Scientific Reports (May 2023)

SARS-CoV-2 intra-host diversity, antibody response, and disease severity after reinfection by the variant of concern Gamma in Brazil

  • Felipe Gomes Naveca,
  • Valdinete Alves Nascimento,
  • Fernanda Nascimento,
  • Maria Ogrzewalska,
  • Alex Pauvolid-Corrêa,
  • Mia Ferreira Araújo,
  • Ighor Arantes,
  • Érika Rocha Batista,
  • Alessandro Álvares Magalhães,
  • Fernando Vinhal,
  • Tirza Peixoto Mattos,
  • Irina Riediger,
  • Maria do Carmo Debur,
  • Beatriz Grinsztejn,
  • Valdiléa G. Veloso,
  • Patrícia Brasil,
  • Rodrigo Ribeiro Rodrigues,
  • Darcita Buerger Rovaris,
  • Sandra Bianchini Fernandes,
  • Cristiano Fernandes,
  • João Hugo Abdalla Santos,
  • Lígia Fernandes Abdalla,
  • Rubens Costa-Filho,
  • Marineide Silva,
  • Victor Souza,
  • Ágatha Araújo Costa,
  • Matilde Mejía,
  • Maria Júlia Brandão,
  • Luciana Fé Gonçalves,
  • George Allan Silva,
  • Michele Silva de Jesus,
  • Karina Pessoa,
  • André de Lima Guerra Corado,
  • Debora Camila Gomes Duarte,
  • Ana Beatriz Machado,
  • Ketiuce de Azevedo Zukeram,
  • Natalia Valente,
  • Renata Serrano Lopes,
  • Elisa Cavalcante Pereira,
  • Luciana Reis Appolinario,
  • Alice Sampaio Rocha,
  • Luis Fernando Lopez Tort,
  • Tsuyoshi Sekizuka,
  • Kentaro Itokawa,
  • Masanori Hashino,
  • Makoto Kuroda,
  • Filipe Zimmer Dezordi,
  • Gabriel Luz Wallau,
  • Edson Delatorre,
  • Tiago Gräf,
  • Marilda Mendonça Siqueira,
  • Gonzalo Bello,
  • Paola Cristina Resende

DOI
https://doi.org/10.1038/s41598-023-33443-1
Journal volume & issue
Vol. 13, no. 1
pp. 1 – 11

Abstract

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Abstract The rapid spread of the SARS-CoV-2 Variant of Concern (VOC) Gamma in Amazonas during early 2021 fueled a second large COVID-19 epidemic wave and raised concern about the potential role of reinfections. Very few cases of reinfection associated with the VOC Gamma have been reported to date, and their potential impact on clinical, immunological, and virological parameters remains largely unexplored. Here we describe 25 cases of SARS-CoV-2 reinfection in Brazil. SARS-CoV-2 genomic analysis confirmed that individuals were primo-infected with distinct viral lineages between March and December 2020 (B.1.1, B.1.1.28, B.1.1.33, B.1.195, and P.2) and reinfected with the VOC Gamma between 3 to 12 months after primo-infection. We found a similar mean cycle threshold (Ct) value and limited intra-host viral diversity in both primo-infection and reinfection samples. Sera of 14 patients tested 10–75 days after reinfection displayed detectable neutralizing antibodies (NAb) titers against SARS-CoV-2 variants that circulated before (B.1.*), during (Gamma), and after (Delta and Omicron) the second epidemic wave in Brazil. All individuals had milder or no symptoms after reinfection, and none required hospitalization. These findings demonstrate that individuals reinfected with the VOC Gamma may display relatively high RNA viral loads at the upper respiratory tract after reinfection, thus contributing to onward viral transmissions. Despite this, our study points to a low overall risk of severe Gamma reinfections, supporting that the abrupt increase in hospital admissions and deaths observed in Amazonas and other Brazilian states during the Gamma wave was mostly driven by primary infections. Our findings also indicate that most individuals analyzed developed a high anti-SARS-CoV-2 NAb response after reinfection that may provide some protection against reinfection or disease by different SARS-CoV-2 variants.