Differential protection against SARS-CoV-2 reinfection pre- and post-Omicron

• 成果类型: Article
• 署名作者: Chemaitelly, Hiam; Ayoub, Houssein H.; Coyle, Peter; Tang, Patrick; Hasan, Mohammad R.; Yassine, Hadi M.; Al Thani, Asmaa A.; Al-Kanaani, Zaina; Al-Kuwari, Einas; Jeremijenko, Andrew; Kaleeckal, Anvar Hassan; Latif, Ali Nizar; Shaik, Riyazuddin Mohammad; Abdul-Rahim, Hanan F.; Nasrallah, Gheyath K.; Al-Kuwari, Mohamed Ghaith; Butt, Adeel A.; Al-Romaihi, Hamad Eid; Al-Thani, Mohamed H.; Al-Khal, Abdullatif; Bertollini, Roberto; Abu-Raddad, Laith J.
• 署名单位: Qatar Foundation (QF); Weill Cornell Medical College Qatar; Qatar Foundation (QF); Weill Cornell Medical College Qatar; Cornell University; Weill Cornell Medicine; Qatar University; Qatar University; Hamad Medical Corporation; Queens University Belfast; Sidra Medical & Research Center; McMaster University; Qatar University; Qatar University; Hamad Medical Corporation; Primary Health Care Corporation (PHCC); Cornell University; Weill Cornell Medicine; Qatar Foundation (QF); Hamad Bin Khalifa University-Qatar
• 刊物名称: Nature
• ISSN/ISSBN: 0028-3540
• DOI: 10.1038/s41586-024-08511-9
• 发表日期: 2025-03-27
• 关键词: covid-19; immunity; vaccination; infection; variants; DESIGN

摘要

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly evolved over short timescales, leading to the emergence of more transmissible variants such as Alpha and Delta1, 2-3. The arrival of the Omicron variant marked a major shift, introducing numerous extra mutations in the spike gene compared with earlier variants1,2. These evolutionary changes have raised concerns regarding their potential impact on immune evasion, disease severity and the effectiveness of vaccines and treatments1,3. In this epidemiological study, we identified two distinct patterns in the protective effect of natural infection against reinfection in the Omicron versus pre-Omicron eras. Before Omicron, natural infection provided strong and durable protection against reinfection, with minimal waning over time. However, during the Omicron era, protection was robust only for those recently infected, declining rapidly over time and diminishing within a year. These results demonstrate that SARS-CoV-2 immune protection is shaped by a dynamic interaction between host immunity and viral evolution, leading to contrasting reinfection patterns before and after Omicron's first wave. This shift in patterns suggests a change in evolutionary pressures, with intrinsic transmissibility driving adaptation pre-Omicron and immune escape becoming dominant post-Omicron, underscoring the need for periodic vaccine updates to sustain immunity.