Mild SARS-CoV-2 Illness Is Not Associated with Reinfections and Provides Persistent Spike, Nucleocapsid, and Virus-Neutralizing Antibodies

Schuler, Charles F.; Gherasim, Carmen; O’Shea, Kelly; Manthei, David M; Chen, Jesse; Zettel, Cristyn; Troost, Jonathan P.; Kennedy, Andrew; Tai, Andrew W.; Giacherio, Donald; Valdez, Riccardo; Baldwin, James L.; Baker, James R.

doi:10.1128/spectrum.00087-21

Cited by 18 publications

(19 citation statements)

References 24 publications

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“…Comparing studies that used sampling methods that detected people with no or mild symptoms ( 27 , 31 , 35–37 ) with those that recruited only symptomatic people ( 25 , 26 , 28 , 33 ) did not show a clear relationship between recruitment method and protection against reinfection. A recently published cohort study found that mild COVID-19 was associated with protection against reinfection and generally supports our conclusions, although no reinfections were observed and the sample was relatively small ( 23 ).…”

Section: Resultssupporting

confidence: 90%

Risk for Reinfection After SARS-CoV-2: A Living, Rapid Review for American College of Physicians Practice Points on the Role of the Antibody Response in Conferring Immunity Following SARS-CoV-2 Infection

et al. 2022

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Patients and clinicians want to know who is protected from SARS-CoV-2 infection. This update is part of a living systematic review to understand the potential value of antibody testing as a correlate of protection against infection. Because the previous review found that seroconversion was a near-universal consequence of recent infection in immunocompetent patients, this review examines the risk for reinfection in adults after SARS-CoV-2 infection, whether diagnosed by polymerase chain reaction test, antibody test, or a combination of both.

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Section: Resultssupporting

confidence: 90%

Risk for Reinfection After SARS-CoV-2: A Living, Rapid Review for American College of Physicians Practice Points on the Role of the Antibody Response in Conferring Immunity Following SARS-CoV-2 Infection

et al. 2022

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“… ELISA; Anti-RBD IgG tested by an uncommercially kit following the Krammer laboratory protocol Unadjusted RR b – 8 (HQ) 16 Sebastian Havervall et al, 2021 [ 56 ] 300 HCWs in Stockholm, Sweden Median (IQR) 46 (35-54) 2020.04.09-2021.02.26 10.6 A positive PCR result detected more than 7 months after a baseline seropositive result. Luminex; Anti-S IgG tested by a bead-based high-throughput multiplex assay based on the FlexMap3D (Luminex Corp.) platform Unadjusted RR b – 5 (MQ) 17 Charles F Schuler 4 th et al, 2021 [ 57 ] 653 subjects were either HCWs or patients with a high risk of exposure to COVID-19 in Michigan, USA Median (IQR) 41 (31-51) 2020.05-2021.02 9.0 A positive PCR result detected after a baseline seropositive result. 1.…”

Section: Resultsmentioning

confidence: 99%

The Protection of Naturally Acquired Antibodies Against Subsequent SARS-CoV-2 Infection: A Systematic Review and Meta-Analysis

Chen

Zhu

Liu

et al. 2022

Emerging Microbes & Infections

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The specific antibodies induced by SARS-CoV-2 infection may provide protection against a subsequent infection. However, the efficacy and duration of protection provided by naturally acquired immunity against subsequent SARS-CoV-2 infection remain controversial. We systematically searched for the literature describing COVID-19 reinfection published before 07 February 2022. The outcomes were the pooled incidence rate ratio (IRR) for estimating the risk of subsequent infection. The Newcastle–Ottawa Scale (NOS) was used to assess the quality of the included studies. Statistical analyses were conducted using the R programming language 4.0.2. We identified 19 eligible studies including more than 3.5 million individuals without the history of COVID-19 vaccination. The efficacy of naturally acquired antibodies against reinfection was estimated at 84% (pooled IRR = 0.16, 95% CI: 0.14-0.18), with higher efficacy against symptomatic COVID-19 cases (pooled IRR = 0.09, 95% CI = 0.07-0.12) than asymptomatic infection (pooled IRR = 0.28, 95% CI = 0.14-0.54). In the subgroup analyses, the pooled IRRs of COVID-19 infection in health care workers (HCWs) and the general population were 0.22 (95% CI = 0.16-0.31) and 0.14 (95% CI = 0.12-0.17), respectively, with a significant difference ( P = 0.02), and those in older (over 60 years) and younger (under 60 years) populations were 0.26 (95% CI = 0.15–0.48) and 0.16 (95% CI = 0.14-0.19), respectively. The risk of subsequent infection in the seropositive population appeared to increase slowly over time. In conclusion, naturally acquired antibodies against SARS-CoV-2 can significantly reduce the risk of subsequent infection, with a protection efficacy of 84%. Registration number: CRD42021286222

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“…Moreover, differentiation between persistent COVID-19 and reinfection is challenging, in particular in older persons ( Ringlander et al, 2021 ). It is also not entirely clear whether disease severity of the initial SARS-CoV-2 infection significantly modifies the risk of reinfections, but it should be noted that even asymptomatic SARS-CoV-2 infections elicit a strong immunological response ( Boyton and Altmann, 2021 ; Garrido et al, 2021 ; Murillo-Zamora et al, 2021a ; Schuler et al, 2021 ; Spicer et al, 2021 ).…”

Section: Efficacy and Duration Of Natural Immunity Against Reinfectionsmentioning

confidence: 99%

SARS-CoV-2 reinfections: Overview of efficacy and duration of natural and hybrid immunity

Pilz

Theiler‐Schwetz

Trummer

et al. 2022

Environmental Research

213

191

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Seroprevalence surveys suggest that more than a third and possibly more than half of the global population has been infected with SARS-CoV-2 by early 2022. As large numbers of people continue to be infected, the efficacy and duration of natural immunity in terms of protection against SARS-CoV-2 reinfections and severe disease is of crucial significance for the future. This narrative review provides an overview on epidemiological studies addressing this issue. National surveys covering 2020–2021 documented that a previous SARS-CoV-2 infection is associated with a significantly reduced risk of reinfections with efficacy lasting for at least one year and only relatively moderate waning immunity. Importantly, natural immunity showed roughly similar effect sizes regarding protection against reinfection across different SARS-CoV-2 variants, with the exception of the Omicron variant for which data are just emerging before final conclusions can be drawn. Risk of hospitalizations and deaths was also reduced in SARS-CoV-2 reinfections versus primary infections. Observational studies indicate that natural immunity may offer equal or greater protection against SARS-CoV-2 infections compared to individuals receiving two doses of an mRNA vaccine, but data are not fully consistent. The combination of a previous SARS-CoV-2 infection and a respective vaccination, termed hybrid immunity, seems to confer the greatest protection against SARS-CoV-2 infections, but several knowledge gaps remain regarding this issue. Natural immunity should be considered for public health policy regarding SARS-CoV-2.

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Mild SARS-CoV-2 Illness Is Not Associated with Reinfections and Provides Persistent Spike, Nucleocapsid, and Virus-Neutralizing Antibodies

Abstract: This article demonstrates that people who have mild COVID-19 illnesses and produce antibodies are protected from reinfection for up to 6 months afterward. The antibodies that people produce in this situation are stable for up to 6 months as well.

Cited by 18 publications

References 24 publications

Risk for Reinfection After SARS-CoV-2: A Living, Rapid Review for American College of Physicians Practice Points on the Role of the Antibody Response in Conferring Immunity Following SARS-CoV-2 Infection

Risk for Reinfection After SARS-CoV-2: A Living, Rapid Review for American College of Physicians Practice Points on the Role of the Antibody Response in Conferring Immunity Following SARS-CoV-2 Infection

The Protection of Naturally Acquired Antibodies Against Subsequent SARS-CoV-2 Infection: A Systematic Review and Meta-Analysis

SARS-CoV-2 reinfections: Overview of efficacy and duration of natural and hybrid immunity

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