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Correlates of Protection Against Symptomatic COVID-19: The CORSER 5 Case–Control Study
Author(s)
Léopold Beeker
Institut Pasteur
Thomas Obadia
Institut Pasteur
Emma Bloch
Institut Pasteur
Laura García
Institut Pasteur
Marek Fol
Institut Pasteur
Tiffany Charmet
Institut Pasteur
Laurence Arowas
Institut Pasteur
Rémy Artus
Institut Pasteur
Olivia Chény
Institut Pasteur
Dorian Cheval
Institut Pasteur
Yanis Dahoumane
Institut Pasteur
Maurine Delhaye
Institut Pasteur
Delal Ergen
Institut Pasteur
Mariem Essaidani
Institut Pasteur
Christine Fanaud
Institut Pasteur
Sandrine Fernandes Pellerin
Institut Pasteur
Nathalie Jolly
Institut Pasteur
Hélène Laude
Institut Pasteur
Emmanuel Roux
Institut Pasteur
Marine Samson
Institut Pasteur
Linda Sangari
Institut Pasteur
Marie-Noëlle Ungeheuer
Institut Pasteur
Sophie Vacant
Institut Pasteur
Ayla Zayoud
Institut Pasteur
Françoise Donnadieu
Institut Pasteur
Stéphane Pelleau
Institut Pasteur
Simon Galmiche
Institut Pasteur
Arnaud Fontanet
Conservatoire National des Arts et Métiers
Michaël White
Institut Pasteur
Date Issued
23 de diciembre de 2024
Type
Article
Volume
12
Issue
1
Series/Report No.
Open Forum Infectious Diseases
Start Page
ofaf006
End Page
ofaf006
ISSN
2328-8957
Abstract
Background: Establishing correlates of protection often requires large cohorts. A rapid and adaptable case-control study design can be used to identify antibody correlates of protection against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in serum and saliva. Methods: We designed a case-control study to compare antibody levels between cases of SARS-CoV-2 infection within 5 days of symptom onset and uninfected controls. Controls were matched on age, number of coronavirus disease 2019 vaccine doses, time since last dose, and past episodes of infection. We quantified anti-SARS-CoV-2 and seasonal coronavirus immunoglobulin (Ig) G in serum and saliva at inclusion, 1 month, and 6 months. Results: We included 90 cases and 62 controls between February and September 2022. A boost and decay pattern of serum antibodies was observed in cases at 1 and 6 months, respectively, but not in controls. Anti-SARS-CoV-2 antibody levels were significantly higher in controls at inclusion both in serum (particularly antinucleocapsid IgG: 4.14 times higher compared with cases; 95% CI, 2.46-6.96) and saliva (particularly antispike for Delta variant IgG: 4.89 times higher compared with cases; 95% CI, 2.91-9.89). Saliva antibodies generally outperformed serum antibodies for case/control differentiation. Conclusions: In this case-control study, we provided evidence of correlates of protection of anti-SARS-CoV-2 IgG in saliva and serum, with saliva antibodies often outperforming serum. The finding that antibodies in saliva are a better correlate of protection than antibodies in serum may inform vaccine development by highlighting the importance of robust induction of mucosal immune responses. This study design may be used during future epidemics for the prompt assessment of correlates of protection.
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