SARS-CoV-2 antibodies cross-react and enhance dengue infection

Abstract

Dengue disease is highly prevalent in tropical and subtropical regions worldwide. However, its pathogenesis is still incompletely understood, particularly in comparison to other endemic viruses. Antibody-dependent enhancement (ADE) is a well-known phenomenon for dengue viruses. Given the recent surge in dengue cases and potential cross-reactivity with SARS-CoV-2 antibodies, this study explores the impact of anti-SARS-CoV-2 antibodies on DENV-2 infection.The study assessed the cross-reactivity of SARS-CoV-2 antibodies with the DENV-2 Virus. Human convalescent plasma samples collected during different waves of COVID-19 and monoclonal and polyclonal antibodies raised against SARS-CoV-2 were examined for their potential to cause ADE of DENV-2 infection using cell-based assays. The study found that anti-SARS-CoV-2 antibodies acquired from natural infection in humans or through experimental immunization in animals were cross-reactive with DENV-2 and had the potential to enhance DENV-2 infection in K562 and U937 cells. In-silico and in-vitro studies indicated a strong interaction between SARS-CoV-2 antibodies and DENV-2 E-protein, providing a molecular basis for these findings. This study is the first to demonstrate that anti-SARS-CoV-2 antibodies can cross-react with DENV-2 and can enhance its infection through ADE. These findings have implications for SARS-CoV-2 vaccine development and deployment strategies in regions where dengue is endemic.SummaryAntibodies against SARS-CoV-2 (RBD and Spike) showed significant cross reactivity with DENV-2 (E protein). Also, anti-SARS-CoV-2-commercial antibodies, immunised animal sera and 46 human convalescent plasma samples (from different waves of pandemic) demonstrated antibody-dependent enhancement (ADE) of DENV-2 infection.

Bangladesh records persistently increased number of dengue deaths in recent years: Dissecting the shortcomings and means to resolve

“…Thus, the effect of climate change, along with urbanization, poor waste management and water storage practices, and inadequate vector control, is believed to be related to the upsurge of dengue cases and deaths in Bangladesh [ 8 , 9 ]. In addition, several viral and host factors, including dengue reinfection and the effect of COVID-19, may have contributed to the increased burden of dengue in recent years [ [10] , [11] , [12] , [13] , [14] , [15] ]. Although all four serotypes of DENV have been recorded in Bangladesh at different times since 2000, DENV-2 and DENV-3 dominantly prevail in the country in recent years [ 16 , 17 ].…”

Letter to the editor: Critical need for robust surveillance in response to DENV-2 and SARS-CoV-2 cross-reactivity

“…Given these findings, we wish to highlight that the recent discoveries of strong binding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies to the DENV-2 envelope (E)-protein have emerged as a pressing issue [2]. This cross-reactivity may potentially lead to more DENV replication, worsening the course of dengue, a phenomenon recognised as antibody-dependent enhancement (ADE) [3].…”

Author’s response: Critical need for robust surveillance in response to DENV-2 and SARS-CoV-2 cross-reactivity

“…In their letter, the authors refer to a recent preprint titled "SARS-CoV-2 antibodies cross-react and enhance dengue infection" that investigates the enhancement of DENV2 infection in vitro with cross-reactive SARS-CoV-2 antibodies acquired from natural infection in humans, through experimental immunisation in animals, or available commercially [3]. This is a very preliminary step before demonstrating the clinical implication of an antibody dependent enhancement (ADE) phenomenon of DENV2 infection by SARS-CoV-2 antibodies.…”