Durability of Immunity Against Reinfection by SARS-CoV-2: A Comparative Evolutionary Study   [open pdf - 3MB]

From the Introduction: "The ongoing COVID-19 [coronavirus disease 2019] pandemic has resulted in over 4∙5 million deaths worldwide. Approaches to control COVID-19 depend on the durability of immunity conferred by recovery and by vaccination. However, predicting the durability of immunity against the virus causing COVID-19, SARS-CoV-2 [severe acute respiratory syndrome coronavirus 2], remains challenging amid a pandemic. During the rapid expansion of the pandemic, there have been few documented reinfections relative to the overall incidence. Short-term longitudinal studies of the levels of SARS-CoV-2 neutralising antibodies at best provide lower bounds for the durability of immunity. By contrast, the long-term waning of antibody levels following infection has been assessed among close coronavirus relatives of SARS-CoV-2, including SARS-CoV, MERS-CoV [Middle East respiratory syndrome coronavirus], human coronavirus (HCoV)-OC43, HCoV-229E, and HCoV-NL63. Extensive reinfection data over time have been collected for seasonal endemic coronaviruses (HCoV-OC43, HCoV-229E, and HCoV-NL63). The zoonotic coronavirus SARS-CoV-2 is unlikely to have evolved an especially divergent interaction with the mammalian immune system compared with its close coronavirus relatives. Therefore, the waning of humoral immunity against SARS-CoV-2, the observed rates of antibody decline after infection, and the probability of reinfection given antibody levels for multiple close relatives of SARS-CoV-2 can be estimated from a phylogenetic analysis of the ancestral and descendent states that fills in critical gaps in our knowledge of SARS-CoV-2."

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