在芝加哥的医护人员中进行的一项队列研究：长达 6 个月的随访中血清学状态和 SARS-CoV-2 感染情况。
Serologic Status and SARS-CoV-2 Infection over 6 Months of Follow Up in Healthcare Workers in Chicago: A Cohort Study.
机构信息
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Division of Cardiology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
出版信息
Infect Control Hosp Epidemiol. 2022 Sep;43(9):1207-1215. doi: 10.1017/ice.2021.367. Epub 2021 Aug 9.
OBJECTIVE
To determine the changes in severe acute respiratory coronavirus virus 2 (SARS-CoV-2) serologic status and SARS-CoV-2 infection rates in healthcare workers (HCWs) over 6-months of follow-up.
DESIGN
Prospective cohort study.
SETTING AND PARTICIPANTS
HCWs in the Chicago area.
METHODS
Cohort participants were recruited in May and June 2020 for baseline serology testing (Abbott anti-nucleocapsid IgG) and were then invited for follow-up serology testing 6 months later. Participants completed monthly online surveys that assessed demographics, medical history, coronavirus disease 2019 (COVID-19), and exposures to SARS-CoV-2. The electronic medical record was used to identify SARS-CoV-2 polymerase chain reaction (PCR) positivity during follow-up. Serologic conversion and SARS-CoV-2 infection or possible reinfection rates (cases per 10,000 person days) by antibody status at baseline and follow-up were assessed.
RESULTS
In total, 6,510 HCWs were followed for a total of 1,285,395 person days (median follow-up, 216 days). For participants who had baseline and follow-up serology checked, 285 (6.1%) of the 4,681 seronegative participants at baseline seroconverted to positive at follow-up; 138 (48%) of the 263 who were seropositive at baseline were seronegative at follow-up. When analyzed by baseline serostatus alone, 519 (8.4%) of 6,194 baseline seronegative participants had a positive PCR after baseline serology testing (4.25 per 10,000 person days). Of 316 participants who were seropositive at baseline, 8 (2.5%) met criteria for possible SARS-CoV-2 reinfection (ie, PCR positive >90 days after baseline serology) during follow-up, a rate of 1.27 per 10,000 days at risk. The adjusted rate ratio for possible reinfection in baseline seropositive compared to infection in baseline seronegative participants was 0.26 (95% confidence interval, 0.13-0.53).
CONCLUSIONS
Seropositivity in HCWs is associated with moderate protection from future SARS-CoV-2 infection.
目的
确定在 6 个月的随访中，医护人员（HCWs）中严重急性呼吸冠状病毒 2 型（SARS-CoV-2）血清学状态和 SARS-CoV-2 感染率的变化。
设计
前瞻性队列研究。
地点和参与者
芝加哥地区的 HCWs。
方法
于 2020 年 5 月和 6 月招募队列参与者进行基线血清学检测（雅培抗核衣壳 IgG），然后邀请他们在 6 个月后进行随访血清学检测。参与者每月完成在线调查，评估人口统计学、病史、2019 年冠状病毒病（COVID-19）以及 SARS-CoV-2 的暴露情况。在随访期间，使用电子病历来确定 SARS-CoV-2 聚合酶链反应（PCR）阳性。根据基线和随访时的抗体状态评估血清学转换和 SARS-CoV-2 感染或可能再感染率（每 10000 人天的病例数）。
结果
共有 6510 名 HCWs 随访了总共 1285395 人天（中位随访时间为 216 天）。对于基线和随访时进行了血清学检查的参与者，4681 名基线时血清学阴性的参与者中有 285 名（6.1%）在随访时转为阳性；263 名基线时血清学阳性的参与者中有 138 名（48%）在随访时转为阴性。仅根据基线血清学状态分析，在基线血清学检测后，6194 名基线血清学阴性的参与者中有 519 名（8.4%）PCR 阳性（每 10000 人天 4.25 例）。在 316 名基线时血清学阳性的参与者中，有 8 名（2.5%）在随访期间符合 SARS-CoV-2 再感染的标准（即，基线血清学后 90 天以上 PCR 阳性），再感染率为每 10000 人天 1.27 例。与基线血清学阴性的参与者相比，基线血清学阳性的参与者发生可能再感染的调整后率比值为 0.26（95%置信区间，0.13-0.53）。
结论
HCWs 的血清学阳性与未来 SARS-CoV-2 感染的中度保护有关。
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