Serologic Responses in Healthy Adult with SARS-CoV-2 Reinfection, Hong Kong, August 2020

Chan, Paul K.S.; Lui, Grace; Hachim, Asmaa; Ko, Ronald C.; Boon, Siaw Shi; Li, Timothy; Kavian, Niloufar; Luk, Fion; Chen, Zigui; Yau, Emily M; Chan, Kin Ho; Tsang, Chi-Hang; Cheng, Samuel; Chu, Daniel K W; Perera, Ranawaka A.P.M.; Ho, Walter K.K.; Yeung, Albert T.; Chow, Chit Kwong; Poon, Leo L M; Valkenburg, Sophie A.; Hui, David; Peiris, Malik

doi:10.3201/eid2612.203833

Cited by 43 publications

(44 citation statements)

References 8 publications

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“…20,21 Second, our preclinical study 15 indicated that the neutralising antibody titres of 1/24 elicited in macaque models conferred complete protection against SARS-CoV-2. Third, although several studies have found that antibody res ponses generated from natural infection with corona viruses (eg, SARS-CoV-2, severe acute respi ratory syndrome coronavirus, and Middle East respi ratory syndrome coronavirus) might decrease substantially over time, [22][23][24] reinfection in these patients has rarely been reported, [25][26][27] which indicates that immunological memory might have an important role of prevention of re-infections. Therefore, the antibody level itself might not be the key for a successful COVID-19 vaccine, but rather the establishment of a recallable specific immune response to SARS-CoV-2.…”

Section: Discussionmentioning

confidence: 99%

Safety, tolerability, and immunogenicity of an inactivated SARS-CoV-2 vaccine in healthy adults aged 18–59 years: a randomised, double-blind, placebo-controlled, phase 1/2 clinical trial

Zhang

Zeng

Pan

et al. 2021

The Lancet Infectious Diseases

1,247

1,266

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Background With the unprecedented morbidity and mortality associated with the COVID-19 pandemic, a vaccine against COVID-19 is urgently needed. We investigated CoronaVac (Sinovac Life Sciences, Beijing, China), an inactivated vaccine candidate against COVID-19, containing inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), for its safety, tolerability and immunogenicity. Methods In this randomised, double-blind, placebo-controlled, phase 1/2 clinical trial, healthy adults aged 18-59 years were recruited from the community in Suining County of Jiangsu province, China. Adults with SARS-CoV-2 exposure or infection history, with axillary temperature above 37•0°C, or an allergic reaction to any vaccine component were excluded. The experimental vaccine for the phase 1 trial was manufactured using a cell factory process (CellSTACK Cell Culture Chamber 10, Corning, Wujiang, China) , whereas those for the phase 2 trial were produced through a bioreactor process (ReadyToProcess WAVE 25, GE, Umea, Sweden). The phase 1 trial was done in a dose-escalating manner. At screening, participants were initially separated (1:1), with no specific randomisation, into two vaccination schedule cohorts, the days 0 and 14 vaccination cohort and the days 0 and 28 vaccination cohort, and within each cohort the first 36 participants were assigned to block 1 (low dose CoronaVac [3 μg per 0•5 mL of aluminium hydroxide diluent per dose) then another 36 were assigned to block 2 (high-dose Coronavc [6 μg per 0•5 mL of aluminium hydroxide diluent per dse]). Within each block, participants were randomly assigned (2:1), using block randomisation with a block size of six, to either two doses of CoronaVac or two doses of placebo. In the phase 2 trial, at screening, participants were initially separated (1:1), with no specific randomisation, into the days 0 and 14 vaccination cohort and the days 0 and 28 vaccination cohort, and participants were randomly assigned (2:2:1), using block randomisation with a block size of five, to receive two doses of either low-dose CoronaVac, high-dose CoronaVac, or placebo. Participants, investigators, and laboratory staff were masked to treatment allocation. The primary safety endpoint was adverse reactions within 28 days after injection in all participants who were given at least one dose of study drug (safety population). The primary immunogenic outcome was seroconversion rates of neutralising antibodies to live SARS-CoV-2 at day 14 after the last dose in the days 0 and 14 cohort, and at day 28 after the last dose in the days 0 and 28 cohort in participants who completed their allocated two-dose vaccination schedule (per-protocol population). This trial is registered with ClinicalTrials.gov, NCT04352608, and is closed to accrual. Findings Between April 16 and April 25, 2020, 144 participants were enrolled in the phase 1 trial, and between May 3 and May 5, 2020, 600 participants were enrolled in the phase 2 trial. 743 participants received at least one dose of investigational product (n=143 for ph...

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Section: Discussionmentioning

confidence: 99%

Safety, tolerability, and immunogenicity of an inactivated SARS-CoV-2 vaccine in healthy adults aged 18–59 years: a randomised, double-blind, placebo-controlled, phase 1/2 clinical trial

Zhang

Zeng

Pan

et al. 2021

The Lancet Infectious Diseases

1,247

1,266

View full text Add to dashboard Cite

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“…The clinical symptoms of SARS-CoV-2 infection include cough, breathing problems, diarrhoea, and fever. Different studies suggest that 48 to 67% of deceased persons exhibited SARS-CoV-2 RNA in the stool ( Chan et al, 2020 ; Cheung et al, 2020 ; Parasa et al, 2020; Wong et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Unravelling the early warning capability of wastewater surveillance for COVID-19: A temporal study on SARS-CoV-2 RNA detection and need for the escalation

Kumar

Joshi

Patel

et al. 2021

Environmental Research

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Wastewater-based Epidemiological (WBE) surveillance offers a promising approach to assess the pandemic situation covering pre-symptomatic and asymptomatic cases in highly populated area under limited clinical tests. In the present study, we analysed SARS-CoV-2 RNA in the influent wastewater samples ( n = 43) from four wastewater treatment plants (WWTPs) in Gandhinagar, India, during August 7 th to September 30 th , 2020. A total of 40 samples out of 43 were found positive i.e. having at least two genes of SARS-CoV-2. The average Ct values for S, N, and ORF 1ab genes were 32.66, 33.03, and 33.95, respectively. Monthly variation depicted a substantial rise in the average copies of N (∼120%) and ORF 1ab (∼38%) genes in the month of September as compared to August, while S-gene copies declined by 58% in September 2020. The SARS-CoV-2 genome concentration was higher in the month of September (∼924.5 copies/L) than August (∼897.5 copies/L), corresponding to a ∼ 2.2-fold rise in the number of confirmed cases during the study period. Further, the percentage change in genome concentration level on a particular date was found in the lead of 1-2 weeks of time with respect to the official confirmed cases registered based on clinical tests on a temporal scale. The results profoundly unravel the potential of WBE surveillance to predict the fluctuation of COVID-19 cases to provide an early warning. Our study explicitly suggests that it is the need of hour that the wastewater surveillance must be included as an integral part of COVID-19 pandemic monitoring which can not only help the water authorities to identify the hotspots within a city but can provide up to 2 weeks of time lead for better tuning the management interventions.

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“…Reports have established that SARS-CoV-2 reinfection occurs after previous infection as well as in seropositive individuals 13-22 . Several studies have reported that SARS-CoV-2 IgG antibodies 22,23 and neutralizing antibodies 24 provide protection against subsequent infection.…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 seropositivity and subsequent infection risk in healthy young adults: a prospective cohort study

Letizia

Vangeti

et al. 2021

Preprint

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SummaryBackgroundThe risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) subsequent infection among seropositive young adults was studied prospectively.MethodsThe study population comprised 3,249 predominantly male, 18-20-year-old Marine recruits. Upon arrival at a Marine-supervised two-week quarantine, participants were assessed for baseline SARS-CoV-2 IgG seropositivity, defined as a 1:150 dilution or greater on receptor binding domain and full-length spike protein enzyme-linked immunosorbent (ELISA) assays. SARS-CoV-2 infection was assessed by PCR at initiation, middle and end of the quarantine. After appropriate exclusions, including participants with a positive PCR during quarantine, we performed three biweekly PCR tests in both seropositive and in seronegative groups once recruits left quarantine and entered basic training and baseline neutralizing antibody titers on all subsequently infected seropositive and selected seropositive uninfected participants.FindingsAmong 189 seropositive participants, 19 (10.1%) had at least one positive PCR test for SARS-CoV-2 during the six-week follow-up (1.1 cases per person-year). In contrast, 1,079 (48.0%) of the 2,247 seronegative participants tested positive (6.2 cases per person-year). The incidence rate ratio was 0.18 (95% CI 0.11-0.28, p<0.00001). Among seropositive recruits, infection was associated with lower baseline full-length spike protein IgG titers (p<0.0001). Compared with seronegative recruits, seropositive recruits had about 10-fold lower viral loads (ORF1ab gene, p<0.005), and trended towards shorter duration of PCR positivity (p=0.18) and more frequent asymptomatic infections (p=0.13). Among seropositive participants, baseline neutralizing titers were detected in 45 of 54 (83.3%) uninfected and in 6 of 19 (31.6%) infected participants during the 6 weeks of observation (ID50 difference p<.0001).InterpretationSeropositive young adults had about one-fifth the risk of subsequent infection compared with seronegative individuals. Although antibodies induced by initial infection are largely protective, they do not guarantee effective SARS-CoV-2 neutralization activity or immunity against subsequent infection. These findings may be relevant for optimization of mass vaccination strategies.FundingDefense Health Agency and Defense Advanced Research Projects Agency

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Serologic Responses in Healthy Adult with SARS-CoV-2 Reinfection, Hong Kong, August 2020

Cited by 43 publications

References 8 publications

Safety, tolerability, and immunogenicity of an inactivated SARS-CoV-2 vaccine in healthy adults aged 18–59 years: a randomised, double-blind, placebo-controlled, phase 1/2 clinical trial

Safety, tolerability, and immunogenicity of an inactivated SARS-CoV-2 vaccine in healthy adults aged 18–59 years: a randomised, double-blind, placebo-controlled, phase 1/2 clinical trial

Unravelling the early warning capability of wastewater surveillance for COVID-19: A temporal study on SARS-CoV-2 RNA detection and need for the escalation

SARS-CoV-2 seropositivity and subsequent infection risk in healthy young adults: a prospective cohort study

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