Abo-Leyah Hani, Gallant Stephanie, Cassidy Diane, Giam Yan Hui, Killick Justin, Marshall Beth, Hay Gordon, Snowdon Caroline, Hothersall Eleanor J, Pembridge Thomas, Strachan Rachel, Gallant Natalie, Parcell Benjamin J, George Jacob, Furrie Elizabeth, Chalmers James D
Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, Dundee, UK.
Dept of Immunology, NHS Tayside, Ninewells Hospital and Medical School, Dundee, UK.
ERJ Open Res. 2021 Jun 7;7(2). doi: 10.1183/23120541.00080-2021. eCollection 2021 Apr.
Healthcare workers (HCWs) are believed to be at increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. It is not known to what extent the natural production of antibodies to SARS-CoV-2 is protective against re-infection.
A prospective observational study of HCWs in Scotland (UK) from May to September 2020 was performed. The Siemens SARS-CoV-2 total antibody assay was used to establish seroprevalence in this cohort. Controls, matched for age and sex to the general local population, were studied for comparison. New infections (up to 2 December 2020) post antibody testing were recorded to determine whether the presence of SARS-CoV-2 antibodies protects against re-infection.
A total of 2063 health and social care workers were recruited for this study. At enrolment, 300 HCWs had a positive antibody test (14.5%). 11 out of 231 control sera tested positive (4.8%). HCWs therefore had an increased likelihood of a positive test (OR 3.4, 95% CI 1.85-6.16; p<0.0001). Dentists were most likely to test positive. 97.3% of patients who had previously tested positive for SARS-CoV-2 by reverse transcriptase (RT)-PCR had positive antibodies. 18.7% had an asymptomatic infection. There were 38 new infections with SARS-CoV-2 in HCWs who were previously antibody negative, and one symptomatic RT-PCR-positive re-infection. The presence of antibodies was therefore associated with an 85% reduced risk of re-infection with SARS-CoV-2 (hazard ratio 0.15, 95% CI 0.06-0.35; p=0.026).
HCWs were three times more likely to test positive for SARS-CoV-2 than the general population. Almost all infected individuals developed an antibody response, which was 85% effective in protecting against re-infection with SARS-CoV-2.
医护人员被认为感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的风险增加。目前尚不清楚SARS-CoV-2抗体的自然产生在多大程度上能预防再次感染。
对2020年5月至9月在苏格兰（英国）的医护人员进行了一项前瞻性观察研究。使用西门子SARS-CoV-2总抗体检测法确定该队列中的血清阳性率。选取年龄和性别与当地普通人群匹配的对照组进行研究以作比较。记录抗体检测后（截至2020年12月2日）的新感染情况，以确定SARS-CoV-2抗体的存在是否能预防再次感染。
本研究共招募了2063名卫生和社会护理工作者。入组时，300名医护人员抗体检测呈阳性（14.5%）。231份对照血清中有11份检测呈阳性（4.8%）。因此，医护人员检测呈阳性的可能性更高（比值比3.4，95%置信区间1.85 - 6.16；p<0.0001）。牙医检测呈阳性的可能性最大。先前通过逆转录酶（RT）-PCR检测SARS-CoV-2呈阳性的患者中，97.3%抗体呈阳性。18.7%有无症状感染。在先前抗体呈阴性的医护人员中有38例新感染SARS-CoV-2，以及1例有症状的RT-PCR阳性再次感染。因此，抗体的存在与SARS-CoV-2再次感染风险降低85%相关（风险比0.15，95%置信区间0.06 - 0.35；p = 0.026）。
医护人员SARS-CoV-2检测呈阳性的可能性是普通人群的三倍。几乎所有受感染个体都产生了抗体反应，该反应在预防SARS-CoV-2再次感染方面有85%的有效性。
