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\begin{document}

\title{Malaria and other infections induce polyreactive antibodies that impact
SARS-CoV-2 seropositivity estimations in endemic settings}



\author[1]{Ruth Aguilar}%
\author[1]{Alfons Jiménez}%
\author[1]{Rebeca Santano}%
\author[1]{Marta Vidal}%
\author[2]{Oumou Maiga-Ascofare}%
\author[3]{Ricardo Strauss}%
\author[2]{Joseph Bonney}%
\author[2]{Melvin Agbogbatey}%
\author[4]{Odin Goovaerts}%
\author[2]{Eric Ebenezer Amprofi Boham}%
\author[2]{Evan Asamoah Adu}%
\author[5]{Inocencia Cuamba}%
\author[6]{Anna Ramírez-Morros}%
\author[7]{Sheetij Dutta}%
\author[7]{Evelina Angov}%
\author[8]{Bin Zhan}%
\author[1]{Luis Izquierdo}%
\author[9]{Pere Santamaria}%
\author[1]{Alfredo Mayor}%
\author[1]{Joaquim Gascón}%
\author[6]{Anna Ruiz-Comellas}%
\author[1]{Luis M. Molinos-Albert}%
\author[2]{John H. Amuasi}%
\author[2]{Anthony Afum-Adjei Awuah}%
\author[4]{Wim Adriaensen}%
\author[1]{Carlota Dobano}%
\author[1]{Gemma Moncunill}%
\affil[1]{Hospital Clinic de Barcelona}%
\affil[2]{Kwame Nkrumah University of Science and Technology College of Agriculture and Natural Resources}%
\affil[3]{Bernhard-Nocht-Institut fur Tropenmedizin}%
\affil[4]{Instituut voor Tropische Geneeskunde Departement Klinische Wetenschappen}%
\affil[5]{Centro de Investigacao em Saude de Manhica}%
\affil[6]{Institut de Recerca en Atencio Primaria Jordi Gol}%
\affil[7]{Walter Reed Army Institute of Research}%
\affil[8]{Baylor College of Medicine}%
\affil[9]{Institut d'Investigacions Biomediques August Pi i Sunyer}%


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  \date{May 25, 2024}


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\selectlanguage{english}
\begin{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 \emph{P.
falciparum}. African subjects presented higher levels of autoantibodies,
a surrogate of polyreactivity, which correlated with \emph{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.%
\end{abstract}%



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\textbf{Hosted file}

\verb`Afriprecovid_manuscrip_30 Jan 2024_JMV_Aguilar_clean.docx`  available at \url{https://authorea.com/users/744817/articles/732192-malaria-and-other-infections-induce-polyreactive-antibodies-that-impact-sars-cov-2-seropositivity-estimations-in-endemic-settings}

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