Long-Term Follow-Up of COVID-19 Convalescents-Immune Response Associated with Reinfection Rate and Symptoms

Anna Seller; Christopher Hackenbruch; Juliane S Walz; Annika Nelde; Jonas S Heitmann

doi:10.3390/v15102100

Long-Term Follow-Up of COVID-19 Convalescents-Immune Response Associated with Reinfection Rate and Symptoms

Viruses. 2023 Oct 17;15(10):2100. doi: 10.3390/v15102100.

Authors

Anna Seller^{1

2

3}, Christopher Hackenbruch^{1

3}, Juliane S Walz^{1

3

4}, Annika Nelde^{3

4}, Jonas S Heitmann^{1

3

4}

Affiliations

¹ Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tuebingen, Otfried-Müller-Str. 10, 72076 Tuebingen, Germany.
² Department of Obstetrics and Gynecology, University Hospital Tuebingen, Calwerstraße 7, 72076 Tuebingen, Germany.
³ Department of Peptide-Based Immunotherapy, Institute of Immunology, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076 Tuebingen, Germany.
⁴ Cluster of Excellence iFIT (EXC2180) "Image-Guided and Functionally Instructed Tumor Therapies", University of Tübingen, Röntgenweg 11, 72076 Tuebingen, Germany.

Abstract

SARS-CoV-2 has spread worldwide, causing millions of deaths and leaving a significant proportion of people with long-term sequelae of COVID-19 ("post-COVID syndrome"). Whereas the precise mechanism of post-COVID syndrome is still unknown, the immune response after the first infection may play a role. Here, we performed a long-term follow-up analysis of 110 COVID-19 convalescents, analyzing the first SARS-CoV-2-directed immune response, vaccination status, long-term symptoms (approximately 2.5 years after first infection), and reinfections. A total of 96% of convalescents were vaccinated at least once against SARS-CoV-2 after their first infection. A reinfection rate of 47% was observed, and lower levels of anti-spike IgG antibodies after the first infection were shown to associate with reinfection. While T-cell responses could not be clearly associated with persistent postinfectious symptoms, convalescents with long-term symptoms showed elevated SARS-CoV-2-specific antibody levels at the first infection. Evaluating the immune response after the first infection might be a useful tool for identifying individuals with increased risk for re-infections and long-term symptoms.

Keywords: COVID-19; SARS-CoV-2; immune response; post-COVID syndrome.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Antibodies, Viral
COVID-19*
Follow-Up Studies
Humans
Reinfection
SARS-CoV-2

Substances

Antibodies, Viral

Grants and funding

This work was supported by the Federal Ministry of Education and Research (BMBF 16LW0005 and BMBF/SEA-Europe Joint Funding 2020/01DP21014, J.S.W.), the German Research Foundation (DFG, German Research Foundation, Grant WA 4608/1-2, J.S.W.), the German Research Foundation under Germany’s Excellence Strategy (Grant EXC2180-390900677, J.S.W.), the German Cancer Consortium (DKTK, J.S.W.), the Wilhelm Sander-Stiftung (Grant 2016.177.3, J.S.W.), Deutsche Krebshilfe (Grant 70114948, J.S.W.), and a Publication Cost Grant by the Open Access Publication Fund of the University of Tübingen.