Predictors of reinfection with pre-Omicron and Omicron variants of concern among individuals who recovered from COVID-19 in the first year of the pandemic

Dani Cohen, Marina Izak, Evgeniy Stoyanov, Michal Mandelboim, Saritte Perlman, Yonatan Amir, Sophy Goren, Anya Bialik, Limor Kliker, Nofar Atari, Ruti Yshai, Yona Zaide, Hadar Marcus, Noa Madar-Balakirski, Tomer Israely, Nir Paran, Oren Zimhony, Eilat Shinar, Yasmin Maor, Khitam Muhsen

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11 Scopus citations

Abstract

Objectives: The predictors of SARS-CoV-2 reinfection are unclear. We examined predictors of reinfection with pre-Omicron and Omicron variants among COVID-19-recovered individuals. Methods: Randomly selected COVID-19-recovered patients (N = 1004) who donated convalescent plasma during 2020 were interviewed between August 2021 and March 2022 regarding COVID-19 vaccination and laboratory-proven reinfection. The sera from 224 (22.3%) participants were tested for antispike (anti-S) immunoglobulin G and neutralizing antibodies. Results: The participants’ median age was 31.1 years (78.6% males). The overall reinfection incidence rate was 12.8%; 2.7% versus 21.6% for the pre-Omicron (mostly Delta) versus Omicron variants. Negative associations were found between fever during the first illness and pre-Omicron reinfection: relative risk 0.29 (95% confidence interval 0.09-0.94), high anti-N level at first illness and Omicron reinfection: 0.53 (0.33-0.85), and overall reinfection: 0.56 (0.37-0.84), as well as between subsequent COVID-19 vaccination with the BNT162b2 vaccine and pre-Omicron 0.15 (0.07-0.32), Omicron 0.48 (0.25-0.45), and overall reinfections 0.38 (0.25-0.58). These variables significantly correlated with immunoglobulin G anti-S follow-up levels. High pre-existing anti-S binding and neutralizing antibody levels against the SARS-CoV-2 Wuhan and Alpha strains predicted protection against Omicron reinfections. Conclusion: Strong immune responses after the first COVID-19 infection and subsequent vaccination with the BNT162b2 vaccine provided cross-protection against reinfections with the Delta and Omicron variants.

Original languageEnglish
Pages (from-to)72-79
Number of pages8
JournalInternational Journal of Infectious Diseases
Volume132
DOIs
StatePublished - Jul 2023
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2023 The Authors

Funding

The authors are grateful to SodaStream International Ltd and PepsiCo for the donation that supported the study in part. SodaStream and PepsiCo did not have any role in the study design, data collection and analysis, interpretation of the study findings, writing, or submitting the manuscript. The study protocol was approved by the ethics committees of the Wolfson Medical Center (no. 0074-WOMC) and Tel Aviv University (no. 0003409-1). Participants gave verbal documented consent before being interviewed by phone and those who provided blood samples signed written informed consent form. The authors are thankful to all the volunteers who participated in the follow-up study and to the MDA personnel that assisted in the logistics of the study. Study design: Dani Cohen, Khitam Muhsen, Marina Izak, Oren Zimhony, Eilat Shinar, Yasmin Maor; Data collection: Marina Izak, Evgeniy Stoyanov; Saritte Perlman, Yonatan Amir. Laboratory tests: Anya Bialik, Limor Kliker, Nofar Atari, Ruti Yshai, Yona Zaide, Michal Mandelboim; Data analysis: Sophy Goren, Dani Cohen, Khitam Muhsen; Interpretation of the findings: Dani Cohen, Khitam Muhsen, Marina Izak, Oren Zimhony, Eilat Shinar, Yasmin Maor, Hadar Marcus, Noa Madar-Balakirski, Tomer Israely, Nir Paran; Writing: Dani Cohen, Khitam Muhsen; Reviewing and critical editing: all authors.

FundersFunder number
SodaStream International Ltd
Wolfson Medical Center0074-WOMC
PepsiCo
Tel Aviv University0003409-1

    Keywords

    • Hybrid immunity
    • Longitudinal study
    • Omicron
    • Pre-omicron variants
    • Reinfection

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