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Malaria and other infections induce polyreactive antibodies that impact SARS-CoV-2 seropositivity estimations in endemic settings
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  • Ruth Aguilar,
  • Alfons Jiménez,
  • Rebeca Santano,
  • Marta Vidal,
  • Oumou Maiga-Ascofare,
  • Ricardo Strauss,
  • Joseph Bonney,
  • Melvin Agbogbatey,
  • Odin Goovaerts,
  • Eric Ebenezer Amprofi Boham,
  • Evan Asamoah Adu,
  • Inocencia Cuamba,
  • Anna Ramírez-Morros,
  • Sheetij Dutta,
  • Evelina Angov,
  • Bin Zhan,
  • Luis Izquierdo,
  • Pere Santamaria,
  • Alfredo Mayor,
  • Joaquim Gascón,
  • Anna Ruiz-Comellas,
  • Luis M. Molinos-Albert,
  • John H. Amuasi,
  • Anthony Afum-Adjei Awuah,
  • Wim Adriaensen,
  • Carlota Dobano,
  • Gemma Moncunill
Ruth Aguilar
Hospital Clinic de Barcelona
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Alfons Jiménez
Hospital Clinic de Barcelona
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Rebeca Santano
Hospital Clinic de Barcelona
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Marta Vidal
Hospital Clinic de Barcelona
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Oumou Maiga-Ascofare
Kwame Nkrumah University of Science and Technology College of Agriculture and Natural Resources
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Ricardo Strauss
Bernhard-Nocht-Institut fur Tropenmedizin
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Joseph Bonney
Kwame Nkrumah University of Science and Technology College of Agriculture and Natural Resources
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Melvin Agbogbatey
Kwame Nkrumah University of Science and Technology College of Agriculture and Natural Resources
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Odin Goovaerts
Instituut voor Tropische Geneeskunde Departement Klinische Wetenschappen
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Eric Ebenezer Amprofi Boham
Kwame Nkrumah University of Science and Technology College of Agriculture and Natural Resources
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Evan Asamoah Adu
Kwame Nkrumah University of Science and Technology College of Agriculture and Natural Resources
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Inocencia Cuamba
Centro de Investigacao em Saude de Manhica
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Anna Ramírez-Morros
Institut de Recerca en Atencio Primaria Jordi Gol
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Sheetij Dutta
Walter Reed Army Institute of Research
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Evelina Angov
Walter Reed Army Institute of Research
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Bin Zhan
Baylor College of Medicine
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Luis Izquierdo
Hospital Clinic de Barcelona
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Pere Santamaria
Institut d'Investigacions Biomediques August Pi i Sunyer
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Alfredo Mayor
Hospital Clinic de Barcelona
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Joaquim Gascón
Hospital Clinic de Barcelona
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Anna Ruiz-Comellas
Institut de Recerca en Atencio Primaria Jordi Gol
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Luis M. Molinos-Albert
Hospital Clinic de Barcelona
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John H. Amuasi
Kwame Nkrumah University of Science and Technology College of Agriculture and Natural Resources
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Anthony Afum-Adjei Awuah
Kwame Nkrumah University of Science and Technology College of Agriculture and Natural Resources
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Wim Adriaensen
Instituut voor Tropische Geneeskunde Departement Klinische Wetenschappen
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Carlota Dobano
Hospital Clinic de Barcelona
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Gemma Moncunill
Hospital Clinic de Barcelona

Corresponding Author:gemma.moncunill@isglobal.org

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Abstract

Anti-SARS-CoV-2 seroprevalence is used as marker of viral exposure to estimate the proportion of previously infected population, track transmission, and monitor naturally- and vaccine-induced protection. However, in sub-Saharan African settings, antibodies induced by higher exposure to pathogens may increase unspecific seroreactivity to SARS-CoV-2 antigens, resulting in false positive responses. To investigate the level and type of unspecific seroreactivitiy to SARS-CoV-2 in Africa, we measured IgG, IgA and IgM to a broad panel of antigens from different pathogens by Luminex in 659 plasma samples from African and European subjects differing in COVID-19, malaria and other exposures. Seroreactivity to SARS-CoV-2 antigens in pre-pandemic African was higher compared to European samples, and positively correlated with antibodies against HuCoV, helminths, protozoa, and especially P. falciparum. African subjects presented higher levels of autoantibodies, a surrogate of polyreactivity, which correlated with P. falciparum and SARS-CoV-2 antibodies. Finally, we found an improved sensitivity in the IgG assay in African samples when using urea as chaotropic agent. In conclusion, our data suggests that polyreactive antibodies induced mostly by malaria are important mediators of the unspecific anti-SARS-CoV-2 responses, and that the use of dissociating agents in immunoassays could be useful for more accurate estimations of SARS-CoV-2 seroprevalence in African settings.