The following is a summary of “A Robust Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)–Specific T- and B-Cell Response Is Associated With Early Viral Clearance in SARS-CoV-2 Omicron-Infected Immunocompromised Individuals,” published in the June 2024 issue of Infectious Disease by Vergouwe et al.

The factors influencing delayed viral clearance and intra-host viral evolution, which leads to pathogenic virus strain development in individuals with compromised immune responses, remain unclear.

Researchers conducted a retrospective study characterizing SARS-CoV-2-specific immune responses in individuals with compromised immune responses to elucidate the association with viral clearance and potential evolution.

They examined the immune response to the Omicron variant in individuals with compromised immune responses by including measuring specific T and B cell activity against SARS-CoV-2, anti-spike IgG(3) titers, neutralization titers, and the presence of mutations known to resist treatment with monoclonal antibodies (mAbs). Participants were categorized as having early viral clearance (RT-PCR within 28 days) or late clearance (RT-PCR- positive >28 days).

The result showed that 30 patients were included in the study, with a median age of 61.9 years (IQR 47.4-72.3), and half (50%) were female. A total of 20 patients (66.7%) received mAb therapy. Patients who cleared the virus early and those without mutations associated with resistance showed notably higher baseline levels of IFN-γ release. A greater frequency of SARS-CoV-2-specific B-cells at baseline was observed in patients achieving early viral clearance. Day 7 IgG and neutralization titers were significantly higher in individuals with early viral clearance compared to late clearance in patients not treated with mAb.

Investigators concluded that early immune responses were crucial for effective viral clearance and reducing mAb-resistance mutations in Omicron-infected individuals with compromised immune systems, underscoring the need for novel therapeutic strategies.

Source: academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiae306/7689068