학술논문
Protective role of SARS-CoV-2 anti-S IgG against breakthrough infections among European healthcare workers during pre and post-Omicron surge—ORCHESTRA project
Document Type
Original Paper
Author
Spiteri, Gianluca; D’Agostini, Marika; Abedini, Mahsa; Ditano, Giorgia; Collatuzzo, Giulia; Boffetta, Paolo; Vimercati, Luigi; Sansone, Emanuele; De Palma, Giuseppe; Modenese, Alberto; Gobba, Fabriziomaria; Liviero, Filippo; Moretto, Angelo; dell’Omo, Marco; Fiordi, Tiziana; Larese Filon, Francesca; Mauro, Marcella; Violán, Concepción; Mates, Dana; Oravec Bérešová, Jana; Monaco, Maria Grazia Lourdes; Carta, Angela; Verlato, Giuseppe; Porru, Stefano
Source
Infection: A Journal of Infectious Diseases. :1-10
Subject
Language
English
ISSN
0300-8126
1439-0973
1439-0973
Abstract
Purpose: Anti SARS-CoV-2 vaccination initially showed high effectiveness in preventing COVID-19. However, after the surge of variants of concern, the effectiveness dropped. Several studies investigated if this was related to the decrease of the humoral response over time; however, this issue is still unclear. The aim of this study was to understand whether SARS-CoV-2 anti-S IgG levels can be used to predict breakthrough infection risk and define the timing for further booster doses administration.Method: Within the framework of the ORCHESTRA Project, over 20,000 health workers from 11 European centers were enrolled since December 2020. We performed two Cox proportional hazards survival analyses regarding pre-Omicron (from January to July 2021) and Omicron (December 2021–May 2022) periods. The serological response was classified as high (above the 75th percentile), medium (25th-75th), or low (< 25th).Results: Seventy-four (0.33%) and 2122 (20%) health workers were infected during the first and second periods, respectively. Both Cox analyses showed that having high anti-S titer was linked to a significantly lower risk of infection as compared to having medium serological response [HR of high vs medium anti-S titer = 0.27 (95% CI 0.11–0.66) during the first phase, HR = 0.76 (95% CI 0.62–0.93) during the second phase].Conclusion: Vaccine effectiveness wanes significantly after new variants surge, making anti-S titer unsuitable to predict optimal timing for further booster dose administration. Studies on other immunological indicators, such as cellular immunity, are therefore needed to better understand the mechanisms and duration of protection against breakthrough infection risk.