Variants and vaccines impact nasal immunity over three waves of SARS-CoV-2

Nat Immunol. 2025 Feb;26(2):294-307. doi: 10.1038/s41590-024-02052-z. Epub 2025 Jan 20.

Abstract

Viral variant and host vaccination status impact infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), yet how these factors shift cellular responses in the human nasal mucosa remains uncharacterized. We performed single-cell RNA sequencing (scRNA-seq) on nasopharyngeal swabs from vaccinated and unvaccinated adults with acute Delta and Omicron SARS-CoV-2 infections and integrated with data from acute infections with ancestral SARS-CoV-2. Patients with Delta and Omicron exhibited greater similarity in nasal cell composition driven by myeloid, T cell and SARS-CoV-2hi cell subsets, which was distinct from that of ancestral cases. Delta-infected samples had a marked increase in viral RNA, and a subset of PER2+EGR1+GDF15+ epithelial cells was enriched in SARS-CoV-2 RNA+ cells in all variants. Prior vaccination was associated with increased frequency and activation of nasal macrophages. Expression of interferon-stimulated genes negatively correlated with coronavirus disease 2019 (COVID-19) severity in patients with ancestral and Delta but not Omicron variants. Our study defines nasal cell responses and signatures of disease severity across SARS-CoV-2 variants and vaccination.

MeSH terms

  • Adult
  • Aged
  • COVID-19 Vaccines* / immunology
  • COVID-19* / immunology
  • COVID-19* / prevention & control
  • COVID-19* / virology
  • Female
  • Humans
  • Macrophages / immunology
  • Male
  • Middle Aged
  • Nasal Mucosa* / immunology
  • Nasal Mucosa* / virology
  • Nasopharynx / immunology
  • Nasopharynx / virology
  • RNA, Viral / genetics
  • SARS-CoV-2* / genetics
  • SARS-CoV-2* / immunology
  • Single-Cell Analysis
  • Vaccination

Substances

  • COVID-19 Vaccines
  • RNA, Viral

Supplementary concepts

  • SARS-CoV-2 variants