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

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

    J Clin Immunol


    . 2024 Jun 10;44(6):147.
    doi: 10.1007/s10875-024-01739-0. Lower Humoral and Cellular Immunity Following Asymptomatic SARS-CoV-2 Infection Compared to Symptomatic Infection in Education (The ACE Cohort)

    Georgina Hopkins 1 , Nancy Gomez 1 , Davis Tucis 1 , Laura Bartlett 1 , Graham Steers 1 , Ellie Burns 1 , Michaela Brown 1 , Tyler Harvey-Cowlishaw 1 , Rute Santos 1 , Sarah N Lauder 2 , Martin Scurr 2 3 , Lorenzo Capitani 2 , Stephanie Burnell 2 , Tara Rees 2 , Kathryn Smart 2 , Michelle Somerville 2 , Awen Gallimore 2 , Marianne Perera 4 , Martin Potts 4 , Marina Metaxaki 4 , Benjamin Krishna 4 , Hannah Jackson 1 , Paddy Tighe 1 , David Onion 1 , Andrew Godkin 2 3 , Mark Wills 4 , Lucy Fairclough 5



    AffiliationsAbstract

    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.

    Keywords: Antibody; Asymptomatic; SARS-CoV-2; Symptomatic; T cells; Vaccination.

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