PMID- 33667629
OWN - NLM
STAT- MEDLINE
DCOM- 20210604
LR  - 20210604
IS  - 1469-0691 (Electronic)
IS  - 1198-743X (Print)
IS  - 1198-743X (Linking)
VI  - 27
IP  - 6
DP  - 2021 Jun
TI  - SARS CoV-2 infections in healthcare workers with a pre-existing T-cell response: 
      a prospective cohort study.
PG  - 916.e1-916.e4
LID - S1198-743X(21)00102-6 [pii]
LID - 10.1016/j.cmi.2021.02.020 [doi]
AB  - OBJECTIVE: T-cell responses against severe acute respiratory syndrome coronavirus 
      2 (SARS-CoV-2) are observed in unexposed individuals. We evaluated the impact of 
      this pre-existing cellular response on incident SARS-CoV-2 infections. METHODS: 
      This was a follow-up study of 38 seronegative healthcare workers (HCWs) with 
      previous evaluation of CD8+ and CD4+ T-cell responses after stimulation with 
      SARS-CoV-2 structural proteins. Infection was considered in the presence of a 
      positive RT-PCR test and/or confirmed seroconversion. RESULTS: Twenty of the 38 
      HCWs included (53%) had a previous specific CD8+ T-cell response to peptides 
      encompassing the spike protein (S) in 13 (34%), the membrane (M) in 17 (45%), 
      or/and the nucleocapsid (N) in three (8%). During a follow-up of 189 days 
      (interquartile range (IQR) 172-195), 11 HCWs (29%) had an RT-PCR-positive test 
      (n = 9) or seroconverted (n = 2). Median duration of symptoms was 2 days (IQR 
      0-7), and time to negative RT-PCR was 9 days (IQR 4-10). Notably, six incident 
      infections (55%) occurred in HCWs with a pre-existing T-cell response (30% of 
      those with a cellular response), who showed a significantly lower duration of 
      symptoms (three were asymptomatic). Three of the six HCWs having a previous 
      T-cell response continued to test seronegative. All the infected patients 
      developed a robust T-cell response to different structural SARS-CoV-2 proteins, 
      especially to protein S (91%). CONCLUSION: A pre-existing T-cell response does 
      not seem to reduce incident SARS-CoV-2 infections, but it may contribute to 
      asymptomatic or mild disease, rapid viral clearance and differences in 
      seroconversion.
CI  - Copyright (c) 2021 European Society of Clinical Microbiology and Infectious 
      Diseases. Published by Elsevier Ltd. All rights reserved.
FAU - Casado, Jose L
AU  - Casado JL
AD  - Department of Infectious Diseases, Hospital Universitario Ramon y Cajal, Madrid, 
      Spain. Electronic address: jose.casado@salud.madrid.org.
FAU - Haemmerle, Johannes
AU  - Haemmerle J
AD  - Department of Prevention of Occupational Risks, Hospital Universitario Ramon y 
      Cajal, Madrid, Spain.
FAU - Vizcarra, Pilar
AU  - Vizcarra P
AD  - Department of Infectious Diseases, Hospital Universitario Ramon y Cajal, Madrid, 
      Spain.
FAU - Velasco, Hector
AU  - Velasco H
AD  - Laboratory of Immunovirology, Hospital Universitario Ramon y Cajal, Madrid, 
      Spain.
FAU - Velasco, Tamara
AU  - Velasco T
AD  - Department of Infectious Diseases, Hospital Universitario Ramon y Cajal, Madrid, 
      Spain.
FAU - Fernandez-Escribano, Marina
AU  - Fernandez-Escribano M
AD  - Department of Prevention of Occupational Risks, Hospital Universitario Ramon y 
      Cajal, Madrid, Spain.
FAU - Vallejo, Alejandro
AU  - Vallejo A
AD  - Department of Infectious Diseases, Hospital Universitario Ramon y Cajal, Madrid, 
      Spain; Laboratory of Immunovirology, Hospital Universitario Ramon y Cajal, 
      Madrid, Spain.
LA  - eng
PT  - Journal Article
DEP - 20210302
PL  - England
TA  - Clin Microbiol Infect
JT  - Clinical microbiology and infection : the official publication of the European 
      Society of Clinical Microbiology and Infectious Diseases
JID - 9516420
RN  - 0 (Antibodies, Viral)
RN  - 0 (Viral Structural Proteins)
SB  - IM
MH  - Adult
MH  - Antibodies, Viral
MH  - COVID-19/*immunology
MH  - COVID-19 Nucleic Acid Testing
MH  - Female
MH  - Follow-Up Studies
MH  - Health Personnel
MH  - Humans
MH  - Immunity
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Seroconversion
MH  - T-Lymphocytes/*immunology
MH  - Viral Structural Proteins/*immunology
MH  - Young Adult
PMC - PMC7923873
OTO - NOTNLM
OT  - COVID-19
OT  - Cross-reactivity
OT  - Healthcare workers
OT  - Immune response
OT  - SARS-CoV-2
OT  - T-cell response
EDAT- 2021/03/06 06:00
MHDA- 2021/06/05 06:00
PMCR- 2021/03/02
CRDT- 2021/03/05 20:11
PHST- 2021/01/11 00:00 [received]
PHST- 2021/02/12 00:00 [revised]
PHST- 2021/02/20 00:00 [accepted]
PHST- 2021/03/06 06:00 [pubmed]
PHST- 2021/06/05 06:00 [medline]
PHST- 2021/03/05 20:11 [entrez]
PHST- 2021/03/02 00:00 [pmc-release]
AID - S1198-743X(21)00102-6 [pii]
AID - 10.1016/j.cmi.2021.02.020 [doi]
PST - ppublish
SO  - Clin Microbiol Infect. 2021 Jun;27(6):916.e1-916.e4. doi: 
      10.1016/j.cmi.2021.02.020. Epub 2021 Mar 2.