Impaired humoral immunity to BQ.1.1 in convalescent and vaccinated patients

Felix Dewald, Martin Pirkl, Martha Paluschinski, Joachim Kühn, Carina Elsner, Bianca Schulte, Jacqueline Knüfer, Elvin Ahmadov, Maike Schlotz, Göksu Oral, Michael Bernhard, Mark Michael, Maura Luxenburger, Marcel Andrée, Marc Tim Hennies, Wali Hafezi, Marlin Maybrit Müller, Philipp Kümpers, Joachim Risse, Clemens Kill, Randi Katrin Manegold, Ute Frantzki, Enrico Richter, Dorian Emmert, Werner O. Monzon-Posadas, Ingo Gräff, Monika Kogej, Antonia Büning, Maximilian Baum, Finn Teipel, Babak Mochtarzadeh, Martin Wolff, Henning Gruell, Veronica Cristanziano, Volker Burst, Hendrik Streeck, Ulf Dittmer, Stephan Ludwig, Jörg Timm and Florian Klein ()
Additional contact information
Felix Dewald: Faculty of Medicine and University Hospital Cologne, University of Cologne
Martin Pirkl: Faculty of Medicine and University Hospital Cologne, University of Cologne
Martha Paluschinski: University Hospital Düsseldorf, Heinrich Heine University Düsseldorf
Joachim Kühn: Faculty of Medicine and University Hospital Muenster, University of Muenster
Carina Elsner: University Hospital Essen, University Duisburg-Essen
Bianca Schulte: University Hospital Bonn, University of Bonn
Jacqueline Knüfer: Faculty of Medicine and University Hospital Cologne, University of Cologne
Elvin Ahmadov: Faculty of Medicine and University Hospital Cologne, University of Cologne
Maike Schlotz: Faculty of Medicine and University Hospital Cologne, University of Cologne
Göksu Oral: Faculty of Medicine and University Hospital Cologne, University of Cologne
Michael Bernhard: Medical Faculty and University Hospital of Düsseldorf, Heinrich Heine University Düsseldorf
Mark Michael: Medical Faculty and University Hospital of Düsseldorf, Heinrich Heine University Düsseldorf
Maura Luxenburger: University Hospital Düsseldorf, Heinrich Heine University Düsseldorf
Marcel Andrée: University Hospital Düsseldorf, Heinrich Heine University Düsseldorf
Marc Tim Hennies: Faculty of Medicine and University Hospital Muenster, University of Muenster
Wali Hafezi: Faculty of Medicine and University Hospital Muenster, University of Muenster
Marlin Maybrit Müller: Faculty of Medicine and University Hospital Muenster, University of Muenster
Philipp Kümpers: Faculty of Medicine and University Hospital Muenster, University of Muenster
Joachim Risse: University Hospital Essen
Clemens Kill: University Hospital Essen
Randi Katrin Manegold: University Hospital Essen
Ute Frantzki: University Hospital Essen
Enrico Richter: University Hospital Bonn, University of Bonn
Dorian Emmert: University Hospital Bonn, University of Bonn
Werner O. Monzon-Posadas: University Hospital Bonn
Ingo Gräff: University Hospital Bonn, University of Bonn
Monika Kogej: University Hospital Bonn, University of Bonn
Antonia Büning: University Hospital Bonn, University of Bonn
Maximilian Baum: University Hospital Bonn, University of Bonn
Finn Teipel: Faculty of Medicine and University Hospital Cologne, University of Cologne
Babak Mochtarzadeh: Faculty of Medicine and University Hospital Cologne, University of Cologne
Martin Wolff: Faculty of Medicine and University Hospital Cologne, University of Cologne
Henning Gruell: Faculty of Medicine and University Hospital Cologne, University of Cologne
Veronica Cristanziano: Faculty of Medicine and University Hospital Cologne, University of Cologne
Volker Burst: Faculty of Medicine and University Hospital Cologne University of Cologne
Hendrik Streeck: University Hospital Bonn, University of Bonn
Ulf Dittmer: University Hospital Essen, University Duisburg-Essen
Stephan Ludwig: Faculty of Medicine and University Hospital Muenster, University of Muenster
Jörg Timm: University Hospital Düsseldorf, Heinrich Heine University Düsseldorf
Florian Klein: Faculty of Medicine and University Hospital Cologne, University of Cologne

Nature Communications, 2023, vol. 14, issue 1, 1-13

Abstract: Abstract Determining SARS-CoV-2 immunity is critical to assess COVID-19 risk and the need for prevention and mitigation strategies. We measured SARS-CoV-2 Spike/Nucleocapsid seroprevalence and serum neutralizing activity against Wu01, BA.4/5 and BQ.1.1 in a convenience sample of 1,411 patients receiving medical treatment in the emergency departments of five university hospitals in North Rhine-Westphalia, Germany, in August/September 2022. 62% reported underlying medical conditions and 67.7% were vaccinated according to German COVID-19 vaccination recommendations (13.9% fully vaccinated, 54.3% one booster, 23.4% two boosters). We detected Spike-IgG in 95.6%, Nucleocapsid-IgG in 24.0%, and neutralization against Wu01, BA.4/5 and BQ.1.1 in 94.4%, 85.0%, and 73.8% of participants, respectively. Neutralization against BA.4/5 and BQ.1.1 was 5.6- and 23.4-fold lower compared to Wu01. Accuracy of S-IgG detection for determination of neutralizing activity against BQ.1.1 was reduced substantially. We explored previous vaccinations and infections as correlates of BQ.1.1 neutralization using multivariable and Bayesian network analyses. Given a rather moderate adherence to COVID-19 vaccination recommendations, this analysis highlights the need to improve vaccine-uptake to reduce the COVID-19 risk of immune evasive variants. The study was registered as clinical trial (DRKS00029414).

Date: 2023
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DOI: 10.1038/s41467-023-38127-y

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