Orsi Andrea, Domnich Alexander, Pace Vanessa De, Ricucci Valentina, Caligiuri Patrizia, Bottiglieri Livio, Vagge Rosanna, Cavalleri Maurizio A, Orlandini Francesco, Bruzzone Bianca, Icardi Giancarlo
Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy.
Hygiene Unit, San Martino Policlinico Hospital-IRCCS for Oncology and Neurosciences, 16132 Genoa, Italy.
Vaccines (Basel). 2021 Jun 2;9(6):591. doi: 10.3390/vaccines9060591.
Elderly residents in nursing homes are at very high risk of life-threatening COVID-19-related outcomes. In this report, an epidemiological and serological investigation of a SARS-CoV-2 outbreak in an Italian nursing home is described. Among the residents, all but one (19/20) were regularly vaccinated against SARS-CoV-2. In mid-February 2021, a non-vaccinated staff member of the nursing home was diagnosed with the SARS-CoV-2 infection. Following the outbreak investigation, a total of 70% (14/20) of residents aged 77-100 years were found positive. The phylogenetic analysis showed that the outbreak was caused by the SARS-CoV-2 variant of concern 202012/01 (the so-called "UK variant"). However, all but one positive subjects (13/14) were fully asymptomatic. The only symptomatic patient was a vaccinated 86-year-old female with a highly compromised health background and deceased approximately two weeks later. The subsequent serological investigation showed that the deceased patient was the only vaccinated subject that did not develop the anti-spike protein antibody response, therefore being likely a vaccine non-responder. Although the available mRNA SARS-CoV-2 vaccine was not able to prevent several asymptomatic infections, it was able to avert most symptomatic disease cases caused by the SARS-CoV-2 variant of concern 202012/01 in nursing home residents.
养老院中的老年居民面临与新冠病毒相关的危及生命后果的风险非常高。在本报告中，描述了对意大利一家养老院中新冠病毒疫情的流行病学和血清学调查。在居民中，除一人外（19/20）都定期接种了新冠病毒疫苗。2021年2月中旬，该养老院一名未接种疫苗的工作人员被诊断感染新冠病毒。在疫情调查后，发现77至100岁的居民中共有70%（14/20）呈阳性。系统发育分析表明，此次疫情是由202012/01新冠病毒变异株（所谓的“英国变异株”）引起的。然而，除一名阳性受试者外（13/14），所有阳性受试者均完全无症状。唯一有症状的患者是一名接种过疫苗的86岁女性，其健康状况严重受损，大约两周后死亡。随后的血清学调查显示，该死亡患者是唯一未产生抗刺突蛋白抗体反应的接种疫苗受试者，因此可能是疫苗无应答者。尽管现有的新冠病毒mRNA疫苗无法预防多种无症状感染，但它能够避免养老院居民中由202012/01新冠病毒变异株引起的大多数有症状疾病病例。
