Infectious virus shedding duration reflects secretory IgA antibody response latency after SARS-CoV-2 infection
Shô Miyamoto, Takara Nishiyama, Akira Ueno, Hyeongki Park, Takayuki Kanno, Naotoshi Nakamura, Seiya Ozono, Kazuyuki Aihara, Kenichiro Takahashi, Yuuki Tsuchihashi, Masahiro Ishikane, Takeshi Arashiro, Shinji Saito, Akira Ainai, Yuichiro Hirata, Shun Iida, Harutaka Katano, Minoru Tobiume, Kenzo Tokunaga, Tsuguto Fujimoto, Michiyo Suzuki, Maki Nagashima, Hidenori Nakagawa, Masashi Narita, Yasuyuki Kato, Hidetoshi Igari, Kaori Fujita, Tatsuo Kato, Kazutoshi Hiyama, Keisuke Shindou, Takuya Adachi, Kazuaki Fukushima, Fukumi Nakamura‐Uchiyama, Ryota Hase, Yukihiro Yoshimura, Masaya Yamato, Yasuhiro Nozaki, Norio Ohmagari, Motoi Suzuki, Tomoya Saito, Shingo Iwami, Tadaki Suzuki
Abstract
Infectious virus shedding from individuals infected with severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) is used to estimate human-to-human transmission risk. Control of SARS-CoV-2 transmission requires identifying the immune correlates that protect infectious virus shedding. Mucosal immunity prevents infection by SARS-CoV-2, which replicates in the respiratory epithelium and spreads rapidly to other hosts. However, whether mucosal immunity prevents the shedding of the infectious virus in SARS-CoV-2-infected individuals is unknown. We examined the relationship between viral RNA shedding dynamics, duration of infectious virus shedding, and mucosal antibody responses during SARS-CoV-2 infection. Anti-spike secretory IgA antibodies (S-IgA) reduced viral RNA load and infectivity more than anti-spike IgG/IgA antibodies in infected nasopharyngeal samples. Compared with the IgG/IgA response, the anti-spike S-IgA post-infection responses affected the viral RNA shedding dynamics and predicted the duration of infectious virus shedding regardless of the immune history. These findings highlight the importance of anti-spike S-IgA responses in individuals infected with SARS-CoV-2 for preventing infectious virus shedding and SARS-CoV-2 transmission. Developing medical countermeasures to shorten S-IgA response time may help control human-to-human transmission of SARS-CoV-2 infection and prevent future respiratory virus pandemics.