Antibody Response to SARS-CoV-2 and Common Cold Coronaviruses Spike and Nucleocapsid Proteins in Sub-Saharan Africa
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Background: Sub-Saharan Africa (SSA) has reported much lower rates of COVID-19 infections compared to the Americas, Europe, and Asia. Numerous socio-economic factors have been proposed as an explanation for these differences, e.g., access to healthcare and COVID-19 testing. However, it has also been hypothesized that high background exposure to other infectious diseases, including other coronaviruses, prior to the COVID-19 pandemic, provides some degree of cross-protection from SARS-CoV-2. Of the seven human coronaviruses (HCoV), the common cold HCoVs cause mild to moderate upper respiratory tract infections and the pandemic HCoVs cause mild to severe upper and lower respiratory tract infections.
Hypothesis: Lower rates of COVID-19 in SSA are due to pre-existing immunity against common cold coronaviruses.
Objectives: This study aims to investigate the prevalence of cross-reactive SARS-CoV-2 and common cold coronaviruses antibodies among plasma samples collected from febrile Cameroonian patients prior to the COVID-19 pandemic.
Methods: We screened 378 plasma samples collected in 2014-2015 from adult and pediatric febrile Cameroonians at three sites - Maroua, Nkolbisson, and Bamenda - for the presence of anti-HCoV spike (S1) and nucleocapsid (N) immunoglobulin G (IgG) antibodies for all seven human coronaviruses using a laboratory developed microsphere immunoassay. These samples were collected prior to the COVID-19 pandemic for previous malaria research studies conducted by Dr. Kenji Obadia.
Results: We found higher levels of cross-reactive anti-SARS-CoV-2 N IgG (73%) as compared to anti-SARS-CoV-2 S1 IgG (10%) among plasma samples collected from febrile Cameroonians prior to the COVID-19 pandemic. When evaluating samples that contained both anti-SARS-CoV-2 and other coronavirus antibodies, cross-reactivity was most apparent among antibodies directed towards HCoV N.
Conclusion: These data suggest pre-existing immunity against common cold coronavirus infections might provide cross-protection against SARS-CoV-2, leading to the low rates of COVID-19 in Cameroon.