The durability of immunity against reinfection by SARS-CoV-2: a comparative evolutionary study.
The durability of immunity against reinfection by SARS-CoV-2: a comparative evolutionary study.
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DOI：
10.1016/s2666-5247(21)00219-6
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发表时间：
2021-12
期刊：
影响因子：
--
通讯作者：
Dornburg A
中科院分区：
文献类型：
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作者：
Townsend JP;Hassler HB;Wang Z;Miura S;Singh J;Kumar S;Ruddle NH;Galvani AP;Dornburg A
在毁灭性的COVID-19大流行中，最重要的未知因素是免疫力的持久性和可能再次感染的时间。关于SARS-CoV-2长期免疫应答和再感染的直接数据有限。本研究的目的是利用SARS-CoV-2进化上密切的冠状病毒亲属之间的免疫持久性数据，通过对相关病毒SARS-CoV、MERS-CoV、人类冠状病毒（HCoV）-229 E、HCoV-OC 43和HCoV-NL 63的比较进化分析，估计再感染的时间。我们对S、M和ORF 1b基因进行了系统发育分析，以重建人类感染冠状病毒的最大可能性分子系统发育。这种同源性使峰归一化核衣壳蛋白，刺突蛋白，和全病毒裂解物IgG抗体光密度水平的比较分析，结合再感染数据的地方性人类感染冠状病毒。我们进行了祖先和后代状态分析，以估计抗体水平随时间的预期下降，基于抗体水平的再感染概率，以及在SARS-CoV-2和其他人类感染冠状病毒地方性传播条件下恢复后再感染的预期时间。我们获得了6种感染人类的冠状病毒的抗体光密度数据，从1984年到2020年感染后的128天到28年。这些数据提供了一种手段，以估计典型的抗体下降和再感染的概率随着时间的推移，在地方病的条件下。在地方病条件下，SARS-CoV-2的再感染可能发生在抗体反应峰值后3个月至5·1年之间，中位数为16个月。这种保护作用的持续时间不到在人类中传播的地方性冠状病毒的一半（5-95%分位数，HCoV-OC 43为15个月至10年，HCoV-NL 63为31个月至12年，HCoV-229 E为16个月至12年）。对于SARS-CoV，5-95%分位数为4个月至6年，而MERS-CoV的95%分位数与数据集不一致。再感染的时间框架对于公共卫生决策的许多方面至关重要。随着COVID-19疫情持续，再感染可能会变得越来越普遍。维持公共卫生措施以遏制传播--包括在先前感染SARS-CoV-2的个体中--再加上持续努力在全球范围内加速疫苗接种，对于预防COVID-19的发病率和死亡率至关重要。美国国家科学基金会.
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. 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. 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. 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. US National Science Foundation.