Effectiveness of natural immune protection against COVID-19 reinfection: systematic review with meta-analysis

##plugins.themes.academic_pro.article.sidebar##

Published Jul 10, 2023
Download
PDF
Vol. 101 No. 2 (2023): Issue Feb 2023

##plugins.themes.academic_pro.article.main##

Abderrahmane Moundir
Laboratoire d’Immunologie Clinique, Inflammation et Allergies (LICIA), Faculté de Médecine et de Pharmacie, université Hassan II, Casablanca, Maroc.
Abderrahmane Errami
Laboratoire d’Immunologie Clinique, Inflammation et Allergies (LICIA), Faculté de Médecine et de Pharmacie, université Hassan II, Casablanca, Maroc.
Jalila El Bakkouri
1. Laboratoire d’Immunologie Clinique, Inflammation et Allergies (LICIA), Faculté de Médecine et de Pharmacie, université Hassan II, Casablanca, Maroc. /2. Centre hospitalier universitaire Ibn-Rochd, Casablanca, Maroc.
Ahmed Ben Abdelaziz
Médecine Préventive et Communautaire. Faculté de Médecine de Sousse. Université de Sousse. Tunisie / Laboratoire de Recherche LR19SP01 (Mesure et appui à la performance hospitalière). Direction des Systèmes d’Information. Hôpital Sahloul de Sousse, Tunisie
Ahmed Aziz Bousfiha
Laboratoire d’Immunologie Clinique, Inflammation et Allergies (LICIA), Faculté de Médecine et de Pharmacie, université Hassan II, Casablanca, Maroc. / Centre hospitalier universitaire Ibn-Rochd, Casablanca, Maroc.

Abstract

Introduction: The future of the COVID-19 pandemic depends on the evolution of the virus and immune protection stimulated by vaccination
or upon exposure to natural infection. While most research focuses on vaccine efficacy, data remain unclear on the efficacy and duration of
natural immune protection against infection. In this article, we aim to determine the efficacy of natural immune protection against reinfection with
COVID-19 or severe COVID-19.
Methods: We performed a systematic review of available studies in electronic databases followed by a meta-analysis to determine the efficacy
of natural immune protection against COVID-19 reinfection and severe infection.
Results: Of the 414 studies identified for the full review, 8 studies met the inclusion criteria and were analyzed. The total number of individuals
participating in the 8 studies included 19,837,147 people. Individuals with a history of SARS-CoV-2 infection (1,9% [0,6%-3,1%]) had a lower rate
of infection than individuals without a history of infection (7,1% [3,9%-10,1%]). The mean efficacy of natural immune protection against reinfection
was 84,7% [78,5%-90,9%], while the mean efficacy of natural immune protection against severe COVID-19 infection was 96,9% [94%-99,6%].
Conclusion: These results indicate that natural immune protection against reinfection is high, particularly against severe COVID-19. However,
further research is needed to determine the duration of natural immune protection and the impact of different variants of SARS-CoV-2.

Keywords:

COVID-19, Natural immune protection , Effectiveness, Reinfection, Systematic review, Meta-analysis.

##plugins.themes.academic_pro.article.details##

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

References

  1. Gomes MG, White LJ, Medley GF. Infection, reinfection, and vaccination under suboptimal immune protection: epidemiological perspectives. J Theor Biol. 2004;228(4):539-49.
  2. Chemaitelly H, Tang P, Hasan MR, AlMukdad S, Yassine HM, Benslimane FM, et al. Waning of BNT162b2 Vaccine Protection against SARS-CoV-2 Infection in Qatar. New Engl J Med. 2021;385(24):e83.
  3. Higdon MM, Baidya A, Walter KK, Patel MK, Issa H, Espie E, et al. Duration of effectiveness of vaccination against COVID-19 caused by the omicron variant. Lancet Infect Dis. 2022;22(8):1114-6.
  4. Lee IK, Wang CC, Lin MC, Kung CT, Lan KC, Lee CT. Effective strategies to prevent coronavirus disease-2019 (COVID-19) outbreak in hospital. J Hosp Infect. 2020;105(1):102-3.
  5. Wajnberg A, Amanat F, Firpo A, Altman DR, Bailey MJ, Mansour M, et al. Robust neutralizing antibodies to SARS-CoV-2 infection persist for months. Science. 2020;370(6521):1227-30.
  6. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264-9, W64.
  7. Prevention CfDCa. Interim guidance on duration of isolation and precautions for adults with COVID-10. [cited 2021 Jun 6] https://www.cdc.gov/coronavirus/2019-ncov/hcp/duration-isolation.html. Published March 16, 2021. 2021.
  8. Stephens DS, McElrath MJ. COVID-19 and the Path to Immunity. JAMA. 2020;324(13):1279-81.
  9. Feikin DR, Higdon MM, Abu-Raddad LJ, Andrews N, Araos R, Goldberg Y, et al. Duration of effectiveness of vaccines against SARS-CoV-2 infection and COVID-19 disease: results of a systematic review and meta-regression. Lancet. 2022;399(10328):924-44.
  10. Cao WC, Liu W, Zhang PH, Zhang F, Richardus JH. The disappearance of antibodies to SARS-associated coronavirus after recovery. New Engl J Med. 2007;357(11):1162-3.
  11. Nordstrom P, Ballin M, Nordstrom A. Risk of SARS-CoV-2 reinfection and COVID-19 hospitalisation in individuals with natural and hybrid immunity: a retrospective, total population cohort study in Sweden. Lancet Infect Dis. 2022;22(6):781-90.
  12. Chemaitelly H, Nagelkerke N, Ayoub HH, Coyle P, Tang P, Yassine HM, et al. Duration of immune protection of SARS-CoV-2 natural infection against reinfection in Qatar. medRxiv. 2022:2022.07.06.22277306.
  13. Abu-Raddad LJ, Chemaitelly H, Coyle P, Malek JA, Ahmed AA, Mohamoud YA, et al. SARS-CoV-2 antibody-positivity protects against reinfection for at least seven months with 95% efficacy. E Clin Med. 2021;35:100861.
  14. Pilz S, Theiler-Schwetz V, Trummer C, Krause R, Ioannidis JPA. SARS-CoV-2 reinfections: Overview of efficacy and duration of natural and hybrid immunity. Environ Res. 2022;209:112911.
  15. Altarawneh HN, Chemaitelly H, Hasan MR, Ayoub HH, Qassim S, AlMukdad S, et al. Protection against the Omicron Variant from Previous SARS-CoV-2 Infection. New Engl J Med. 2022;386(13):1288-90.
  16. Altarawneh HN, Chemaitelly H, Ayoub HH, Tang P, Hasan MR, Yassine HM, et al. Effects of Previous Infection and Vaccination on Symptomatic Omicron Infections. New Engl J Med. 2022;387(1):21-34.
  17. Goldberg Y, Mandel M, Woodbridge Y, Fluss R, Novikov I, Yaari R, et al. Protection of previous SARS-CoV-2 infection is similar to that of BNT162b2 vaccine protection: A three-month nationwide experience from Israel. medRxiv. 2021:2021.04.20.21255670.
  18. Bastard P, Gervais A, Le Voyer T, Rosain J, Philippot Q, Manry J, et al. Autoantibodies neutralizing type I IFNs are present in ~4% of uninfected individuals over 70 years old and account for ~20% of COVID-19 deaths. Science immunology. 2021;6(62).
  19. Pilz S, Chakeri A, Ioannidis JP, Richter L, Theiler-Schwetz V, Trummer C, et al. SARS-CoV-2 re-infection risk in Austria. Eur J Clin Invest. 2021;51(4):e13520.
  20. Hansen CH, Michlmayr D, Gubbels SM, Molbak K, Ethelberg S. Assessment of protection against reinfection with SARS-CoV-2 among 4 million PCR-tested individuals in Denmark in 2020: a population-level observational study. Lancet. 2021;397(10280):1204-12.
  21. Sheehan MM, Reddy AJ, Rothberg MB. Reinfection Rates Among Patients Who Previously Tested Positive for Coronavirus Disease 2019: A Retrospective Cohort Study. Clin Infect Dis. 2021;73(10):1882-6.
  22. Lacy J, Mensah A, Simmons R, Andrews N, Siddiqui MR, Bukasa A, et al. Protective effect of a first SARS-CoV-2 infection from reinfection: a matched retrospective cohort study using PCR testing data in England. Epidemiol Infect. 2022;150:e109.
  23. Michlmayr D, Hansen CH, Gubbels SM, Valentiner-Branth P, Bager P, Obel N, et al. Observed protection against SARS-CoV-2 reinfection following a primary infection: A Danish cohort study among unvaccinated using two years of nationwide PCR-test data. Lancet Reg Health Eur. 2022;20:100452.