effectiveness and feasibility of booster vaccinations in preventing reinfection continues.ConclusionsThe reinfection rate during the Omicron epidemic is significantly higher than in previous epidemic periods. However, the symptoms and infectivity of reinfection were weaker than those of the prior infection. Medical staff and individuals at high risk of reinfection should be vigilant. The efficacy of booster vaccinations in reducing reinfection is currently under debate.

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A case of breakthrough infection with SARS-CoV-2 Delta derivative and reinfection with Omicron variant in a fully vaccinated health care professional

Cited by 3 publications

References 10 publications

Identification of severe acute respiratory syndrome coronavirus 2 breakthrough infections by anti-nucleocapsid antibody among fully vaccinated non-healthcare workers during the transition from the delta to omicron wave

Identification of severe acute respiratory syndrome coronavirus 2 breakthrough infections by anti-nucleocapsid antibody among fully vaccinated non-healthcare workers during the transition from the delta to omicron wave

Omicron BA.2 lineage predominance in severe acute respiratory syndrome coronavirus 2 positive cases during the third wave in North India

A mini review of reinfection with the SARS‐CoV‐2 Omicron variant

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