ArticleInfection2024
Protective role of SARS-CoV-2 anti-S IgG against breakthrough infections among European healthcare workers during pre and post-Omicron surge-ORCHESTRA project.
Article in Infection, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Impact of Occupational and Extra-Professional Exposure Across the Different Waves of the Pandemic on the Risk of SARS-CoV-2 Infection Among Healthcare Workers-The ORCHESTRA Project.Healthcare (Basel, Switzerland) · 2026Article
- 400 AU/mL IgG protective threshold against SARS-CoV-2 XBB reinfection in Chinese inactivated vaccine recipients: implications for booster vaccination.Frontiers in immunology · 2026Article
- Article
- Article
- Risk factors for infection with SARS-CoV-2 in a cohort of Canadian healthcare workers: 2020-2023.Epidemiology and infection · 2025Article
- Article
- Breakthrough SARS-CoV-2 outcomes in immune-disordered people during the Omicron era: a prospective cohort study.BMJ public health · 2025Article
- Nurses' perspectives on working conditions while caring for patients with COVID-19 during the epidemic threat in Poland.Frontiers in public health · 2025Article
- Changes in cerebrovascular reactivity within functional networks in older adults with long-COVID.Frontiers in neurology · 2025Article
- Utility of ISARIC 4C Mortality Score, Vaccination History, and Anti-S Antibody Titre in Predicting Risk of Severe COVID-19.Viruses · 2024Article
- Symptomatology and IgG Levels before and after SARS-CoV-2 Omicron Breakthrough Infections in Vaccinated Individuals.Vaccines · 2024Article
- Hybrid Immunity and the Incidence of SARS-CoV-2 Reinfections during the Omicron Era in Frontline Healthcare Workers.Vaccines · 2024Article
- Review
- The impact of the COVID-19 pandemic on musculoskeletal disorders-related sick leave among healthcare workers: a retrospective analysis of Slovenian national data.Frontiers in public health · 2024Article
- Clinical characteristics and antibody response to Omicron variants among solid carcinoma patients in China on the 2022.12-2023.4 wave of the COVID-19 pandemic.Frontiers in immunology · 2024Article
Corrections and comments
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Authors and funding
24 authors.
Funding
Abstract
purposeAnti SARS-CoV-2 vaccination initially showed high effectiveness in preventing COVID-19. However, after the surge of variants of concern, the effectiveness dropped. Several studies investigated if this was related to the decrease of the humoral response over time; however, this issue is still unclear. The aim of this study was to understand whether SARS-CoV-2 anti-S IgG levels can be used to predict breakthrough infection risk and define the timing for further booster doses administration.
methodWithin the framework of the ORCHESTRA Project, over 20,000 health workers from 11 European centers were enrolled since December 2020. We performed two Cox proportional hazards survival analyses regarding pre-Omicron (from January to July 2021) and Omicron (December 2021-May 2022) periods. The serological response was classified as high (above the 75th percentile), medium (25th-75th), or low (< 25th).
resultsSeventy-four (0.33%) and 2122 (20%) health workers were infected during the first and second periods, respectively. Both Cox analyses showed that having high anti-S titer was linked to a significantly lower risk of infection as compared to having medium serological response [HR of high vs medium anti-S titer = 0.27 (95% CI 0.11-0.66) during the first phase, HR = 0.76 (95% CI 0.62-0.93) during the second phase].
conclusionVaccine effectiveness wanes significantly after new variants surge, making anti-S titer unsuitable to predict optimal timing for further booster dose administration. Studies on other immunological indicators, such as cellular immunity, are therefore needed to better understand the mechanisms and duration of protection against breakthrough infection risk.
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