Immunological insights into COVID-19 in Southern Nigeria
Authors: Ugwu Chinedu A. , Alao Oluwasina , John Oluwagboadurami G. , Akinnawo Blossom , Ajayi Israel , Odebode Ooreofe , Bejide Ifeoluwa , Campbell Allan , Campbell Julian , Adole Jolly A. , B. Olawoye Idowu , Akano Kazeem , Okolie Johnson , Eromon Philomena , Olaitan Peter , Olagunoye Ajibola , Adebayo Ibukun , Adebayo Victor , Babalola Elizabeth , Abioye Omowumi , Ajayi Nnennaya , Ogah Emeka , Ukwaja Kingsley , Okoro Sylvanus , Oje Ogbonnaya , Kingsley Ojide Chiedozie , Eke Matthew , Onyia Venatius , Achonduh-Atijegbe Olivia , Ewah Friday Elechi , Obasi Mary , Igwe Violet , Ayodeji Olufemi , Chukwuyem Abejegah , Owhin Sampson , Oyejide Nicholas , Abah Sylvester , Ingbian Winifred , Osoba Moyosoore , Alebiosu Ahmed , Nadesalingam Angalee , Aguinam Ernest T. , Carnell George , Krause Nina , Chan Andrew , George Charlotte , Kinsley Rebecca , Tonks Paul , Temperton Nigel , Heeney Jonathan , Happi Christian 
Published: January 2024

IntroductionOne of the unexpected outcomes of the COVID-19 pandemic was the relatively low levels of morbidity and mortality in Africa compared to the rest of the world. Nigeria, Africa's most populous nation, accounted for less than 0.01% of the global COVID-19 fatalities. The factors responsible for Nigeria's relatively low loss of life due to COVID-19 are unknown. Also, the correlates of protective immunity to SARS-CoV-2 and the impact of pre-existing immunity on the outcome of the COVID-19 pandemic in Africa are yet to be elucidated. Here, we evaluated the natural and vaccine-induced immune responses from vaccinated, non-vaccinated and convalescent individuals in Southern Nigeria throughout the three waves of the COVID-19 pandemic in Nigeria. We also examined the pre-existing immune responses to SARS-CoV-2 from samples collected prior to the COVID-19 pandemic.MethodsWe used spike RBD and N- IgG antibody ELISA to measure binding antibody responses, SARS-CoV-2 pseudotype assay protocol expressing the spike protein of different variants (D614G, Delta, Beta, Omicron BA1) to measure neutralizing antibody responses and nucleoprotein (N) and spike (S1, S2) direct ex vivo interferon gamma (IFNγ) T cell ELISpot to measure T cell responses. ResultOur study demonstrated a similar magnitude of both binding (N-IgG (74% and 62%), S-RBD IgG (70% and 53%) and neutralizing (D614G (49% and 29%), Delta (56% and 47%), Beta (48% and 24%), Omicron BA1 (41% and 21%)) antibody responses from symptomatic and asymptomatic survivors in Nigeria. A similar magnitude was also seen among vaccinated participants. Interestingly, we revealed the presence of preexisting binding antibodies (N-IgG (60%) and S-RBD IgG (44%)) but no neutralizing antibodies from samples collected prior to the pandemic. DiscussionThese findings revealed that both vaccinated, non-vaccinated and convalescent individuals in Southern Nigeria make similar magnitude of both binding and cross-reactive neutralizing antibody responses. It supported the presence of preexisting binding antibody responses among some Nigerians prior to the COVID-19 pandemic. Lastly, hybrid immunity and heterologous vaccine boosting induced the strongest binding and broadly neutralizing antibody responses compared to vaccine or infection-acquired immunity alone.