Natural immunity weak and short-lived in unvaccinated after Omicron infection

In a recent study posted to the journal Nature, researchers showed that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron infection without SARS-CoV-2 vaccination conferred limited cross-variant neutralizing capacities.

Study: Limited cross-variant immunity from SARS-CoV-2 Omicron without vaccination. Image Credit: Naeblys / ShutterstockStudy: Limited cross-variant immunity from SARS-CoV-2 Omicron without vaccination. Image Credit: Naeblys / Shutterstock

Background

Numerous waves of infection have occurred since the start of the coronavirus disease 2019 (COVID-19) pandemic, with novel SARS-CoV-2 variants of concern (VOCs) continuing to emerge and out-compete prior variants. The SARS-CoV-2 Omicron and Delta variants are internationally significant VOCs compared to the Gamma, Beta, and Alpha VOCs, which spread more regionally. While Delta infection can lead to severe lung illness, Omicron infection usually has milder symptoms, particularly in those who have been vaccinated. The current concern is whether extensive Omicron infections will result in subsequent cross-variant immunity, hastening the COVID-19 pandemic's termination.

About the study

In the present study, the scientists analyzed the SARS-CoV-2 Omicron, Delta, and WA1 strains infections in mice. The team employed transgenic mice overexpressing human angiotensin-converting enzyme 2 (hACE2), named K18-hACE2 mice, since Delta and WA1 variants cannot infect conventional laboratory mice. These mice were infected intranasally with the three SARS-CoV-2 isolates for a week, and their weight and body temperature were monitored for illness progression.

The authors measured viral ribonucleic acid (RNA) production and infectious particle formation in infected mice's lungs and respiratory tracts with time to determine viral replication dynamics. Further, they assessed the SARS-CoV-2 replication patterns in virus-infected human cell lines and lung organoids. 

The team evaluated T-cell phenotypes and cytokine expression in infected mouse lungs. Besides, single-cell suspensions from the lungs of mock- and virus-infected mice were generated. Additionally, cytometry by time of flight (CyTOF) mass spectrometry was performed on them before and after activation with intersecting 15-mer peptides spanning the entire spike (S) protein to assess if the pro-inflammatory response observed was connected with T-cell depletion in late infection.

The researchers procured sera from mice one week following infections and examined their neutralization efficacy against the SARS-CoV-2 Omicron, Delta, Alpha, and WA1 isolates to evaluate humoral immune responses caused by infection with the analyzed three isolates. They estimated the 50% neutralization (NT50) titers by measuring plaque-forming units at various serum dilutions. Similarly, humoral immunity in COVID-19 non-vaccinated/vaccinated and Omicron/Delta convalescent individuals against the Omicron, Delta, Alpha, and WA1 variants were analyzed. Furthermore, sera samples from COVID-19 naive and non-vaccinated subjects were also tested against the four SARS-CoV-2 variants.

Results

The study results depicted that the SARS-CoV-2 WA1- and Delta-infected mice had gradual hypothermia and significant weight loss. In contrast, Omicron-infected mice showed mild symptoms, such as a modest rise in body temperature and zero weight loss. While every Omicron-infected animal survived the one-week trial, 60% of Delta- and 100% of WA1-infected mice exhibited humane end-point traits.

WA1- and Delta-infected animals had higher infectious SARS-CoV-2 titers in the upper airways, brain, and lungs at all timepoints relative to Omicron. Similar results were found in the human airway organoids and the alveolar epithelial cell line. Pro-inflammatory markers of severe COVID, like C-C motif chemokine ligand 2 (CCL2) and C-X-C motif chemokine ligand 10 (CXCL10), were readily triggered by WA1 and Delta infections versus Omicron. Interleukin 1 (IL1) induction did not differ substantially among the three viral isolates. However, there was a tendency toward reduced IL1 expression in Omicron-infected mice two days after infection.

Delta, WA.1, and Omicron infections caused phenotypic alterations in pulmonary T cells, but this was lower in Omicron-infected mice. In addition, the scientists found that Omicron induced lower degrees of pro-inflammatory cytokines and exhausted pulmonary T cells. Hence, the Omicron-infected animals had reduced Omicron pathogenicity and a two to three log drop in Omicron replication.

Sera from mice infected with Omicron and overexpressing the hACE2 receptor neutralize just Omicron but not other VOCs, whereas SARS-CoV-2 Delta and WA1 infections result in significant cross-variant neutralization. Sera from Omicron-infected patients who had not been vaccinated displayed the same restricted neutralization of solely Omicron as in mice. On the other hand, Omicron and Delta breakthrough infections resulted in overall broader neutralization titers towards all SARS-CoV-2 VOCs.

Conclusions

To conclude, the study findings showed that infection with Omicron caused a modest humoral immune response in humans and mice without COVID-19 vaccination and without prior infection. Unlike the Delta and WA1 variants, Omicron multiplies to a low extent in infected animals' brains and lungs, resulting in mild illness with reduced lung-resident T cell activation and pro-inflammatory cytokine production.

Omicron showed poor cross-variant neutralization than other tested isolates in non-vaccinated human and mice sera samples. Namely, WA1 and Delta demonstrated broader cross-variant neutralization. This was probably due to its significantly altered S protein or lesser replicative potential. Despite possessing identical inflammatory and replicative capabilities, WA1 and Delta had distinct neutralization patterns. This inference highlighted the importance of S proteins in triggering cross-variant neutralization. Interestingly, Delta and Omicron breakthrough infections enhanced vaccination-induced immunity, resulting in a hybrid immunity that protected against not just themselves but also additional SARS-CoV-2 variants.

Collectively, the present work illustrated that Omicron infection boosts preexisting immunity evoked by COVID-19 vaccinations but may not provide widespread protection against non-Omicron SARS-CoV-2 variants in non-vaccinated people without prior infection. In addition, the current findings supported the incorporation of Omicron- and Delta-based immunogens in future multivalent/heterologous COVID-19 vaccination approaches for broader protection against SARS-CoV-2 variants. 

Journal reference:
Shanet Susan Alex

Written by

Shanet Susan Alex

Shanet Susan Alex, a medical writer, based in Kerala, India, is a Doctor of Pharmacy graduate from Kerala University of Health Sciences. Her academic background is in clinical pharmacy and research, and she is passionate about medical writing. Shanet has published papers in the International Journal of Medical Science and Current Research (IJMSCR), the International Journal of Pharmacy (IJP), and the International Journal of Medical Science and Applied Research (IJMSAR). Apart from work, she enjoys listening to music and watching movies.

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Comments

  1. Daefn Oldin Daefn Oldin Japan says:

    The study does show that omicron infection after vaccination does provide more immune response Vs those who have never had previous infection.

    BUT it clearly states that broader cross-variant neutralization was observed after WA1 and Delta infections e.g those who were previously infected with previous strains but are unvaccinated.

    The final paragraph also states "this, together with our
    186 finding that Delta infection also elicits broad cross-variant neutralization in vaccinated individuals,
    187 supports the inclusion of Omicron- and Delta-based immunogens in future heterologous or
    188 multivalent vaccination strategies for broad protection against variants". SO, if you combine this with the research into Delta infection, which showed infection offered stronger follow up protection than the vaccine, you can also bolster the arguement for this article being misleading and misinformation given that it does not distinguish between unvaccinated with and without prior infection.

    Therefore to say "unvaccinated" is misleading and it should state clearly "Natural immunity weakER and short-lived in unvaccinated WITHOUT PRIOR INFECTION after Omicron infection, BUT THOSE WITH PRIOR INFECTION OF PREVIOUS VARIANTS ALSO SHOWED STRONG NEUTRALIZATION"

    I am not advocating for people to get infected to provide immunity, I am however in favour or proper journalism that provides all the facts Vs cherry picks.

  2. Jaco Schlebusch Jaco Schlebusch South Africa says:

    Study is done on mice not Humans. Do study on humans over a broad scope of population who had previous infection without vaccination. Here in Africa is lot of people infected again but because of previous infections infections now much less severe because of natural immunity. Vaccination rate very low due to lack of trust in government and big Pharma. Medical fraternity need a more balanced scientific view. Môre studie needs to be done on natural immunity but I doubt if it will be done because of lack of funding and there is no money to be made out of these studies.

  3. M Atchie M Atchie United States says:

    Well I don’t know who they’re taking about, if it’s those who are 65 and older? Those who are immunocompromised? I had covid alpha August 2020 and covid omicron January 2022. My natural immune system protected me from delta in 2021. My entire experience with covid has been mild. I never had to be hospitalized or vaccinated. Both cases with alpha and omicron were mild without the help of vaccine. I’ve been covid free since January 2022 with omnicron.

The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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