SARS-CoV-2-specific nasal IgA wanes 9 months after hospitalisation with COVID-19 and is not induced by subsequent vaccination
<p><strong>Background</strong> Most studies of immunity to SARS-CoV-2 focus on circulating antibody, giving limited insights into mucosal defences that prevent viral replication and onward transmission. We studied nasal and plasma antibody responses one year after hospitalisation f...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Other Authors: | |
| Format: | Journal article |
| Language: | English |
| Published: |
Elsevier
2022
|
| _version_ | 1797109527655481344 |
|---|---|
| author | Liew, F Talwar, S Cross, A Willett, BJ Scott, S Logan, N Siggins, MK Swieboda, D Sidhu, JK Efstathiou, C Moore, SC Davis, C Mohamed, N Nunag, J King, C Thompson, AAR Rowland-Jones, SL Docherty, AB Chalmers, JD Ho, L-P Horsley, A Raman, B Poinasamy, K Marks, M Kon, OM Howard, L Wootton, DG Dunachie, S Quint, JK Evans, RA Wain, LV Fontanella, S de Silva, TI Ho, A Harrison, E Baillie, JK Semple, MG Brightling, C Thwaites, RS Turtle, L Openshaw, PJM |
| author2 | ISARIC4C Investigators |
| author_facet | ISARIC4C Investigators Liew, F Talwar, S Cross, A Willett, BJ Scott, S Logan, N Siggins, MK Swieboda, D Sidhu, JK Efstathiou, C Moore, SC Davis, C Mohamed, N Nunag, J King, C Thompson, AAR Rowland-Jones, SL Docherty, AB Chalmers, JD Ho, L-P Horsley, A Raman, B Poinasamy, K Marks, M Kon, OM Howard, L Wootton, DG Dunachie, S Quint, JK Evans, RA Wain, LV Fontanella, S de Silva, TI Ho, A Harrison, E Baillie, JK Semple, MG Brightling, C Thwaites, RS Turtle, L Openshaw, PJM |
| author_sort | Liew, F |
| collection | OXFORD |
| description | <p><strong>Background</strong>
Most studies of immunity to SARS-CoV-2 focus on circulating antibody, giving limited insights into mucosal defences that prevent viral replication and onward transmission. We studied nasal and plasma antibody responses one year after hospitalisation for COVID-19, including a period when SARS-CoV-2 vaccination was introduced.</p>
<p><strong>Methods</strong>
In this follow up study, plasma and nasosorption samples were prospectively collected from 446 adults hospitalised for COVID-19 between February 2020 and March 2021 via the ISARIC4C and PHOSP-COVID consortia. IgA and IgG responses to NP and S of ancestral SARS-CoV-2, Delta and Omicron (BA.1) variants were measured by electrochemiluminescence and compared with plasma neutralisation data.</p>
<p><strong>Findings</strong>
Strong and consistent nasal anti-NP and anti-S IgA responses were demonstrated, which remained elevated for nine months (<i>p</i> < 0.0001). Nasal and plasma anti-S IgG remained elevated for at least 12 months (<i>p</i> < 0.0001) with plasma neutralising titres that were raised against all variants compared to controls (<i>p</i> < 0.0001). Of 323 with complete data, 307 were vaccinated between 6 and 12 months; coinciding with rises in nasal and plasma IgA and IgG anti-S titres for all SARS-CoV-2 variants, although the change in nasal IgA was minimal (1.46-fold change after 10 months, <i>p</i> = 0.011) and the median remained below the positive threshold determined by pre-pandemic controls. Samples 12 months after admission showed no association between nasal IgA and plasma IgG anti-S responses (<i>R</i> = 0.05, <i>p</i> = 0.18), indicating that nasal IgA responses are distinct from those in plasma and minimally boosted by vaccination.</p>
<p><strong>Interpretation</strong>
The decline in nasal IgA responses 9 months after infection and minimal impact of subsequent vaccination may explain the lack of long-lasting nasal defence against reinfection and the limited effects of vaccination on transmission. These findings highlight the need to develop vaccines that enhance nasal immunity.</p>
<p><strong>Funding</strong>
This study has been supported by ISARIC4C and PHOSP-COVID consortia. ISARIC4C is supported by grants from the National Institute for Health and Care Research and the Medical Research Council. Liverpool Experimental Cancer Medicine Centre provided infrastructure support for this research. The PHOSP-COVD study is jointly funded by UK Research and Innovation and National Institute of Health and Care Research. The funders were not involved in the study design, interpretation of data or the writing of this manuscript.</p> |
| first_indexed | 2024-03-07T07:43:00Z |
| format | Journal article |
| id | oxford-uuid:c27b6b38-6b9f-4364-a5f4-7728a98b3f11 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T07:43:00Z |
| publishDate | 2022 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:c27b6b38-6b9f-4364-a5f4-7728a98b3f112023-05-04T11:44:46ZSARS-CoV-2-specific nasal IgA wanes 9 months after hospitalisation with COVID-19 and is not induced by subsequent vaccinationJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:c27b6b38-6b9f-4364-a5f4-7728a98b3f11EnglishSymplectic ElementsElsevier2022Liew, FTalwar, SCross, AWillett, BJScott, SLogan, NSiggins, MKSwieboda, DSidhu, JKEfstathiou, CMoore, SCDavis, CMohamed, NNunag, JKing, CThompson, AARRowland-Jones, SLDocherty, ABChalmers, JDHo, L-PHorsley, ARaman, BPoinasamy, KMarks, MKon, OMHoward, LWootton, DGDunachie, SQuint, JKEvans, RAWain, LVFontanella, Sde Silva, TIHo, AHarrison, EBaillie, JKSemple, MGBrightling, CThwaites, RSTurtle, LOpenshaw, PJMISARIC4C InvestigatorsPHOSP-COVID collaborative groupSigfrid, L<p><strong>Background</strong> Most studies of immunity to SARS-CoV-2 focus on circulating antibody, giving limited insights into mucosal defences that prevent viral replication and onward transmission. We studied nasal and plasma antibody responses one year after hospitalisation for COVID-19, including a period when SARS-CoV-2 vaccination was introduced.</p> <p><strong>Methods</strong> In this follow up study, plasma and nasosorption samples were prospectively collected from 446 adults hospitalised for COVID-19 between February 2020 and March 2021 via the ISARIC4C and PHOSP-COVID consortia. IgA and IgG responses to NP and S of ancestral SARS-CoV-2, Delta and Omicron (BA.1) variants were measured by electrochemiluminescence and compared with plasma neutralisation data.</p> <p><strong>Findings</strong> Strong and consistent nasal anti-NP and anti-S IgA responses were demonstrated, which remained elevated for nine months (<i>p</i> < 0.0001). Nasal and plasma anti-S IgG remained elevated for at least 12 months (<i>p</i> < 0.0001) with plasma neutralising titres that were raised against all variants compared to controls (<i>p</i> < 0.0001). Of 323 with complete data, 307 were vaccinated between 6 and 12 months; coinciding with rises in nasal and plasma IgA and IgG anti-S titres for all SARS-CoV-2 variants, although the change in nasal IgA was minimal (1.46-fold change after 10 months, <i>p</i> = 0.011) and the median remained below the positive threshold determined by pre-pandemic controls. Samples 12 months after admission showed no association between nasal IgA and plasma IgG anti-S responses (<i>R</i> = 0.05, <i>p</i> = 0.18), indicating that nasal IgA responses are distinct from those in plasma and minimally boosted by vaccination.</p> <p><strong>Interpretation</strong> The decline in nasal IgA responses 9 months after infection and minimal impact of subsequent vaccination may explain the lack of long-lasting nasal defence against reinfection and the limited effects of vaccination on transmission. These findings highlight the need to develop vaccines that enhance nasal immunity.</p> <p><strong>Funding</strong> This study has been supported by ISARIC4C and PHOSP-COVID consortia. ISARIC4C is supported by grants from the National Institute for Health and Care Research and the Medical Research Council. Liverpool Experimental Cancer Medicine Centre provided infrastructure support for this research. The PHOSP-COVD study is jointly funded by UK Research and Innovation and National Institute of Health and Care Research. The funders were not involved in the study design, interpretation of data or the writing of this manuscript.</p> |
| spellingShingle | Liew, F Talwar, S Cross, A Willett, BJ Scott, S Logan, N Siggins, MK Swieboda, D Sidhu, JK Efstathiou, C Moore, SC Davis, C Mohamed, N Nunag, J King, C Thompson, AAR Rowland-Jones, SL Docherty, AB Chalmers, JD Ho, L-P Horsley, A Raman, B Poinasamy, K Marks, M Kon, OM Howard, L Wootton, DG Dunachie, S Quint, JK Evans, RA Wain, LV Fontanella, S de Silva, TI Ho, A Harrison, E Baillie, JK Semple, MG Brightling, C Thwaites, RS Turtle, L Openshaw, PJM SARS-CoV-2-specific nasal IgA wanes 9 months after hospitalisation with COVID-19 and is not induced by subsequent vaccination |
| title | SARS-CoV-2-specific nasal IgA wanes 9 months after hospitalisation with COVID-19 and is not induced by subsequent vaccination |
| title_full | SARS-CoV-2-specific nasal IgA wanes 9 months after hospitalisation with COVID-19 and is not induced by subsequent vaccination |
| title_fullStr | SARS-CoV-2-specific nasal IgA wanes 9 months after hospitalisation with COVID-19 and is not induced by subsequent vaccination |
| title_full_unstemmed | SARS-CoV-2-specific nasal IgA wanes 9 months after hospitalisation with COVID-19 and is not induced by subsequent vaccination |
| title_short | SARS-CoV-2-specific nasal IgA wanes 9 months after hospitalisation with COVID-19 and is not induced by subsequent vaccination |
| title_sort | sars cov 2 specific nasal iga wanes 9 months after hospitalisation with covid 19 and is not induced by subsequent vaccination |
| work_keys_str_mv | AT liewf sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT talwars sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT crossa sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT willettbj sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT scotts sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT logann sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT sigginsmk sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT swiebodad sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT sidhujk sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT efstathiouc sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT mooresc sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT davisc sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT mohamedn sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT nunagj sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT kingc sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT thompsonaar sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT rowlandjonessl sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT dochertyab sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT chalmersjd sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT holp sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT horsleya sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT ramanb sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT poinasamyk sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT marksm sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT konom sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT howardl sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT woottondg sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT dunachies sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT quintjk sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT evansra sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT wainlv sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT fontanellas sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT desilvati sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT hoa sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT harrisone sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT bailliejk sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT semplemg sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT brightlingc sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT thwaitesrs sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT turtlel sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination AT openshawpjm sarscov2specificnasaligawanes9monthsafterhospitalisationwithcovid19andisnotinducedbysubsequentvaccination |