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Boosting of Serum Neutralizing Activity Against the Omicron Variant Among Recovered COVID-19 Patients by BNT162b2 and Coronavac Vaccines

36 Pages Posted: 8 Feb 2022

See all articles by Lu Lu

Lu Lu

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases

Lin-Lei Chen

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases

Ricky Rui-Qi Zhang

The University of Hong Kong - Li Ka Shing Faculty of Medicine

Owen Tak-Yin Tsang

Princess Margaret Hospital - Department of Medicine

Jacky Man-Chun Chan

The University of Hong Kong

Anthony Raymond Tam

The University of Hong Kong - Division of Infectious Disease

Wai-Shing Leung

The University of Hong Kong

Thomas Shiu-Hong Chik

The University of Hong Kong

Daphne Pui-Ling Lau

The University of Hong Kong

Chris Yau-Chung Choi

The University of Hong Kong

Carol Ho-Yan Fong

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases

Jian-Piao Cai

Southern Medical University - Division of Laboratory Medicine

Hoi-Wah Tsoi

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases

Charlotte Yee-Ki Choi

The University of Hong Kong

Xiaojuan Zhang

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases

Syed Muhammad Umer Abdullah

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases

Brian Pui-Chun Chan

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases

Kwok-Hung Chan

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases

Kwok-Yung Yuen

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases

Ivan Fan Ngai Hung

The University of Hong Kong - School of Clinical Medicine

Kelvin Kai-Wang To

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases

More...

Abstract

Background: SARS-CoV-2 Omicron variant evades immunity from past infection or vaccination and is associated with a greater risk of reinfection among recovered COVID-19 patients. We assessed the serum neutralizing antibody (NAb) activity against Omicron variant (Omicron NAb) among recovered COVID-19 patients with or without vaccination.

Methods: In this prospective cohort study with 135 recovered COVID-19 patients, we determined the serum NAb titers against ancestral virus or variants using a live virus NAb assay. We used the receiver operating characteristic analysis to determine the optimal cutoff for a commercially-available surrogate NAb assay.

Findings: Among recovered COVID-19 patients, the serum live virus geometric mean Omicron NAb titer was statistically significantly higher among BNT162b2 recipients compared to non-vaccinated individuals (85.4 vs 5.6, P<0.0001). The Omicron seropositive rates in live virus NAb test (NAb titer ≥10) were statistically significantly higher among BNT162b2 (93.5% [29/32];P<0.0001) or CoronaVac (36.7% [11/30]; P=0.0115) recipients when compared with non-vaccinated individuals (12.3% [9/73]). Subgroup analysis of CoronaVac recipients showed that the Omicron seropositive rates were higher among individuals with two doses than those with one dose (85.7% vs 21.7%;P=0.0045). For the surrogate NAb assay, a cutoff of 109.1 AU/ml, which is 7.3-fold higher than the manufacturer’s recommended cutoff, could achieve a sensitivity and specificity of 89.5% and 89.8%, respectively, in detecting Omicron NAb.

Interpretation: Among individuals with prior COVID-19, one dose of BNT162b2 and two doses of CoronaVac could induce detectable serum Omicron NAb. Our result would be particularly important for guiding vaccine policies in countries with COVID-19 vaccine shortage.

Funding Information: This work was supported by Health and Medical Research Fund, the Food and Health Bureau, The Government of the Hong Kong Special Administrative Region (Ref no.: COVID190124 and COVID1903010 [Project 1]), and donations of Richard Yu and Carol Yu, Shaw Foundation Hong Kong, Michael Seak-Kan Tong, May Tam Mak Mei Yin, Lee Wan Keung Charity Foundation Limited, Hong Kong Sanatorium & Hospital, Respiratory Viral Research Foundation Limited, Hui Ming, Hui Hoy and Chow Sin Lan Charity Fund Limited, Chan Yin Chuen Memorial Charitable Foundation, Marina Man-Wai Lee, the Hong Kong Hainan Commercial Association South China Microbiology Research Fund, the Jessie & George Ho Charitable Foundation, Kai Chong Tong, Tse Kam Ming Laurence, Foo Oi Foundation Limited, Betty Hing-Chu Lee, and Ping Cham So.

Declaration of Interests: KYY and KKWT report collaboration with SinoVac and Sinopharm. Other authors declare no conflict of interest.

Ethics Approval Statement: Written informed consent was obtained from all recruited patients. The Institutional Review Board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster (UW 13-265 and UW 21- 214) and the Kowloon West Cluster REC (KW/EX-20-038[144-26]) have approved this study.

Keywords: COVID-19, SARS-CoV-2, Omicron variant, Neutralizing antibody, Surrogate neutralizing antibody test, spike protein receptor binding domain, Variants of Concern

Suggested Citation

Lu, Lu and Chen, Lin-Lei and Zhang, Ricky Rui-Qi and Tsang, Owen Tak-Yin and Chan, Jacky Man-Chun and Tam, Anthony Raymond and Leung, Wai-Shing and Chik, Thomas Shiu-Hong and Lau, Daphne Pui-Ling and Choi, Chris Yau-Chung and Fong, Carol Ho-Yan and Cai, Jian-Piao and Tsoi, Hoi-Wah and Choi, Charlotte Yee-Ki and Zhang, Xiaojuan and Abdullah, Syed Muhammad Umer and Chan, Brian Pui-Chun and Chan, Kwok-Hung and Yuen, Kwok-Yung and Hung, Ivan Fan Ngai and To, Kelvin Kai-Wang, Boosting of Serum Neutralizing Activity Against the Omicron Variant Among Recovered COVID-19 Patients by BNT162b2 and Coronavac Vaccines. Available at SSRN: https://ssrn.com/abstract=4029746 or http://dx.doi.org/10.2139/ssrn.4029746

Lu Lu

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases ( email )

Lin-Lei Chen

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases ( email )

Ricky Rui-Qi Zhang

The University of Hong Kong - Li Ka Shing Faculty of Medicine ( email )

Owen Tak-Yin Tsang

Princess Margaret Hospital - Department of Medicine ( email )

China

Jacky Man-Chun Chan

The University of Hong Kong ( email )

Pokfulam Road
Hong Kong, HK
China

Anthony Raymond Tam

The University of Hong Kong - Division of Infectious Disease ( email )

Wai-Shing Leung

The University of Hong Kong ( email )

Pokfulam Road
Hong Kong, HK
China

Thomas Shiu-Hong Chik

The University of Hong Kong ( email )

Pokfulam Road
Hong Kong, HK
China

Daphne Pui-Ling Lau

The University of Hong Kong ( email )

Pokfulam Road
Hong Kong, HK
China

Chris Yau-Chung Choi

The University of Hong Kong ( email )

Pokfulam Road
Hong Kong, HK
China

Carol Ho-Yan Fong

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases ( email )

Jian-Piao Cai

Southern Medical University - Division of Laboratory Medicine

Guangzhou, Guangdong Province
China

Hoi-Wah Tsoi

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases ( email )

Charlotte Yee-Ki Choi

The University of Hong Kong ( email )

Pokfulam Road
Hong Kong, HK
China

Xiaojuan Zhang

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases ( email )

Syed Muhammad Umer Abdullah

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases ( email )

Brian Pui-Chun Chan

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases ( email )

Kwok-Hung Chan

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases ( email )

Kwok-Yung Yuen

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases ( email )

Ivan Fan Ngai Hung

The University of Hong Kong - School of Clinical Medicine ( email )

Kelvin Kai-Wang To (Contact Author)

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases ( email )