Dynamics of IgG antibody responses to SARS-CoV-2 reveals insight into immunity during the early pandemic period in Pakistan

Kiran I. Masood, Shama Qaiser, Syed Hani Abidi, Erum Khan, Syed Faisal Mahmood, Areeba Hussain, Zara Ghous, Kehkashan Imtiaz, Natasha Bahadur Ali, Hassan Hayat, Haris Ali Memon, Maliha Yameen, Shiza Ali, Gulzar S. Lakhani, Sadaf Baloch, Najeeha Talat Iqbal, Kumail Ahmed, Junaid Mehmood, Zulfiqar Ahmed Bhutta, Rabia HussainKulsoom Ghias, Zahra Hasan

Research output: Contribution to journalArticle

Abstract

Background: COVID-19 related disease morbidity and mortality has varied worldwide. We investigated antibody and T cell responses to SARS-CoV-2 in COVID-19 cases and exposed but healthy individuals further compared with pre-pandemic controls in a high infectious disease burden setting.Methods: IgG antibodies against Spike and Spike Receptor Binding Domain (RBD) were determined by ELISA in a Health Care cohort (HC; n=304), COVID-19 cases (n=163) and Pre-Pandemic Controls (PPC; n=114). Neutralizing antibody assays and T cell ELISpot assays were also conducted.Findings: IgG anti Spike proteins and RBD were present in all three groups albeit at varying levels. The highest rate of positivity was observed in COVID-19 cases (87.7% to Spike; 53.9% to RBD); followed by HC (35% to Spike; 21.3% to RBD) and PPC (12.2% to Spike; 10.50% to RBD). Antibody positivity in HC rose from 4.5% in October 2020 to 61% in January 2021. Levels of IgG antibodies to Spike and RBD strongly correlated in COVID-19 and HC but not in PPC. IgG to RBD was associated with neutralizing activity against SARS-CoV-2. Spike reactive T cells were identified in COVID-19 patients (6/18), HC (2/7) and but only one PPC (1/6).Interpretation: IgG to Spike and RBD in pre-pandemic sera is likely associated with cross-protection induced by other pathogens. The increasing percentage of IgG antibody positivity in HCC over the pandemic period may be due to expansion of cross-reactive B cells as observed in PPC, due either to exposure or asymptomatic subclinical infection with SARS-CoV-2. Neutralizing activity of RBD IgG antibodies and reactive T cells to Spike in PPC suggests the presence of memory B and T cells to cross-reactive epitopes that can expand quickly, jumpstarting protection against SARS-CoV-2.Funding Information: This work was supported by the Provost’s Academic Priorities Fund, Aga Khan University. Funding support was also received through Swedish Research Council project SRL 4-182/2019. We acknowledge the support for recombinant protein provided by IBET, NOVA University, Portugal. MV was supported by the European Union H2020 ERA project (No 667824 – EXCELLtoINNOV). Declaration of Interests: The authors have no competing interests to declareEthics Approval Statement: This study was approved by the Ethical Review Committee of The Aga Khan University (projects #2020-5152-11688 and 2020-3687-10181).

Original languageUndefined/Unknown
JournalDepartment of Pathology and Laboratory Medicine
Publication statusPublished - 8 Mar 2022

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