Differential association of SARS-CoV-2 IgG responses with anti-OC43 IgG in a Senegalese cohort

Numerous studies elucidated the kinetics of the humoral immune response post-SARS-CoV-2 infection. However, in sub-Saharan Africa, the evolution of SARS-CoV-2 IgG antibody responses and their interaction with pre-existing seasonal human coronavirus (HCoVs: OC43, 229E, NL63, HKU1) immunity remain underexplored. A prospective cohort study was conducted in Senegal during the first year of the COVID-19 pandemic (March to December 2020). A total of 204 patients with laboratory-confirmed COVID-19 were included. Patients were classified as symptomatic (n=157) or asymptomatic (n=47) based on clinical presentation. Plasma samples (n=705) were collected over 6 months from SARS-CoV-2 positive individuals. IgG levels against SARS-CoV-2 and HCoVs were measured using a multiplex bead-based assay. Among the 204 participants included (95 [46.6%] female, median age, 44 [7-95]), SARS-CoV-2 IgG were detectable 6 months post-infection, peaking at 1 month for most antigens, except for Spike (S), which peaked at 3 months. Elderly patients (>60 years) exhibited higher IgG levels against both SARS- CoV-2 and HCoVs. Symptomatic patients had higher IgG levels than asymptomatic individuals, especially for WTS, RBD, S2, and N. Anti-HCoV IgG levels remained stable post-infection, with OC43 peaking at week 3 in symptomatic patients. A positive correlation was found between anti-SARS-CoV- 2 and anti-OC43 IgG in symptomatic patients. The study highlights persistent SARS-CoV-2 IgG antibodies for up to 6 months and suggests a link between pre-existing HCoV-OC43 immunity and COVID-19 outcomes in Senegal. These findings could help shape future vaccine strategies, considering the influence of circulating HCoVs on long- term protection against SARS-CoV-2. Author summaryUnderstanding how our immune system responds to SARS-CoV-2, the virus responsible for COVID- 19, is essential for guiding public health countermeasures and informing vaccine development strategies. In our study, we monitored, in COVID-19 patients, the evolution of IgG antibody responses against SARS-CoV-2 structural proteins over a six-month period. Additionally, we examined how previous exposure to common seasonal coronaviruses might influence immune responses to SARS-CoV-2. Conducting this research in an African context is particularly important, as data on immune responses to SARS-CoV-2 in this region are scarce. Our results provide valuable insights into the complex interplay between immune responses elicited by SARS-CoV-2 and pre-existing immunity from seasonal circulating coronaviruses. These findings enhance our understanding of immune memory and cross-reactivity, two critical factors for assessing long-term protection and optimizing vaccine strategies. By shedding light on the dynamics of antibody responses over time within a sub-Saharan population, our research contributes to the global effort aimed at developing effective interventions against COVID-19 and preparing for future coronavirus outbreaks.