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Mitsi, Elena, Reiné, Jesús, Urban, Britta 
ORCID: https://orcid.org/0000-0002-4197-8393, SolorzanoGonzalez, Carla, Nikolaou, Elissavet, Hyder-Wright, Angela, Pojar, Sherin ORCID: https://orcid.org/0000-0002-7746-3279, Howard, Ashleigh, Hitchins, Lisa, Glynn, Sharon, Farrar, Madlen, Liatsikos, Konstantin, Collins, Andrea ORCID: https://orcid.org/0000-0002-4094-1572, Walker, Naomi ORCID: https://orcid.org/0000-0002-3345-7694, Hill, Helen, German, Esther, Cheliotis, Katerina, Byrne, Rachel, Williams, Chris, CubasAtienzar, Ana, Fletcher, Tom, Adams, Emily ORCID: https://orcid.org/0000-0002-0816-2835, Draper, Simon J, Pulido, David, Beavon, Rohini, Theilacker, Christian, Begier, Elizabeth, Jodar, Luis, Gessner, Bradford D and Ferreira, Daniela ORCID: https://orcid.org/0000-0002-0594-0902
(2022)
'Streptococcus pneumoniae colonization associates with impaired adaptive immune responses against SARS-CoV-2.'. Journal of Clinical Investigation, Vol 132, Issue 7, e157124.
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JClinInvest_2022_Mitsi_etal.pdf - Published Version Available under License Creative Commons Attribution. Download (1MB) | Preview |
Abstract
BACKGROUND
Although recent epidemiological data suggest that pneumococci may contribute to the risk of SARS-CoV-2 disease, cases of co-infection with Streptococcus pneumoniae in COVID-19 patients during hospitalisation have been reported infrequently. This apparent contradiction may be explained by interactions of SARS-CoV-2 and pneumococcus in the upper airway, resulting in the escape of SARS-CoV-2 from protective host immune responses.
METHODS
Here, we investigated the relationship of these two respiratory pathogens in two distinct cohorts of a) healthcare workers with asymptomatic or mildly symptomatic SARS-CoV-2 infection identified by systematic screening and b) patients with moderate to severe disease who presented to hospital. We assessed the effect of co-infection on host antibody, cellular and inflammatory responses to the virus.
RESULTS
In both cohorts, pneumococcal colonisation was associated with diminished anti-viral immune responses, which affected primarily mucosal IgA levels among individuals with mild or asymptomatic infection and cellular memory responses in infected patients.
CONCLUSION
Our findings suggest that S. pneumoniae impairs host immunity to SARS-CoV-2 and raises the question if pneumococcal carriage also enables immune escape of other respiratory viruses and facilitates reinfection occurrence.
TRIALS REGISTRATION
ISRCTN89159899 for FASTER study and Clinicaltrials.gov identifier: NCT03502291 for LAIV study.
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