Health
First-line immune defences against COVID-19 are short-lived and may explain reinfection
A new study finds that antibodies produced in the nose decline nine months after COVID-19 infection, while antibodies found in the blood last at least a year.
Newswise — A new study finds that antibodies produced in the nose decline nine months after COVID-19 infection, while antibodies found in the blood last at least a year.
Antibodies in the nasal fluid (known as immunoglobulin A, or IgA) provide first-line defence against COVID-19 by blocking SARS-CoV-2 virus when it first enters the respiratory tract. These antibodies are very effective at preventing the virus from entering cells and causing infection.
However, the investigators found that the nasal antibodies were only present in those recently infected and were particularly short-lived against the Omicron variant, compared to earlier variants.
These new findings – which are published in eBioMedicine – may explain why people who have recovered from COVID are at risk of reinfection, and especially with Omicron and its subvariants.
The study also found that vaccination is very effective in creating and boosting antibodies in the blood, which prevent severe disease, but had very little effect on nasal IgA levels.
First author of the study, Dr Felicity Liew, from the National Heart and Lung Institute at Imperial College London, said: “Before our study, it was unclear how long these important nasal antibodies lasted. Our study found durable immune responses after infection and vaccination, but these key nasal antibodies were shorter-lived than those in the blood. While blood antibodies help to protect against disease, nasal antibodies can prevent infection altogether. This might be an important factor behind repeat infections with the SARS-CoV-2 virus and its new variants.”
The researchers note that studies that directly study these nasal antibodies and reinfections are needed to confirm their results.
The research was led by teams from Imperial College London and the University of Liverpool. It studied almost 450 people who had been hospitalised with COVID-19 between February 2020 and March 2021, before the emergence of Omicron variant and prior to vaccine rollout.
The study also found that whilst current vaccines are effective at boosting blood antibody which can prevent serious illness and death, they do not significantly boost nasal IgA antibodies.
The researchers call for the next generation of vaccines to include nasal spray or inhaled vaccines that target these antibodies more effectively. They say that vaccines capable of boosting these antibodies could potentially reduce infections more effectively and prevent transmission.
Co-senior author of the study, Professor Peter Openshaw, from the National Heart and Lung Institute at Imperial College London, said: “Our results highlight a need for nasal spray vaccines that can boost these local antibodies in the nose and lungs. Such vaccines might be able to prevent people from getting infected with the SARS-CoV-2 virus and reduce transmission of the virus between people. This could help us to better control the pandemic and stop new variants emerging.”
He continues: “Our current vaccines are designed to reduce severe disease and death and are dramatically effective in this aim. It’s now essential to also develop nasal spray vaccines that can provide better protection against infection. It’s brilliant that current vaccines mean fewer people are becoming seriously ill, but it would be even better if we could prevent them from getting infected and transmitting the virus.”
The study analysed antibodies of the participants to understand how long nasal antibodies lasted, compared with antibodies found in the blood. They also studied the effect of subsequent COVID-19 vaccines on antibodies in the nose and blood.
Samples were taken when people were hospitalised and at six months and one year after. Since most people were vaccinated during the study, many samples were also taken before and after vaccination.
They measured how well the antibodies neutralised the original SARS-CoV-2 virus, and the Delta and Omicron variants to see how long the antibodies were effective for after infection or vaccination.
The study included 446 people admitted to hospital in the early phase of the pandemic, including 141 who provided samples at the start of the study and six and 12 months later. For participants who only had one sample taken during the 12-month period of study, the researchers used modelling to estimate how the average antibody responses changed over time.
Of those who confirmed whether they had been vaccinated (323 people), 95% (307 people) received their first vaccination during the study follow-up period. This led to increases in all nasal and blood antibodies, but the change in the first-line defence nasal antibodies (IgA) was small and temporary. The researchers found that the participants’ sex, disease severity and age did not impact how long their nasal immunity lasted, but caution that their study was only in people with severe disease that required hospitalisation.
They also found that blood antibody from participants continued to bind the original SARS-CoV-2 virus, and the Delta and Omicron variants a year after infection, but found that booster vaccines are needed to maintain this immunity.
Co-senior author of the study, Dr Lance Turtle, Senior Clinical Lecturer at the University of Liverpool and Consultant in Infectious Diseases at Liverpool University Hospitals, said: “Our study suggests that this first-line defence immunity is separate from other immune responses, and although it is increased by vaccination and infection, it only lasts for about nine months. Nonetheless, booster vaccines can increase it slightly and otherwise have a significant impact on other areas of immunity, protecting against severe disease and death very effectively, so remain very important.”
The researchers note that their study did not screen participants for reinfection, but that this was unlikely to have occurred since the study took place during periods of national restrictions and lockdowns when COVID-19 incidence was low and people were not mixing. In a preliminary analysis, they found only two cases of reinfection in their study, suggesting that the overall trends seen are accurate.
The study was supported by the ISARIC4C, UKCIC and PHOSP-COVID consortia. It was jointly funded by the National Institute for Health and Care Research, UK Research and Innovation and the Medical Research Council.
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This press release uses a labelling system developed by the Academy of Medical Sciences to improve the communication of evidence. For more information, please see: http://www.sciencemediacentre.org/wp-content/uploads/2018/01/AMS-press-release-labelling-system-GUIDANCE.pdf
About Imperial College London
Imperial College London is a global top ten university with a world-class reputation. The College’s 22,000 students and 8,000 staff are working to solve the biggest challenges in science, medicine, engineering and business.
The Research Excellence Framework (REF) 2021 found that it has a greater proportion of world-leading research than any other UK university, it was named University of the Year 2022 according to The Times and Sunday Times Good University Guide, University of the Year for Student Experience 2022 by the Good University Guide, and awarded a Queen’s Anniversary Prize for its COVID-19 response. https://www.imperial.ac.uk/
The National Institute for Health and Care Research (NIHR)
The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:
– Funding high quality, timely research that benefits the NHS, public health and social care;
– Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;
– Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;
– Attracting, training and supporting the best researchers to tackle complex health and social care challenges;
– Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;
– Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries.
NIHR is funded by the Department of Health and Social Care. Its work in low and middle income countries is principally funded through UK Aid from the UK government.
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Source: Imperial College London
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(Family Features) Some women may be unaware they’re living with risks for heart disease, kidney disease and metabolic conditions like diabetes, which drive risk for cardiovascular disease.
The interplay among these conditions is called cardiovascular-kidney-metabolic (CKM) syndrome, according to the scientific experts at the American Heart Association. Consider these facts women should know about CKM syndrome.
Cardiovascular Disease is the No. 1 Killer of Women
Cardiovascular disease (CVD), which includes heart disease and stroke, affects nearly 45% of women ages 20 and older, and 1 in 3 women will die from it, according to the association.
“Despite heart disease being the leading cause of death for women, most women are not aware of their risk for heart disease,” said Sadiya S. Khan, M.D., M.Sc., FAHA, American Heart Association volunteer and a member of the science advisory group for the association’s CKM Health Initiative, supported by founding sponsors Novo Nordisk and Boehringer Ingelheim and champion sponsor DaVita.
Women may develop heart disease differently than men and experience symptoms uncommon in men. Women are more likely to have blockage in smaller blood vessels around the heart and, while chest pain is the most common heart attack symptom, women are more likely than men to experience pain in the arms, jaw and neck, too.
Early Action is Key
According to a study presented at an American Heart Association scientific conference, women with either Type 2 diabetes or chronic kidney disease are predicted to reach elevated risk for CVD 8-9 years earlier than women with neither condition while women with both conditions may reach high risk 26 years earlier.
Risk Factors are Connected
The health factors that comprise CKM syndrome are connected. They include high blood pressure, abnormal cholesterol, excess weight, high blood glucose sugar and low kidney function. If something goes wrong in one area, it affects others.
“Knowing your health numbers is critical to optimize your CKM health and prioritize prevention of heart, kidney and metabolic disease,” said Khan, who is also the Magerstadt professor of cardiovascular epidemiology and an associate professor of cardiology and preventive medicine at Northwestern School of Medicine.
Since high blood pressure and early stages of kidney disease and diabetes often don’t have symptoms, regular screening is necessary to be aware of your risk.
Pregnancy and Menopause Affect Women’s CKM Health
Each pregnancy is a window into later heart and kidney health, according to Janani Rangaswami, M.D., FAHA, professor of medicine at the George Washington University School of Medicine and Health Sciences and co-chair of the scientific advisory group for the American Heart Association’s presidential advisory that defined CKM syndrome.
Pregnancy complications such as pre-eclampsia, gestational diabetes and gestational hypertension are risk factors for future chronic kidney disease and cardiovascular disease, Rangaswami said.
Changes during menopause also influence long-term heart and metabolic health. This includes declining estrogen levels, increased body fat around the organs, increased cholesterol levels and stiffening or weakening of blood vessels, per the American Heart Association. Early menopause (before age 45) is linked to a higher risk for kidney disease, Type 2 diabetes and CVD.
“Women can mitigate those risks by getting appropriate treatment for their menopause symptoms,” Rangaswami said.
Social Factors Affect Women’s Health
Negative economic, environmental and psychosocial factors are associated with lower levels of preventive health behaviors like physical activity and healthy eating and higher levels of conditions like obesity and diabetes. Some factors affect women differently than men. For example, marriage is associated with worse health for women, and women are more likely than men to delay medical care because of costs, according to an American Heart Association scientific statement. Women are also more likely to have their health concerns dismissed, Khan said.
Women should know their risk and self-advocacy is critical. They should request thorough screenings that assess heart, kidney and metabolic health at visits with their health care providers. Visit heart.org/myCKMhealth to learn more.
Photos courtesy of Shutterstock
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(Family Features) These days, wellness information is practically everywhere you turn. Do this; don’t do that. Eat more of this; eat less of that. This is good for you; that is bad.
It can be hard to cut through all the noise, but the reality is, when it comes to something as serious as your heart health and LDL cholesterol – the “bad” cholesterol – ignoring it can be downright dangerous for your health.
According to the American Heart Association, about every 40 seconds, someone in the United States has a heart attack, and strokes occur at about the same frequency.
High LDL cholesterol, often called “bad” cholesterol, significantly increases your risk of heart disease.
A poll conducted by The Harris Poll for the American Heart Association revealed 75% of heart attack and stroke survivors reported having high cholesterol. Yet nearly half (47%) of heart attack and stroke survivors are unaware of their LDL cholesterol number. This lack of awareness shows more knowledge is needed to help survivors proactively manage their health.
In fact, knowledge is key to reducing your risk of heart disease. Understanding the impact of LDL cholesterol and knowing your LDL number can help you make informed decisions.
Cholesterol: The Good and The Bad
Cholesterol is a waxy, fat-like substance your body needs to build cells and produce hormones. However, not all cholesterol is created equal:
- LDL (low-density lipoprotein) Cholesterol: This is the “bad” cholesterol. When too much LDL cholesterol circulates in the blood, it can build up in the inner walls of the arteries that feed the heart and brain, forming plaque that can narrow and eventually block these arteries, leading to heart attack or stroke.
- HDL (high-density lipoprotein) Cholesterol: Known as the “good” cholesterol, HDL helps remove the “bad” cholesterol from the arteries, protecting against heart attack and stroke.
A Silent Threat
Many people think high cholesterol has obvious signs, but that’s not always the case. In fact, about half of U.S. adults and 42% of heart attack and stroke survivors mistakenly believe high cholesterol has clear symptoms. However, high LDL cholesterol typically doesn’t show any signs, which is why it’s known as a silent threat to your heart.
People who have had a heart attack or stroke are at higher risk of future cardiovascular problems, which is why it’s important to monitor your cholesterol regularly to help prevent future events.
It’s also important to know high LDL cholesterol can be genetic, meaning someone who eats a healthy diet and exercises regularly can still have high cholesterol. Additionally, the risk of high LDL cholesterol increases with age.
That’s why the American Heart Association’s “Lower Your LDL Cholesterol Now” initiative, nationally sponsored by Amgen, emphasizes the importance of regular cholesterol checks regardless of your weight, diet and physical activity levels. Knowing your LDL cholesterol number – and understanding the target levels based on your health history – gives you the opportunity to manage your health proactively. This enables you to make informed decisions to prevent future heart issues.
Know Your Number
You can reduce your risk of a heart attack or stroke by knowing and addressing your LDL cholesterol number.
Working closely with your doctor allows you to actively manage high LDL cholesterol – often a key risk factor you can help control – and together, you can develop a personalized treatment plan. Ask your doctor or health care provider for a cholesterol test to know your LDL number. Understanding your cholesterol number is the first step toward managing it effectively. If necessary, appropriate management of your LDL cholesterol can help reduce your risk of a heart attack or stroke.
Your doctor may also talk with you about your personal and family medical history; previous heart-related medical events such as a heart attack or stroke; lifestyle habits such as tobacco use, obesity, unhealthy living or aging; racial and ethnic backgrounds; and reproductive health.
Lower is Better
When it comes to your cholesterol, guidelines from the American Heart Association and the American College of Cardiology recommend “lower is better” to reduce your risk. Studies show that an LDL number or below 100 mg/dL is ideal for healthy adults.
If you have a history of heart attack or stroke and are already on a cholesterol-lowering medication, your doctor may aim for your LDL to be 70 mg/dL or lower.
Talk to your doctor about the right treatment plan for you. Positive lifestyle habits, such as exercising and eating a healthy diet, may also help.
However, if you’ve had a heart attack or stroke before, lifestyle changes alone may not be enough to lower your risk of another event. Your doctor may recommend cholesterol-lowering medications to protect your heart health.
Learn more about LDL (bad) cholesterol by visiting heart.org/LDL.
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(Family Features) Throughout history, humans’ ability to rely on one another has been crucial to survival. Despite modern developments that help individuals live with minimal human engagement, the human need to connect remains.
However, in many parts of America, a trend toward isolation is emerging. Over the past two decades, people are spending more time alone and less time engaging with others in person, according to data from the Office of the U.S. Surgeon General. One segment of Americans at particular risk of social isolation, loneliness and their negative impacts are select populations who live in rural areas.
“There is an urgent need to take action and improve mental health in rural America,” said Jeff Winton, dairy farmer and founder and chairman of Rural Minds, a nonprofit mental health advocacy organization that partnered with Pfizer to raise awareness about the physical and mental risks of social isolation. “Challenges to mental health can be inherent in a rural lifestyle, including a belief in self-reliance as a virtue, fear of judgment and difficulty getting an appointment with a limited number of mental health professionals, among others.”
Many Americans are increasingly spending more time alone according to the American Time Use Survey. They are increasingly more likely to take meetings, shop, eat and enjoy entertainment at home, making it easier for them to stay within their own four walls and avoid social interactions.
Authentic human connection is a basic but often unacknowledged necessity for health, “as essential to survival as food, water and shelter,” according to the U.S. Surgeon General’s Advisory on the Health Effects of Social Connection and Community.
Understanding Social Isolation
According to the Centers for Disease Control and Prevention (CDC), about one-third of U.S. adults reported feeling lonely and about one-fourth said they don’t have social and emotional support (the basis of social isolation).
The concepts of social isolation and loneliness can go hand-in-hand, but the two are actually quite different.
Social isolation is defined by an absence of relationships or contact with others. Someone experiencing loneliness may or may not have social connections, but lacks feelings of closeness, support or belonging. Despite the distinction, both can have a negative impact on a person’s mental and even physical health.
Several factors can influence a person’s risk for social isolation and loneliness.
“Social connection is a dynamic that changes over time,” said Nikki Shaffer, senior director, occupational health and wellness, Pfizer. “Transient feelings of loneliness or solitude may be beneficial because they can serve as motivation to reconnect. However, chronic loneliness (even if someone is not isolated) and isolation (even if someone is not lonely) can represent significant health concerns.”
Isolation in Rural America
Compared to people who live in urban areas, many rural Americans experience higher rates of depression and suicide but are less likely to access mental health care services, according to the “Health Disparities in Rural America: Current Challenges and Future Solutions” study published in “Clinical Advisor.” What’s more, CDC data shows suicide rates among people living in rural areas can be 64-68% higher than those in large urban areas.
Rural areas have 20% fewer primary care providers compared to urban areas, according to a report in JAMA, and the Health Resources and Services Administration reports more than 25 million rural Americans, more than half of rural residents, live in mental health professional shortage areas.
Among rural counties, 65% lack a psychiatrist. Nearly 30% of rural Americans don’t have internet access in their homes, which complicates the option for telehealth. These figures from Rural Minds exemplify the challenges facing rural America.
“Some people in rural communities still don’t understand or accept that mental illness is a disease,” said Winton, who grew up on a rural farm. “Rather, a mental illness can often be viewed as a personal weakness or character flaw. A lot of the stigma around mental illness results in unwarranted shame, which adds to the burden for someone already suffering from mental illness.”
Health Impacts of Social Isolation
Loneliness is far more than just a bad feeling; it harms both individual and societal health. In fact, loneliness and social isolation can increase the risk for premature death by 26% and 29%, respectively.
Lacking social connection can increase the risk for premature death as much as smoking up to 15 cigarettes a day or drinking six alcoholic drinks daily.
In addition, poor or insufficient social connection is associated with increased risk of disease, including a 29% increased risk of heart disease and a 32% increased risk of stroke.
Social isolation is also associated with increased risk for anxiety, depression and dementia. Additionally, a lack of social connection may increase susceptibility to viruses and respiratory illness.
Learn more about the impact of social isolation, especially on residents of rural areas, and the steps you can take to reduce isolation and loneliness by visiting ruralminds.org.
Boost Your Social Connections
Take a proactive approach to combatting social isolation and loneliness with these everyday actions that can promote stronger social ties.- Invest time in nurturing your relationships through consistent, frequent and high-quality engagement with others. Take time each day to reach out to a friend or family member.
- Minimize distractions during conversation to increase the quality of the time you spend with others. For instance, don’t check your phone during meals with friends, important conversations and family time.
- Seek out opportunities to serve and support others, either by helping your family, co-workers, friends or people in your community or by participating in community service.
- Be responsive, supportive and practice gratitude. As you practice these behaviors, others are more likely to reciprocate, strengthening social bonds, improving relationship satisfaction and building social capital.
- Participate in social and community groups such as religious, hobby, fitness, professional and community service organizations to help foster a sense of belonging, meaning and purpose.
- Seek help during times of struggle with loneliness or isolation by reaching out to a family member, friend, counselor, health care provider or the 988 crisis line.
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