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The durability of immunity against reinfection by SARS-CoV-2: a comparative evolutionary study.
Townsend, Jeffrey P; Hassler, Hayley B; Wang, Zheng; Miura, Sayaka; Singh, Jaiveer; Kumar, Sudhir; Ruddle, Nancy H; Galvani, Alison P; Dornburg, Alex.
  • Townsend JP; Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA.
  • Hassler HB; Department of Ecology and Evolutionary Biology, Yale University, New Haven, CT, USA.
  • Wang Z; Program in Computational Biology and Bioinformatics, Yale University, New Haven, CT, USA.
  • Miura S; Program in Microbiology, Yale University, New Haven, CT, USA.
  • Singh J; Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA.
  • Kumar S; Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA.
  • Ruddle NH; Institute for Genomics and Evolutionary Medicine, and Department of Biology, Temple University, Philadelphia, PA, USA.
  • Galvani AP; Yale College, Yale University, New Haven, CT, USA.
  • Dornburg A; Institute for Genomics and Evolutionary Medicine, and Department of Biology, Temple University, Philadelphia, PA, USA.
Lancet Microbe ; 2(12): e666-e675, 2021 12.
Article in English | MEDLINE | ID: covidwho-1683810
ABSTRACT

BACKGROUND:

Among the most consequential unknowns of the devastating COVID-19 pandemic are the durability of immunity and time to likely reinfection. There are limited direct data on SARS-CoV-2 long-term immune responses and reinfection. The aim of this study is to use data on the durability of immunity among evolutionarily close coronavirus relatives of SARS-CoV-2 to estimate times to reinfection by a comparative evolutionary analysis of related viruses SARS-CoV, MERS-CoV, human coronavirus (HCoV)-229E, HCoV-OC43, and HCoV-NL63.

METHODS:

We conducted phylogenetic analyses of the S, M, and ORF1b genes to reconstruct a maximum-likelihood molecular phylogeny of human-infecting coronaviruses. This phylogeny enabled comparative analyses of peak-normalised nucleocapsid protein, spike protein, and whole-virus lysate IgG antibody optical density levels, in conjunction with reinfection data on endemic human-infecting coronaviruses. We performed ancestral and descendent states analyses to estimate the expected declines in antibody levels over time, the probabilities of reinfection based on antibody level, and the anticipated times to reinfection after recovery under conditions of endemic transmission for SARS-CoV-2, as well as the other human-infecting coronaviruses.

FINDINGS:

We obtained antibody optical density data for six human-infecting coronaviruses, extending from 128 days to 28 years after infection between 1984 and 2020. These data provided a means to estimate profiles of the typical antibody decline and probabilities of reinfection over time under endemic conditions. Reinfection by SARS-CoV-2 under endemic conditions would likely occur between 3 months and 5·1 years after peak antibody response, with a median of 16 months. This protection is less than half the duration revealed for the endemic coronaviruses circulating among humans (5-95% quantiles 15 months to 10 years for HCoV-OC43, 31 months to 12 years for HCoV-NL63, and 16 months to 12 years for HCoV-229E). For SARS-CoV, the 5-95% quantiles were 4 months to 6 years, whereas the 95% quantiles for MERS-CoV were inconsistent by dataset.

INTERPRETATION:

The timeframe for reinfection is fundamental to numerous aspects of public health decision making. As the COVID-19 pandemic continues, reinfection is likely to become increasingly common. Maintaining public health measures that curb transmission-including among individuals who were previously infected with SARS-CoV-2-coupled with persistent efforts to accelerate vaccination worldwide is critical to the prevention of COVID-19 morbidity and mortality.

FUNDING:

US National Science Foundation.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Coronavirus 229E, Human / Coronavirus OC43, Human / Coronavirus NL63, Human / Middle East Respiratory Syndrome Coronavirus / COVID-19 Type of study: Observational study / Randomized controlled trials Topics: Vaccines Limits: Humans Language: English Journal: Lancet Microbe Year: 2021 Document Type: Article Affiliation country: S2666-5247(21)00219-6

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Coronavirus 229E, Human / Coronavirus OC43, Human / Coronavirus NL63, Human / Middle East Respiratory Syndrome Coronavirus / COVID-19 Type of study: Observational study / Randomized controlled trials Topics: Vaccines Limits: Humans Language: English Journal: Lancet Microbe Year: 2021 Document Type: Article Affiliation country: S2666-5247(21)00219-6