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Clinical MedicineIn-Press PreviewCOVID-19Infectious disease Open Access | 10.1172/JCI170011

Prevalence and functional profile of SARS-CoV-2 T cells in asymptomatic Kenyan adults

Taraz Samandari,1 Joshua Ongalo,2 Kimberly McCarthy,3 Richard K. Biegon,4 Philister Madiega,2 Anne Mithika,2 Joseph Orinda,2 Grace M. Mboya,2 Patrick Mwaura,5 Omu Anzala,5 Clayton Onyango,1 Fredrick O. Oluoch,6 Eric M. Osoro,7 Charles-Antoine Dutertre,8 Nicole Tan,9 Shou Kit Hang,9 Smrithi Hariharaputran,9 David C. Lye,10 Amy Herman-Roloff,1 Nina Le Bert,9 and Antonio Bertoletti9

1U.S. Centers for Disease Control & Prevention, Nairobi, Kenya

2Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

3U.S. Centers for Disease Control & Prevention, U.S. Centers for Disease Control & Prevention, Kisumu, Kenya

4Immunology Section, Moi University School of Medicine, Eldoret, Kenya

5KAVI Institute of Research, University of Nairobi, Nairobi, Kenya

6Department of Health & Sanitation, County Government of Kisumu, Kisumu, Kenya

7Global Health, Washington State University Global Health Kenya, Nairobi, Kenya

8Department of Immunohematology, Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Descartes, Paris, France

9Programme in Emerging Infectious Diseases, Duke University-National University of Singapore Medical School, Singapore, Singapore

10National Centre for Infectious Diseases, Singapore, Singapore

Find articles by Samandari, T. in: JCI | PubMed | Google Scholar |

1U.S. Centers for Disease Control & Prevention, Nairobi, Kenya

2Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

3U.S. Centers for Disease Control & Prevention, U.S. Centers for Disease Control & Prevention, Kisumu, Kenya

4Immunology Section, Moi University School of Medicine, Eldoret, Kenya

5KAVI Institute of Research, University of Nairobi, Nairobi, Kenya

6Department of Health & Sanitation, County Government of Kisumu, Kisumu, Kenya

7Global Health, Washington State University Global Health Kenya, Nairobi, Kenya

8Department of Immunohematology, Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Descartes, Paris, France

9Programme in Emerging Infectious Diseases, Duke University-National University of Singapore Medical School, Singapore, Singapore

10National Centre for Infectious Diseases, Singapore, Singapore

Find articles by Ongalo, J. in: JCI | PubMed | Google Scholar |

1U.S. Centers for Disease Control & Prevention, Nairobi, Kenya

2Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

3U.S. Centers for Disease Control & Prevention, U.S. Centers for Disease Control & Prevention, Kisumu, Kenya

4Immunology Section, Moi University School of Medicine, Eldoret, Kenya

5KAVI Institute of Research, University of Nairobi, Nairobi, Kenya

6Department of Health & Sanitation, County Government of Kisumu, Kisumu, Kenya

7Global Health, Washington State University Global Health Kenya, Nairobi, Kenya

8Department of Immunohematology, Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Descartes, Paris, France

9Programme in Emerging Infectious Diseases, Duke University-National University of Singapore Medical School, Singapore, Singapore

10National Centre for Infectious Diseases, Singapore, Singapore

Find articles by McCarthy, K. in: JCI | PubMed | Google Scholar

1U.S. Centers for Disease Control & Prevention, Nairobi, Kenya

2Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

3U.S. Centers for Disease Control & Prevention, U.S. Centers for Disease Control & Prevention, Kisumu, Kenya

4Immunology Section, Moi University School of Medicine, Eldoret, Kenya

5KAVI Institute of Research, University of Nairobi, Nairobi, Kenya

6Department of Health & Sanitation, County Government of Kisumu, Kisumu, Kenya

7Global Health, Washington State University Global Health Kenya, Nairobi, Kenya

8Department of Immunohematology, Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Descartes, Paris, France

9Programme in Emerging Infectious Diseases, Duke University-National University of Singapore Medical School, Singapore, Singapore

10National Centre for Infectious Diseases, Singapore, Singapore

Find articles by Biegon, R. in: JCI | PubMed | Google Scholar

1U.S. Centers for Disease Control & Prevention, Nairobi, Kenya

2Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

3U.S. Centers for Disease Control & Prevention, U.S. Centers for Disease Control & Prevention, Kisumu, Kenya

4Immunology Section, Moi University School of Medicine, Eldoret, Kenya

5KAVI Institute of Research, University of Nairobi, Nairobi, Kenya

6Department of Health & Sanitation, County Government of Kisumu, Kisumu, Kenya

7Global Health, Washington State University Global Health Kenya, Nairobi, Kenya

8Department of Immunohematology, Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Descartes, Paris, France

9Programme in Emerging Infectious Diseases, Duke University-National University of Singapore Medical School, Singapore, Singapore

10National Centre for Infectious Diseases, Singapore, Singapore

Find articles by Madiega, P. in: JCI | PubMed | Google Scholar

1U.S. Centers for Disease Control & Prevention, Nairobi, Kenya

2Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

3U.S. Centers for Disease Control & Prevention, U.S. Centers for Disease Control & Prevention, Kisumu, Kenya

4Immunology Section, Moi University School of Medicine, Eldoret, Kenya

5KAVI Institute of Research, University of Nairobi, Nairobi, Kenya

6Department of Health & Sanitation, County Government of Kisumu, Kisumu, Kenya

7Global Health, Washington State University Global Health Kenya, Nairobi, Kenya

8Department of Immunohematology, Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Descartes, Paris, France

9Programme in Emerging Infectious Diseases, Duke University-National University of Singapore Medical School, Singapore, Singapore

10National Centre for Infectious Diseases, Singapore, Singapore

Find articles by Mithika, A. in: JCI | PubMed | Google Scholar

1U.S. Centers for Disease Control & Prevention, Nairobi, Kenya

2Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

3U.S. Centers for Disease Control & Prevention, U.S. Centers for Disease Control & Prevention, Kisumu, Kenya

4Immunology Section, Moi University School of Medicine, Eldoret, Kenya

5KAVI Institute of Research, University of Nairobi, Nairobi, Kenya

6Department of Health & Sanitation, County Government of Kisumu, Kisumu, Kenya

7Global Health, Washington State University Global Health Kenya, Nairobi, Kenya

8Department of Immunohematology, Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Descartes, Paris, France

9Programme in Emerging Infectious Diseases, Duke University-National University of Singapore Medical School, Singapore, Singapore

10National Centre for Infectious Diseases, Singapore, Singapore

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1U.S. Centers for Disease Control & Prevention, Nairobi, Kenya

2Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

3U.S. Centers for Disease Control & Prevention, U.S. Centers for Disease Control & Prevention, Kisumu, Kenya

4Immunology Section, Moi University School of Medicine, Eldoret, Kenya

5KAVI Institute of Research, University of Nairobi, Nairobi, Kenya

6Department of Health & Sanitation, County Government of Kisumu, Kisumu, Kenya

7Global Health, Washington State University Global Health Kenya, Nairobi, Kenya

8Department of Immunohematology, Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Descartes, Paris, France

9Programme in Emerging Infectious Diseases, Duke University-National University of Singapore Medical School, Singapore, Singapore

10National Centre for Infectious Diseases, Singapore, Singapore

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1U.S. Centers for Disease Control & Prevention, Nairobi, Kenya

2Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

3U.S. Centers for Disease Control & Prevention, U.S. Centers for Disease Control & Prevention, Kisumu, Kenya

4Immunology Section, Moi University School of Medicine, Eldoret, Kenya

5KAVI Institute of Research, University of Nairobi, Nairobi, Kenya

6Department of Health & Sanitation, County Government of Kisumu, Kisumu, Kenya

7Global Health, Washington State University Global Health Kenya, Nairobi, Kenya

8Department of Immunohematology, Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Descartes, Paris, France

9Programme in Emerging Infectious Diseases, Duke University-National University of Singapore Medical School, Singapore, Singapore

10National Centre for Infectious Diseases, Singapore, Singapore

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1U.S. Centers for Disease Control & Prevention, Nairobi, Kenya

2Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

3U.S. Centers for Disease Control & Prevention, U.S. Centers for Disease Control & Prevention, Kisumu, Kenya

4Immunology Section, Moi University School of Medicine, Eldoret, Kenya

5KAVI Institute of Research, University of Nairobi, Nairobi, Kenya

6Department of Health & Sanitation, County Government of Kisumu, Kisumu, Kenya

7Global Health, Washington State University Global Health Kenya, Nairobi, Kenya

8Department of Immunohematology, Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Descartes, Paris, France

9Programme in Emerging Infectious Diseases, Duke University-National University of Singapore Medical School, Singapore, Singapore

10National Centre for Infectious Diseases, Singapore, Singapore

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1U.S. Centers for Disease Control & Prevention, Nairobi, Kenya

2Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

3U.S. Centers for Disease Control & Prevention, U.S. Centers for Disease Control & Prevention, Kisumu, Kenya

4Immunology Section, Moi University School of Medicine, Eldoret, Kenya

5KAVI Institute of Research, University of Nairobi, Nairobi, Kenya

6Department of Health & Sanitation, County Government of Kisumu, Kisumu, Kenya

7Global Health, Washington State University Global Health Kenya, Nairobi, Kenya

8Department of Immunohematology, Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Descartes, Paris, France

9Programme in Emerging Infectious Diseases, Duke University-National University of Singapore Medical School, Singapore, Singapore

10National Centre for Infectious Diseases, Singapore, Singapore

Find articles by Onyango, C. in: JCI | PubMed | Google Scholar

1U.S. Centers for Disease Control & Prevention, Nairobi, Kenya

2Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

3U.S. Centers for Disease Control & Prevention, U.S. Centers for Disease Control & Prevention, Kisumu, Kenya

4Immunology Section, Moi University School of Medicine, Eldoret, Kenya

5KAVI Institute of Research, University of Nairobi, Nairobi, Kenya

6Department of Health & Sanitation, County Government of Kisumu, Kisumu, Kenya

7Global Health, Washington State University Global Health Kenya, Nairobi, Kenya

8Department of Immunohematology, Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Descartes, Paris, France

9Programme in Emerging Infectious Diseases, Duke University-National University of Singapore Medical School, Singapore, Singapore

10National Centre for Infectious Diseases, Singapore, Singapore

Find articles by Oluoch, F. in: JCI | PubMed | Google Scholar |

1U.S. Centers for Disease Control & Prevention, Nairobi, Kenya

2Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

3U.S. Centers for Disease Control & Prevention, U.S. Centers for Disease Control & Prevention, Kisumu, Kenya

4Immunology Section, Moi University School of Medicine, Eldoret, Kenya

5KAVI Institute of Research, University of Nairobi, Nairobi, Kenya

6Department of Health & Sanitation, County Government of Kisumu, Kisumu, Kenya

7Global Health, Washington State University Global Health Kenya, Nairobi, Kenya

8Department of Immunohematology, Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Descartes, Paris, France

9Programme in Emerging Infectious Diseases, Duke University-National University of Singapore Medical School, Singapore, Singapore

10National Centre for Infectious Diseases, Singapore, Singapore

Find articles by Osoro, E. in: JCI | PubMed | Google Scholar |

1U.S. Centers for Disease Control & Prevention, Nairobi, Kenya

2Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

3U.S. Centers for Disease Control & Prevention, U.S. Centers for Disease Control & Prevention, Kisumu, Kenya

4Immunology Section, Moi University School of Medicine, Eldoret, Kenya

5KAVI Institute of Research, University of Nairobi, Nairobi, Kenya

6Department of Health & Sanitation, County Government of Kisumu, Kisumu, Kenya

7Global Health, Washington State University Global Health Kenya, Nairobi, Kenya

8Department of Immunohematology, Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Descartes, Paris, France

9Programme in Emerging Infectious Diseases, Duke University-National University of Singapore Medical School, Singapore, Singapore

10National Centre for Infectious Diseases, Singapore, Singapore

Find articles by Dutertre, C. in: JCI | PubMed | Google Scholar |

1U.S. Centers for Disease Control & Prevention, Nairobi, Kenya

2Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

3U.S. Centers for Disease Control & Prevention, U.S. Centers for Disease Control & Prevention, Kisumu, Kenya

4Immunology Section, Moi University School of Medicine, Eldoret, Kenya

5KAVI Institute of Research, University of Nairobi, Nairobi, Kenya

6Department of Health & Sanitation, County Government of Kisumu, Kisumu, Kenya

7Global Health, Washington State University Global Health Kenya, Nairobi, Kenya

8Department of Immunohematology, Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Descartes, Paris, France

9Programme in Emerging Infectious Diseases, Duke University-National University of Singapore Medical School, Singapore, Singapore

10National Centre for Infectious Diseases, Singapore, Singapore

Find articles by Tan, N. in: JCI | PubMed | Google Scholar

1U.S. Centers for Disease Control & Prevention, Nairobi, Kenya

2Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

3U.S. Centers for Disease Control & Prevention, U.S. Centers for Disease Control & Prevention, Kisumu, Kenya

4Immunology Section, Moi University School of Medicine, Eldoret, Kenya

5KAVI Institute of Research, University of Nairobi, Nairobi, Kenya

6Department of Health & Sanitation, County Government of Kisumu, Kisumu, Kenya

7Global Health, Washington State University Global Health Kenya, Nairobi, Kenya

8Department of Immunohematology, Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Descartes, Paris, France

9Programme in Emerging Infectious Diseases, Duke University-National University of Singapore Medical School, Singapore, Singapore

10National Centre for Infectious Diseases, Singapore, Singapore

Find articles by Hang, S. in: JCI | PubMed | Google Scholar |

1U.S. Centers for Disease Control & Prevention, Nairobi, Kenya

2Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

3U.S. Centers for Disease Control & Prevention, U.S. Centers for Disease Control & Prevention, Kisumu, Kenya

4Immunology Section, Moi University School of Medicine, Eldoret, Kenya

5KAVI Institute of Research, University of Nairobi, Nairobi, Kenya

6Department of Health & Sanitation, County Government of Kisumu, Kisumu, Kenya

7Global Health, Washington State University Global Health Kenya, Nairobi, Kenya

8Department of Immunohematology, Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Descartes, Paris, France

9Programme in Emerging Infectious Diseases, Duke University-National University of Singapore Medical School, Singapore, Singapore

10National Centre for Infectious Diseases, Singapore, Singapore

Find articles by Hariharaputran, S. in: JCI | PubMed | Google Scholar

1U.S. Centers for Disease Control & Prevention, Nairobi, Kenya

2Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

3U.S. Centers for Disease Control & Prevention, U.S. Centers for Disease Control & Prevention, Kisumu, Kenya

4Immunology Section, Moi University School of Medicine, Eldoret, Kenya

5KAVI Institute of Research, University of Nairobi, Nairobi, Kenya

6Department of Health & Sanitation, County Government of Kisumu, Kisumu, Kenya

7Global Health, Washington State University Global Health Kenya, Nairobi, Kenya

8Department of Immunohematology, Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Descartes, Paris, France

9Programme in Emerging Infectious Diseases, Duke University-National University of Singapore Medical School, Singapore, Singapore

10National Centre for Infectious Diseases, Singapore, Singapore

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1U.S. Centers for Disease Control & Prevention, Nairobi, Kenya

2Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

3U.S. Centers for Disease Control & Prevention, U.S. Centers for Disease Control & Prevention, Kisumu, Kenya

4Immunology Section, Moi University School of Medicine, Eldoret, Kenya

5KAVI Institute of Research, University of Nairobi, Nairobi, Kenya

6Department of Health & Sanitation, County Government of Kisumu, Kisumu, Kenya

7Global Health, Washington State University Global Health Kenya, Nairobi, Kenya

8Department of Immunohematology, Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Descartes, Paris, France

9Programme in Emerging Infectious Diseases, Duke University-National University of Singapore Medical School, Singapore, Singapore

10National Centre for Infectious Diseases, Singapore, Singapore

Find articles by Herman-Roloff, A. in: JCI | PubMed | Google Scholar |

1U.S. Centers for Disease Control & Prevention, Nairobi, Kenya

2Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

3U.S. Centers for Disease Control & Prevention, U.S. Centers for Disease Control & Prevention, Kisumu, Kenya

4Immunology Section, Moi University School of Medicine, Eldoret, Kenya

5KAVI Institute of Research, University of Nairobi, Nairobi, Kenya

6Department of Health & Sanitation, County Government of Kisumu, Kisumu, Kenya

7Global Health, Washington State University Global Health Kenya, Nairobi, Kenya

8Department of Immunohematology, Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Descartes, Paris, France

9Programme in Emerging Infectious Diseases, Duke University-National University of Singapore Medical School, Singapore, Singapore

10National Centre for Infectious Diseases, Singapore, Singapore

Find articles by Le Bert, N. in: JCI | PubMed | Google Scholar |

1U.S. Centers for Disease Control & Prevention, Nairobi, Kenya

2Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya

3U.S. Centers for Disease Control & Prevention, U.S. Centers for Disease Control & Prevention, Kisumu, Kenya

4Immunology Section, Moi University School of Medicine, Eldoret, Kenya

5KAVI Institute of Research, University of Nairobi, Nairobi, Kenya

6Department of Health & Sanitation, County Government of Kisumu, Kisumu, Kenya

7Global Health, Washington State University Global Health Kenya, Nairobi, Kenya

8Department of Immunohematology, Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Descartes, Paris, France

9Programme in Emerging Infectious Diseases, Duke University-National University of Singapore Medical School, Singapore, Singapore

10National Centre for Infectious Diseases, Singapore, Singapore

Find articles by Bertoletti, A. in: JCI | PubMed | Google Scholar |

Published May 23, 2023 - More info

J Clin Invest. https://doi.org/10.1172/JCI170011.
Copyright © 2023, Samandari et al. This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Published May 23, 2023 - Version history
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Abstract

BACKGROUND. SARS-CoV-2 infection in Africa has been characterized by less severe disease than elsewhere but the profile of SARS-CoV-2 specific adaptive immunity in this largely asymptomatic spread has not been studied.

METHODS. We collected blood and nasopharyngeal samples from rural Kenyans (n=80) without respiratory symptoms since 2019, had no contact with COVID-19 cases or received COVID-19 vaccines and were negative for current SARS-CoV-2 infection. We analyzed spike-specific antibodies and T cells specific for SARS-CoV-2 structural (membrane, nucleocapsid and spike) and accessory (ORF3a, ORF7, ORF8) proteins. Pre-pandemic samples collected in urban Nairobi, Kenya (n=13) between 2015-2016 and samples of mild-moderately symptomatic COVID-19 convalescents (n=36) living in the urban environment of Singapore were also studied.

RESULTS. Among asymptomatic Kenyans, we detected anti-spike antibodies in 41.0% and T cell responses against ≥2 SARS-CoV-2 proteins in 82.5%. The pre-pandemic samples from Nairobi had low-level, monospecific responses. Furthermore, distinct from cellular immunity in European and Asian COVID-19 convalescents, strong T cell immunogenicity was observed against viral accessory proteins (ORF3a, ORF8) and not structural proteins, as well as a higher IL-10/IFN-γ ratio cytokine profile.

CONCLUSIONS. The high incidence of T cell responses against different SARS-CoV-2 proteins in largely seronegative participants suggests that serosurveys underestimate SARS-CoV-2 prevalence in settings where asymptomatic infections prevail. Similar observations have been made with other coronavirus infections such as MERS and SARS-CoV-1. The functional and antigen-specific profile of SARS-CoV-2 specific T cells in these African individuals suggests that genetic or environmental factors play a role in the development of protective antiviral immunity.

FUNDINGS. U.S. Centers for Disease Control and Prevention, Division of Global Health Protection; the Singapore Ministry of Health’s National Medical Research Council.

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