SARS-CoV-2 Omicron: Light at the End of the Long Pandemic Tunnel or Another False Dawn for Immunodeficient Patients?

Ameratunga, Rohan; Leung, Euphemia; Woon, See‐Tarn; Chan, Lydia; Steele, Richard; Lehnert, Klaus; Longhurst, Hilary

doi:10.1016/j.jaip.2022.06.011

Cited by 13 publications

(12 citation statements)

References 105 publications

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“…Emerging variants of concern, specifically the widespread Omicron variant, drew attention [ 45 , 46 , 47 ] without an Omicron-sourced autoimmunity focus, despite some literature with a broader or a different focus [ 48 , 49 , 50 ]. Changes in infectivity, prevention by vaccination, and other concerns [ 51 , 52 , 53 , 54 ], were of more interest. On a similar basis, there is a need to investigate the possible changes in molecular mimicry-based autoimmunity risk.…”

Section: Introductionmentioning

confidence: 99%

Shared 6mer Peptides of Human and Omicron (21K and 21L) at SARS-CoV-2 Mutation Sites

Adıgüzel

Shoenfeld

2022

Antibodies

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We investigated the short sequences involving Omicron 21K and Omicron 21L variants to reveal any possible molecular mimicry-associated autoimmunity risks and changes in those. We first identified common 6mers of the viral and human protein sequences present for both the mutant (Omicron) and nonmutant (SARS-CoV-2) versions of the same viral sequence and then predicted the binding affinities of those sequences to the HLA supertype representatives. We evaluated change in the potential autoimmunity risk, through comparative assessment of the nonmutant and mutant viral sequences and their similar human peptides with common 6mers and affinities to the same HLA allele. This change is the lost and the new, or de novo, autoimmunity risk, associated with the mutations in the Omicron 21K and Omicron 21L variants. Accordingly, e.g., the affinity of virus-similar sequences of the Ig heavy chain junction regions shifted from the HLA-B*15:01 to the HLA-A*01:01 allele at the mutant sequences. Additionally, peptides of different human proteins sharing 6mers with SARS-CoV-2 proteins at the mutation sites of interest and with affinities to the HLA-B*07:02 allele, such as the respective SARS-CoV-2 sequences, were lost. Among all, any possible molecular mimicry-associated novel risk appeared to be prominent in HLA-A*24:02 and HLA-B*27:05 serotypes upon infection with Omicron 21L. Associated disease, pathway, and tissue expression data supported possible new risks for the HLA-B*27:05 and HLA-A*01:01 serotypes, while the risks for the HLA-B*07:02 serotypes could have been lost or diminished, and those for the HLA-A*03:01 serotypes could have been retained, for the individuals infected with Omicron variants under study. These are likely to affect the complications related to cross-reactions influencing the relevant HLA serotypes upon infection with Omicron 21K and Omicron 21L.

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Section: Introductionmentioning

confidence: 99%

Shared 6mer Peptides of Human and Omicron (21K and 21L) at SARS-CoV-2 Mutation Sites

Adıgüzel

Shoenfeld

2022

Antibodies

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“…However, SARS-CoV-2 Omicron (B.1.529) and its subvariants (BA.1, BA.2, etc. ), which have been dominating COVID-19 infections worldwide since November 2021 [22], are associated with a lower risk of severe forms and appear to have a lower hypoxemia rate when compared to previous SARS-CoV-2 variants [23,24]. On the other hand, recent studies have raised doubts about the coverage and effectiveness of existing COVID-19 vaccines against the Omicron variant [25].…”

Section: Discussionmentioning

confidence: 99%

Does COVID-19 vaccination still have a role in maternal and perinatal outcomes during the Omicron era? A multicentre observational study

Jarraya¹,

Kammoun²,

Kanoun³

et al. 2022

It Journ Gyn Obs

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Objective. COVID-19 vaccination has a reduced efficiency against the Omicron variant. The aim of this study was to assess the clinical impact of COVID-19 vaccination on maternal and perinatal outcomes during the Omicron wave. Materials and Methods.This was an observational multicenter study, pregnant women who gave birth while infected by SARS CoV2 during the Omicron waves were included.Patients with incomplete vaccination and recurrent infections were excluded. Patients were divided into 2 groups: the Vaccinated Group included pregnant women with completed vaccination (≥ 3 doses of mRNA vaccine or 2 doses ≤ 6 months); the Non-vaccinated Group included pregnant women who had no COVID-19vaccination. Data about obstetrical and fetal outcomes in both groups were compared.Results. In total, 59 vaccinated and 49 unvaccinated patients were included. The incidence of patients requiring oxygen support was reduced from 36.7% to 1.7% with p < 0.001. The mode of delivery was comparable in both groups. The need for referral to an intensive care unit was reduced from 22.4% to 1.7% with p ≤ 0.001. The length of hospitalization was reduced from 6.8 ± 5 to 2.8 ± 2 days, with p ≤ 0.001. The prematurity rate was comparable in both groups, but the need for neonatal intensive care admission was reduced from 22.4% to 4.1% with p = 0.019. Conclusions.The COVID-19 vaccination seems to be efficient during the Omicron waves. Obstetrical and neonatal outcomes were improved with complete vaccination. Pregnant women should be advised to have a complete vaccination status.

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“…A SARS-CoV-2 T cell assay may identify breakthrough infections in such patients. Asymptomatic breakthrough infections may signify robust hybrid immunity and may be of considerable reassurance to immunodeficient patients 45…”

Section: Discussion: Clinical Utility Of T Cell Assays For Sars-cov-2...mentioning

confidence: 99%

“…The role of convalescent plasma in treating patients with COVID-19 is uncertain. It is however possible that protection against the Omicron and its subvariants relies more on antibodies than previous variants 45. A recent paper suggested measuring T cell responses in COVID-19 survivors helped identify the best donors of convalescent plasma 66.…”

Section: Discussion: Clinical Utility Of T Cell Assays For Sars-cov-2...mentioning

confidence: 99%

“…Although caused by SARS-CoV-2, the outcome of COVID-19, including its severe sequelae, is likely to be determined by the cellular immune response as well as age, the viral strain, ethnicity and comorbidities 44 45. Ineffective cellular immunity to the virus may result in an aberrant non-protective or even harmful antibody response and may underlie ADE.…”

Section: Introductionmentioning

confidence: 99%

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Critical role of diagnostic SARS-CoV-2 T cell assays for immunodeficient patients

et al. 2022

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After almost 3 years of intense study, the immunological basis of COVID-19 is better understood. Patients who suffer severe disease have a chaotic, destructive immune response. Many patients with severe COVID-19 produce high titres of non-neutralising antibodies, which are unable to sterilise the infection. In contrast, there is increasing evidence that a rapid, balanced cellular immune response is required to eliminate the virus and mitigate disease severity. In the longer term, memory T cell responses, following infection or vaccination, play a critical role in protection against SARS-CoV-2.Given the pivotal role of cellular immunity in the response to COVID-19, diagnostic T cell assays for SARS-CoV-2 may be of particular value for immunodeficient patients. A diagnostic SARS-CoV-2 T cell assay would be of utility for immunocompromised patients who are unable to produce antibodies or have passively acquired antibodies from subcutaneous or intravenous immunoglobulin (SCIG/IVIG) replacement. In many antibody-deficient patients, cellular responses are preserved. SARS-CoV-2 T cell assays may identify breakthrough infections if reverse transcriptase quantitative PCR (RT-qPCR) or rapid antigen tests (RATs) are not undertaken during the window of viral shedding. In addition to utility in patients with immunodeficiency, memory T cell responses could also identify chronically symptomatic patients with long COVID-19 who were infected early in the pandemic. These individuals may have been infected before the availability of reliable RT-qPCR and RAT tests and their antibodies may have waned. T cell responses to SARS-CoV-2 have greater durability than antibodies and can also distinguish patients with infection from vaccinated individuals.

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SARS-CoV-2 Omicron: Light at the End of the Long Pandemic Tunnel or Another False Dawn for Immunodeficient Patients?

Cited by 13 publications

References 105 publications

Shared 6mer Peptides of Human and Omicron (21K and 21L) at SARS-CoV-2 Mutation Sites

Shared 6mer Peptides of Human and Omicron (21K and 21L) at SARS-CoV-2 Mutation Sites

Does COVID-19 vaccination still have a role in maternal and perinatal outcomes during the Omicron era? A multicentre observational study

Critical role of diagnostic SARS-CoV-2 T cell assays for immunodeficient patients

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