Lower Humoral and Cellular Immunity Following Asymptomatic SARS-CoV-2 Infection Compared to Symptomatic Infection in Education (the ACE Cohort)

Georgina Hopkins,Nancy Gomez，Mark Wills,Lucy Fairclough

JOURNAL OF CLINICAL IMMUNOLOGY（2024）

University of Nottingham | Cardiff University | University of Cambridge

Cited 0|Views2

Abstract

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). 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. 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. 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.

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Key words

Asymptomatic,Symptomatic,SARS-CoV-2,Vaccination,Antibody,T cells

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【要点】：无症状感染者在SARS-CoV-2感染后展现的体液免疫和细胞免疫水平低于有症状感染者，疫苗接种后免疫反应有所提升。

【方法】：通过对英国三所大学无症状检测服务中识别的无症状年轻成人进行纵向队列研究，并与年龄和性别匹配的有症状感染者和未感染者进行对比。

【实验】：收集了51名参与者在武汉株感染后及疫苗接种后的血液和唾液样本，测量了抗刺突蛋白抗体滴度、中和抗体以及针对武汉株和B.1.1.529 Omicron变种的 spike 特异性T细胞反应。结果显示，无症状组在疫苗接种前后针对武汉株的中和抗体以及接种后针对Omicron的中和抗体水平均低于有症状组；无症状组在疫苗接种前后针对武汉株和Omicron的IgG滴度也低于有症状组。通过流式细胞术分析和多维聚类分析发现，未接种疫苗的无症状组在武汉株特异性IL-2分泌CD4+ CD45RA+ T细胞和激活CD8+ T细胞数量上显著少于有症状组，但接种疫苗后这些差异消失。

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