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J Infect Dis . Preinfection Neutralizing Antibodies, Omicron BA.5 Breakthrough Infection, and Long COVID: A Propensity Score-Matched Analysis

tetano

Editor, Senior Moderator
J Infect Dis


. 2023 Sep 26;jiad317.
doi: 10.1093/infdis/jiad317. Online ahead of print. Preinfection Neutralizing Antibodies, Omicron BA.5 Breakthrough Infection, and Long COVID: A Propensity Score-Matched Analysis

Shohei Yamamoto[SUP] 1 [/SUP], Kouki Matsuda[SUP] 2 3 4 [/SUP], Kenji Maeda[SUP] 4 5 [/SUP], Kumi Horii[SUP] 6 [/SUP], Kaori Okudera[SUP] 7 [/SUP], Yusuke Oshiro[SUP] 8 [/SUP], Natsumi Inamura[SUP] 8 [/SUP], Takashi Nemoto[SUP] 8 [/SUP], Junko S Takeuchi[SUP] 9 [/SUP], Yunfei Li[SUP] 1 [/SUP], Maki Konishi[SUP] 1 [/SUP], Kiyoto Tsuchiya[SUP] 2 [/SUP], Hiroyuki Gatanaga[SUP] 2 [/SUP], Shinichi Oka[SUP] 2 [/SUP], Tetsuya Mizoue[SUP] 1 [/SUP], Haruhito Sugiyama[SUP] 10 [/SUP], Nobuyoshi Aoyanagi[SUP] 11 [/SUP], Hiroaki Mitsuya[SUP] 5 [/SUP], Wataru Sugiura[SUP] 12 [/SUP], Norio Ohmagari[SUP] 13 [/SUP]



Affiliations
Abstract

Background: Data are limited on the role of preinfection humoral immunity protection against Omicron BA.5 infection and long coronavirus disease (COVID) development.
Methods: We conducted nested case-control analysis among tertiary hospital staff in Tokyo who donated blood samples in June 2022 (1 month before Omicron BA.5 wave), approximately 6 months after receiving a third dose of COVID-19 mRNA vaccine. We measured live virus-neutralizing antibody titers against wild type and Omicron BA.5, and anti-receptor-binding domain (RBD) antibody titers at preinfection, and compared them between cases and propensity-matched controls. Among the breakthrough cases, we examined association between preinfection antibody titers and incidence of long COVID.
Results: Preinfection anti-RBD and neutralizing antibody titers were lower in cases than controls. Neutralizing titers against wild type and Omicron BA.5 were 64% (95% confidence interval [CI], 42%-77%) and 72% (95% CI, 53%-83%) lower, respectively, in cases than controls. Individuals with previous Omicron BA.1/BA.2 infections were more frequent among controls than cases (10.3% vs 0.8%), and their Omicron BA.5 neutralizing titers were 12.8-fold higher than infection-naive individuals. Among cases, preinfection antibody titers were not associated with incidence of long COVID.
Conclusions: Preinfection immunogenicity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may play a role in protecting against the Omicron BA.5 infection but not preventing long COVID.

Keywords: COVID-19; breakthrough infection; long COVID; neutralizing antibody; prior infection; vaccination.

 
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