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医护人员在 COVID-19 疫情爆发后对 SARS-CoV-2 的免疫反应:一项前瞻性纵向研究。

Immune response to SARS-CoV-2 in health care workers following a COVID-19 outbreak: A prospective longitudinal study.

机构信息

University Department of Obstetrics and Gynecology at the Hospital St. Hedwig of the Order of St. John, University of Regensburg, Regensburg, Germany; WECARE Research and Development Campus Regensburg at the Hospital St. Hedwig of the Order of St. John, University of Regensburg, Regensburg, Germany.

University Children's Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John, University of Regensburg, Regensburg, Germany; WECARE Research and Development Campus Regensburg at the Hospital St. Hedwig of the Order of St. John, University of Regensburg, Regensburg, Germany.

出版信息

J Clin Virol. 2020 Sep;130:104575. doi: 10.1016/j.jcv.2020.104575. Epub 2020 Aug 6.

Abstract

OBJECTIVE

Currently, little is known about the progression of an immune response against SARSCoV- 2 upon infection or sub-infection-exposure over time. We examined the serologic response in healthcare workers up to 12 weeks after a well-documented and contained outbreak and compared results with findings from earlier serologic testing in the same population.

METHODS

This study followed 166 health care workers of the University Perinatal Care Center, Regensburg, Germany, for up to 12 weeks. 27 of the subjects had previously tested positive for the presence of SARS-CoV-2 by PCR testing and developed COVID-19. Serologic responses were tested with two independent commercially available test kits.

RESULTS

77.8 % of COVID-19 study subjects developed a specific IgG-response over the course of the 12-week study, while none of the COVID-19 contact groups had a detectable IgG response. Amongst most COVID-19 patients the values of detectable IgG-responses significantly increased over time as confirmed with both tests, while that of positive IgA responses decreased. Between the number of reported symptoms and antibody responses in COVID-19 patients no correlation was found and no new cases of seroconversion were identified in asymptomatic coworkers with negative PCR during the outbreak.

CONCLUSIONS

Immune response after COVID-19 increases significantly over time but still approximately 22 % of COVID-19 patients did not mount a measurable serologic immune response within 60 days. Exposed co-workers did not develop any relevant antibody levels at all. We conclude that immunity after infection increases over time, but the antibody response does not develop reliably in all infected people.

摘要

目的

目前,人们对感染或亚感染暴露后 SARSCoV-2 免疫反应的进展知之甚少。我们研究了在有记录和控制的爆发后长达 12 周的医护人员的血清反应,并将结果与同一人群早期血清学检测的结果进行了比较。

方法

本研究对德国雷根斯堡大学围产期护理中心的 166 名医护人员进行了长达 12 周的随访。其中 27 名受试者先前通过 PCR 检测对 SARS-CoV-2 的存在呈阳性,并出现 COVID-19。采用两种独立的商业试剂盒检测血清学反应。

结果

77.8%的 COVID-19 研究对象在 12 周的研究过程中产生了特异性 IgG 反应,而 COVID-19 接触组均未检测到 IgG 反应。在大多数 COVID-19 患者中,随着时间的推移,两种检测方法均证实可检测到的 IgG 反应值显著增加,而阳性 IgA 反应值下降。COVID-19 患者的症状数量与抗体反应之间没有相关性,在爆发期间,PCR 检测结果为阴性的无症状同事中也没有发现新的血清转化病例。

结论

COVID-19 后的免疫反应随时间显著增加,但仍有约 22%的 COVID-19 患者在 60 天内未产生可测量的血清学免疫反应。暴露的同事根本没有产生任何相关的抗体水平。我们得出结论,感染后免疫力随时间增加,但并非所有感染的人都能可靠地产生抗体反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e30/7406471/ddc6c1b861af/gr1_lrg.jpg

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