Deciphering factors linked with reduced SARS-CoV-2 susceptibility in the Swiss HIV Cohort Study

Irene A Abela; Anthony Hauser; Magdalena Schwarzmüller; Chloé Pasin; Katharina Kusejko; Selina Epp; Matthias Cavassini; Manuel Battegay; Andri Rauch; Alexandra Calmy; Julia Notter; Enos Bernasconi; Christoph A Fux; Karoline Leuzinger; Matthieu Perreau; Alban Ramette; Jochen Gottschalk; Eméry Schindler; Alexander Wepf; Maddalena Marconato; Markus G Manz; Beat M Frey; Dominique L Braun; Michael Huber; Huldrych F Günthard; Alexandra Trkola; Roger D Kouyos; Swiss HIV Cohort Study

doi:10.1093/infdis/jiae002

Deciphering factors linked with reduced SARS-CoV-2 susceptibility in the Swiss HIV Cohort Study

J Infect Dis. 2024 Jan 16:jiae002. doi: 10.1093/infdis/jiae002. Online ahead of print.

Authors

Irene A Abela^{1

2}, Anthony Hauser^{1

2}, Magdalena Schwarzmüller², Chloé Pasin^{1

2

3}, Katharina Kusejko^{1

2}, Selina Epp², Matthias Cavassini⁴, Manuel Battegay⁵, Andri Rauch⁶, Alexandra Calmy⁷, Julia Notter⁸, Enos Bernasconi⁹, Christoph A Fux¹⁰, Karoline Leuzinger¹¹, Matthieu Perreau¹², Alban Ramette¹³, Jochen Gottschalk¹⁴, Eméry Schindler¹⁴, Alexander Wepf¹⁵, Maddalena Marconato¹⁶, Markus G Manz¹⁶, Beat M Frey¹⁴, Dominique L Braun¹, Michael Huber², Huldrych F Günthard^{1

2}, Alexandra Trkola², Roger D Kouyos^{1

2}; Swiss HIV Cohort Study

Collaborators

Swiss HIV Cohort Study:
I Abela, K Aebi-Popp, A Anagnostopoulos, M Battegay, E Bernasconi, D L Braun, H C Bucher, A Calmy, M Cavassini, A Ciuffi, G Dollenmaier, M Egger, L Elzi, J Fehr, J Fellay, H Furrer, C A Fux, H F Günthard, A Hachfeld, D Haerry, B Hasse, H H Hirsch, M Hoffmann, I Hösli, M Huber, D Jackson-Perry, C R Kahlert, L Kaiser, O Keiser, T Klimkait, R D Kouyos, H Kovari, K Kusejko, N Labhardt, K Leuzinger, B Martinez de Tejada, C Marzolini, K J Metzner, N Müller, J Nemeth, D Nicca, J Notter, P Paioni, G Pantaleo, M Perreau, A Rauch, L Salazar-Vizcaya, P Schmid, R Speck, M Stöckle, P Tarr, A Trkola, G Wandeler, M Weisser, S Yerly

Affiliations

¹ Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
² Institute of Medical Virology, University of Zurich, Zurich, Switzerland.
³ Collegium Helveticum, Zurich, Switzerland.
⁴ Division of Infectious Diseases, Lausanne University Hospital, Lausanne, Switzerland.
⁵ Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Basel, Switzerland.
⁶ Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland.
⁷ Laboratory of Virology and Division of Infectious Diseases, Geneva University Hospital, University of Geneva, Geneva, Switzerland.
⁸ Division of Infectious Diseases, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
⁹ Division of Infectious Diseases, Ente Ospedaliero Cantonale Lugano, University of Geneva and University of Southern Switzerland, Lugano, Switzerland.
¹⁰ Department of Infectious Diseases, Kantonsspital Aarau, Aarau, Switzerland.
¹¹ Clinical Virology, University Hospital Basel, Basel, Switzerland.
¹² Division of Immunology and Allergy, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.
¹³ Institute for Infectious Diseases, University of Bern, Bern, Switzerland.
¹⁴ Blood Transfusion Service Zurich, Zurich, Switzerland.
¹⁵ Institute of Laboratory Medicine, Cantonal Hospital Winterthur, Winterthur, Switzerland.
¹⁶ Department of Medical Oncology and Hematology, University Hospital and University of Zurich, Zurich, Switzerland.

PMID: 38227786
DOI: 10.1093/infdis/jiae002

Abstract

Background: Factors influencing susceptibility to SARS-CoV-2 remain to be resolved. Using data of the Swiss HIV Cohort Study (SHCS) on 6,270 people with HIV (PWH) and serologic assessment for SARS-CoV-2 and circulating-human-coronavirus (HCoV) antibodies, we investigated the association of HIV-related and general parameters with SARS-CoV-2 infection.

Methods: We analyzed SARS-CoV-2 PCR-tests, COVID-19 related hospitalizations, and deaths reported to the SHCS between January 1, 2020 and December 31, 2021. Antibodies to SARS-CoV-2 and HCoVs were determined in pre-pandemic (2019) and pandemic (2020) bio-banked plasma and compared to HIV-negative individuals. We applied logistic regression, conditional logistic regression, and Bayesian multivariate regression to identify determinants of SARS-CoV-2 infection and Ab responses to SARS-CoV-2 in PWH.

Results: No HIV-1-related factors were associated with SARS-CoV-2 acquisition. High pre-pandemic HCoV antibodies were associated with a lower risk of subsequent SARS-CoV-2 infection and with higher SARS-CoV-2 antibody responses upon infection. We observed a robust protective effect of smoking on SARS-CoV-2-infection risk (aOR= 0.46 [0.38,0.56], p=2.6*10-14), which occurred even in previous smokers, and was highest for heavy smokers.

Conclusions: Our findings of two independent protective factors, smoking and HCoV antibodies, both affecting the respiratory environment, underscore the importance of the local immune milieu in regulating susceptibility to SARS-CoV-2.

Keywords: HIV; PWH; SARS-CoV-2; endemic human coronaviruses; pre-existing immunity; smoking.