Evidence for increased SARS-CoV-2 susceptibility and COVID-19 severity related to pre-existing immunity to seasonal coronaviruses

• Published in: Cell reports (Cambridge) Vol. 37; no. 13; p. 110169
• Main Authors: Wratil, Paul R., Schmacke, Niklas A., Karakoc, Burak, Dulovic, Alex, Junker, Daniel, Becker, Matthias, Rothbauer, Ulrich, Osterman, Andreas, Spaeth, Patricia M., Ruhle, Adrian, Gapp, Madeleine, Schneider, Stephanie, Muenchhoff, Maximilian, Hellmuth, Johannes C., Scherer, Clemens, Mayerle, Julia, Reincke, Martin, Behr, Juergen, Kääb, Stefan, Zwissler, Bernhard, von Bergwelt-Baildon, Michael, Eberle, Josef, Kaderali, Lars, Schneiderhan-Marra, Nicole, Hornung, Veit, Keppler, Oliver T.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 28.12.2021; The Authors
• Subjects: Adult; antibodies; Antibodies - immunology; Antibodies, Viral - immunology; common cold; Coronavirus - immunology; Coronavirus Infections - immunology; Coronavirus OC43, Human - immunology; Coronavirus OC43, Human - pathogenicity; COVID-19; COVID-19 - etiology; COVID-19 - immunology; Cross Reactions - immunology; disease severity; Female; Germany; HCoV; Humans; humoral immunity; Immunity, Humoral - immunology; Immunoglobulin G - immunology; Longitudinal Studies; Male; Middle Aged; pandemic; Pandemics; SARS-CoV-2; SARS-CoV-2 - immunology; SARS-CoV-2 - pathogenicity; seasonal coronaviruses; Seasons; Severity of Illness Index; Spike Glycoprotein, Coronavirus - immunology; susceptibility; Germany; COVID-19; SARS-CoV-2; humoral immunity; HCoV; susceptibility; seasonal coronaviruses; antibodies; pandemic; disease severity; common cold
• ISSN: 2211-1247; 2211-1247
• DOI: 10.1016/j.celrep.2021.110169

The importance of pre-existing immune responses to seasonal endemic coronaviruses (HCoVs) for the susceptibility to SARS-CoV-2 infection and the course of COVID-19 is the subject of an ongoing scientific debate. Recent studies postulate that immune responses to previous HCoV infections can either have a slightly protective or no effect on SARS-CoV-2 pathogenesis and, consequently, be neglected for COVID-19 risk stratification. Challenging this notion, we provide evidence that pre-existing, anti-nucleocapsid antibodies against endemic α-coronaviruses and S2 domain-specific anti-spike antibodies against β-coronavirus HCoV-OC43 are elevated in patients with COVID-19 compared to pre-pandemic donors. This finding is particularly pronounced in males and in critically ill patients. Longitudinal evaluation reveals that antibody cross-reactivity or polyclonal stimulation by SARS-CoV-2 infection are unlikely to be confounders. Thus, specific pre-existing immunity to seasonal coronaviruses may increase susceptibility to SARS-CoV-2 and predispose individuals to an adverse COVID-19 outcome, guiding risk management and supporting the development of universal coronavirus vaccines. [Display omitted] •Antibody levels against SARS-CoV-2 and human seasonal coronaviruses are assessed•Specific anti-seasonal coronavirus antibodies are elevated in patients with COVID-19•Anti-seasonal coronavirus antibodies are largely independent from COVID-19 course•Pre-existing seasonal coronavirus immunity may increase susceptibility to SARS-CoV-2 Wratil et al. find specific antibody responses against seasonal human coronaviruses, which cause the common cold, to be elevated in patients with COVID-19 compared to pre-pandemic blood donors. This specific immunity is likely pre-existing in patients and increases their susceptibility to SARS-CoV-2 and severity of COVID-19.