Host protection against Omicron BA.2.2 sublineages by prior vaccination in spring 2022 COVID-19 outbreak in Shanghai

Abstract

The Omicron family of SARS-CoV-2 variants are currently driving the COVID-19 pandemic. Here we analyzed the clinical laboratory test results of 9911 Omicron BA.2.2 sublineages-infected symptomatic patients without earlier infection histories during a SARS-CoV-2 outbreak in Shanghai in spring 2022. Compared to an earlier patient cohort infected by SARS-CoV-2 prototype strains in 2020, BA.2.2 infection led to distinct fluctuations of pathophysiological markers in the peripheral blood. In particular, severe/critical cases of COVID-19 post BA.2.2 infection were associated with less pro-inflammatory macrophage activation and stronger interferon alpha response in the bronchoalveolar microenvironment. Importantly, the abnormal biomarkers were significantly subdued in individuals who had been immunized by 2 or 3 doses of SARS-CoV-2 prototype-inactivated vaccines, supporting the estimation of an overall 96.02% of protection rate against severe/critical disease in the 4854 cases in our BA.2.2 patient cohort with traceable vaccination records. Furthermore, even though age was a critical risk factor of the severity of COVID-19 post BA.2.2 infection, vaccination-elicited protection against severe/critical COVID-19 reached 90.15% in patients aged ≥ 60 years old. Together, our study delineates the pathophysiological features of Omicron BA.2.2 sublineages and demonstrates significant protection conferred by prior prototype-based inactivated vaccines.

Keywords

SARS-CoV-2 / COVID-19 / host response / bronchoalveolar lavage fluid (BALF)

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Acknowledgements

We thank the support from the National Natural Science Foundation of China (Nos. 82100158 and 81861148030), the Natural Science Foundation of Shanghai (Nos. 21ZR1480900 and 21YF1427900), Shanghai Clinical Research Center for Hematologic Disease (No. 19MC1910700), Shanghai Major Project for Clinical Medicine (No. 2017ZZ01002), Shanghai Shenkang Hospital Development Center (No. SHDC2020CR5002), Innovative Research Team of High-level Local Universities in Shanghai, and Shanghai Collaborative Innovation Program on Regenerative Medicine and Stem Cell Research (No. 2019CXJQ01). We thank the support from the ASTRA computing platform in the National Research Center for Translational Medicine (Shanghai) and the Pi computing platform in the Center for High-Performance Computing at Shanghai Jiao Tong University.

Electronic Supplementary Material

Supplementary material is available in the online version of this article at https://doi.org/10.1007/s11684-022-0977-3 and is accessible for authorized users.

Compliance with ethics guidelines

Ziyu Fu, Dongguo Liang, Wei Zhang, Dongling Shi, Yuhua Ma, Dong Wei, Junxiang Xi, Sizhe Yang, Xiaoguang Xu, Di Tian, Zhaoqing Zhu, Mingquan Guo, Lu Jiang, Shuting Yu, Shuai Wang, Fangyin Jiang, Yun Ling, Shengyue Wang, Saijuan Chen, Feng Liu, Yun Tan, and Xiaohong Fan declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000(5). Informed consent was obtained from all patients for being included in the study.

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