严重急性呼吸综合征冠状病毒 2 自然免疫持续时间和对德尔塔变异株的保护作用：一项回顾性队列研究。

Duration of Severe Acute Respiratory Syndrome Coronavirus 2 Natural Immunity and Protection Against the Delta Variant: A Retrospective Cohort Study.

机构信息

Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA.

Department of Infectious Disease, Cleveland Clinic, Cleveland, Ohio, USAand.

出版信息

Clin Infect Dis. 2022 Aug 24;75(1):e185-e190. doi: 10.1093/cid/ciab999.

DOI:10.1093/cid/ciab999

PMID:34864907

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8690283/

Abstract

BACKGROUND

Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been shown to be highly protective against reinfection and symptomatic disease. However, effectiveness against the Delta variant and duration of natural immunity remain unknown.

METHODS

This retrospective cohort study included 325 157 patients tested for SARS-CoV-2 via polymerase chain reaction (PCR) from 9 March 2020 to 31 December 2020 (Delta variant analysis) and 152 656 patients tested from 9 March 2020 to 30 August 2020 (long-term effectiveness analysis) with subsequent testing through 9 September 2021. The primary outcome was reinfection, defined as a positive PCR test >90 days after the initial positive test.

RESULTS

Among 325 157 patients tested before 31 December 2020, 50 327 (15.5%) tested positive. After 1 July 2021 (Delta dominant period), 40 (0.08%) initially positive and 1494 (0.5%) initially negative patients tested positive. Protection of prior infection against reinfection with Delta was 85.4% (95% confidence interval [CI], 80.0-89.3). For the long-term effectiveness analysis, among 152 656 patients tested before 30 August 2020, 11 186 (7.3%) tested positive. After at least 90 days, 81 (0.7%) initially positive and 7167 (5.1%) initially negative patients tested positive. Overall protection of previous infection was 85.7% (95% CI, 82.2-88.5) and lasted up to 13 months. Patients aged >65 years had slightly lower protection.

CONCLUSIONS

SARS-CoV-2 infection is highly protective against reinfection with Delta. Immunity from prior infection lasts at least 13 months. Countries facing vaccine shortages should consider delaying vaccinations for previously infected patients to increase access.

摘要

背景

严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染已被证明对再次感染和有症状疾病具有高度保护作用。然而，其对 Delta 变体的有效性和自然免疫的持续时间尚不清楚。

方法

这项回顾性队列研究纳入了 2020 年 3 月 9 日至 2020 年 12 月 31 日期间通过聚合酶链反应（PCR）检测 SARS-CoV-2 的 325157 例患者（Delta 变体分析）和 2020 年 3 月 9 日至 2020 年 8 月 30 日期间检测的 152656 例患者（长期有效性分析），随后检测持续到 2021 年 9 月 9 日。主要结局是再次感染，定义为初次阳性检测后 90 天以上的 PCR 检测阳性。

结果

在 2020 年 12 月 31 日前接受检测的 325157 例患者中，50327 例（15.5%）检测结果为阳性。2021 年 7 月 1 日（Delta 主导期）后，40 例（0.08%）初次阳性和 1494 例（0.5%）初次阴性患者检测结果为阳性。先前感染对 Delta 变体再感染的保护率为 85.4%（95%置信区间[CI]，80.0-89.3）。在 2020 年 8 月 30 日前接受检测的 152656 例患者中，有 11186 例（7.3%）检测结果为阳性。至少 90 天后，81 例（0.7%）初次阳性和 7167 例（5.1%）初次阴性患者检测结果为阳性。先前感染的总体保护率为 85.7%（95%CI，82.2-88.5），持续时间长达 13 个月。年龄>65 岁的患者保护作用略低。