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Lower Humoral and Cellular Immunity Following Asymptomatic SARS-CoV-2 Infection Compared to Symptomatic Infection in Education (The ACE Cohort)

Hopkins, Georgina; Gomez, Nancy; Tucis, Davis; Bartlett, Laura; Steers, Graham; Burns, Ellie; Brown, Michaela; Harvey-Cowlishaw, Tyler; Santos, Rute; Lauder, Sarah N; Scurr, Martin; Capitani, Lorenzo; Burnell, Stephanie; Rees, Tara; Smart, Kathryn; Somerville, Michelle; Gallimore, Awen; Perera, Marianne; Potts, Martin; Metaxaki, Marina; Krishna, Benjamin; Jackson, Hannah; Tighe, Paddy; Onion, David; Godkin, Andrew; Wills, Mark; Fairclough, Lucy

Lower Humoral and Cellular Immunity Following Asymptomatic SARS-CoV-2 Infection Compared to Symptomatic Infection in Education (The ACE Cohort) Thumbnail


Authors

Davis Tucis

Laura Bartlett

Graham Steers

Ellie Burns

Michaela Brown

Tyler Harvey-Cowlishaw

Rute Santos

Sarah N Lauder

Martin Scurr

Lorenzo Capitani

Stephanie Burnell

Tara Rees

Kathryn Smart

Michelle Somerville

Awen Gallimore

Marianne Perera

Martin Potts

Marina Metaxaki

Benjamin Krishna

Hannah Jackson

Paddy Tighe

Dr DAVID ONION david.onion@nottingham.ac.uk
Advanced Technical Specialist (Flow Cytometry)

Andrew Godkin

Mark Wills



Abstract

Purpose
Asymptomatic SARS-CoV-2 infections were widely reported during the COVID-19 pandemic, acting as a hidden source of infection. Many existing studies investigating asymptomatic immunity failed to recruit true asymptomatic individuals. Thus, we conducted a longitudinal cohort study to evaluate humoral- and cell-mediated responses to infection and vaccination in well-defined asymptomatic young adults (the Asymptomatic COVID-19 in Education [ACE] cohort).

Methods
Asymptomatic testing services located at three UK universities identified asymptomatic young adults who were subsequently recruited with age- and sex-matched symptomatic and uninfected controls. Blood and saliva samples were collected after SARS-CoV-2 Wuhan infection, and again after vaccination. 51 participant’s anti-spike antibody titres, neutralizing antibodies, and spike-specific T-cell responses were measured, against both Wuhan and Omicron B.1.1.529.1.

Results
Asymptomatic participants exhibited reduced Wuhan-specific neutralization antibodies pre- and post-vaccination, as well as fewer Omicron-specific neutralization antibodies post-vaccination, compared to symptomatic participants. Lower Wuhan and Omicron-specific IgG titres in asymptomatic individuals were also observed pre- and post-vaccination, compared to symptomatic participants. There were no differences in salivary IgA levels. Conventional flow cytometry analysis and multi-dimensional clustering analysis indicated unvaccinated asymptomatic participants had significantly fewer Wuhan-specific IL-2 secreting CD4+ CD45RA+ T cells and activated CD8+ T cells than symptomatic participants, though these differences dissipated after vaccination.

Conclusions
Asymptomatic infection results in decreased antibody and T cell responses to further exposure to SARS-CoV-2 variants, compared to symptomatic infection. Post-vaccination, antibody responses are still inferior, but T cell immunity increases to match symptomatic subjects, emphasising the importance of vaccination to help protect asymptomatic individuals against future variants.

Citation

Hopkins, G., Gomez, N., Tucis, D., Bartlett, L., Steers, G., Burns, E., Brown, M., Harvey-Cowlishaw, T., Santos, R., Lauder, S. N., Scurr, M., Capitani, L., Burnell, S., Rees, T., Smart, K., Somerville, M., Gallimore, A., Perera, M., Potts, M., Metaxaki, M., …Fairclough, L. (2024). Lower Humoral and Cellular Immunity Following Asymptomatic SARS-CoV-2 Infection Compared to Symptomatic Infection in Education (The ACE Cohort). Journal of Clinical Immunology, 44(6), Article 147. https://doi.org/10.1007/s10875-024-01739-0

Journal Article Type Article
Acceptance Date May 20, 2024
Online Publication Date Jun 10, 2024
Publication Date 2024-08
Deposit Date Aug 6, 2024
Publicly Available Date Aug 20, 2024
Journal Journal of Clinical Immunology
Print ISSN 0271-9142
Electronic ISSN 1573-2592
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 44
Issue 6
Article Number 147
DOI https://doi.org/10.1007/s10875-024-01739-0
Keywords Asymptomatic, Symptomatic, Antibody, SARS-CoV-2, T cells, Vaccination
Public URL https://nottingham-repository.worktribe.com/output/36280445
Publisher URL https://link.springer.com/article/10.1007/s10875-024-01739-0

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Lower Humoral and Cellular Immunity Following Asymptomatic SARS-CoV-2 Infection Compared to Symptomatic Infection in Education (The ACE Cohort) (7.3 Mb)
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Publisher Licence URL
https://creativecommons.org/licenses/by/4.0/

Copyright Statement
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.





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