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纽约SARS-CoV-2 Delta突破性感染病例增加的临床和基因组特征

Clinical and genomic signatures of rising SARS-CoV-2 Delta breakthrough infections in New York.

作者信息

Duerr Ralf, Dimartino Dacia, Marier Christian, Zappile Paul, Levine Samuel, François Fritz, Iturrate Eduardo, Wang Guiqing, Dittmann Meike, Lighter Jennifer, Elbel Brian, Troxel Andrea B, Goldfeld Keith S, Heguy Adriana

机构信息

Department of Microbiology, NYU Grossman School of Medicine.

Genome Technology Center, Office of Science and Research, NYU Langone Health.

出版信息

medRxiv. 2021 Dec 17:2021.12.07.21267431. doi: 10.1101/2021.12.07.21267431.

DOI:10.1101/2021.12.07.21267431
PMID:34909779
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8669846/
Abstract

In 2021, Delta has become the predominant SARS-CoV-2 variant worldwide. While vaccines effectively prevent COVID-19 hospitalization and death, vaccine breakthrough infections increasingly occur. The precise role of clinical and genomic determinants in Delta infections is not known, and whether they contribute to increased rates of breakthrough infections compared to unvaccinated controls. Here, we show a steep and near complete replacement of circulating variants with Delta between May and August 2021 in metropolitan New York. We observed an increase of the Delta sublineage AY.25, its spike mutation S112L, and nsp12 mutation F192V in breakthroughs. Delta infections were associated with younger age and lower hospitalization rates than Alpha. Delta breakthroughs increased significantly with time since vaccination, and, after adjusting for confounders, they rose at similar rates as in unvaccinated individuals. Our data indicate a limited impact of vaccine escape in favor of Delta's increased epidemic growth in times of waning vaccine protection.

摘要

2021年，德尔塔毒株已成为全球主要的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）变体。虽然疫苗能有效预防新冠病毒疾病（COVID-19）导致的住院和死亡，但疫苗突破性感染却越来越频繁地出现。临床和基因组决定因素在德尔塔毒株感染中的具体作用尚不清楚，与未接种疫苗的对照组相比，它们是否会导致突破性感染率上升也不明确。在此，我们发现2021年5月至8月期间，在纽约大都市地区，德尔塔毒株急剧且几乎完全取代了正在传播的其他变体。我们观察到，在突破性感染中，德尔塔亚系AY.25及其刺突蛋白突变S112L和非结构蛋白12（nsp12）突变F192V有所增加。与阿尔法毒株相比，德尔塔毒株感染与更年轻的年龄以及更低的住院率相关。自接种疫苗后，德尔塔毒株突破性感染随时间显著增加，并且在调整混杂因素后，其增长速度与未接种疫苗的个体相似。我们的数据表明，在疫苗保护作用减弱之际，疫苗逃逸对德尔塔毒株流行增长增加的影响有限。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3505/8686047/d82c33f072b2/nihpp-2021.12.07.21267431v2-f0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3505/8686047/de5ee59e188c/nihpp-2021.12.07.21267431v2-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3505/8686047/e0ecd2be0e8f/nihpp-2021.12.07.21267431v2-f0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3505/8686047/321fd82cb18c/nihpp-2021.12.07.21267431v2-f0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3505/8686047/9e7f715349bd/nihpp-2021.12.07.21267431v2-f0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3505/8686047/d82c33f072b2/nihpp-2021.12.07.21267431v2-f0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3505/8686047/de5ee59e188c/nihpp-2021.12.07.21267431v2-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3505/8686047/e0ecd2be0e8f/nihpp-2021.12.07.21267431v2-f0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3505/8686047/321fd82cb18c/nihpp-2021.12.07.21267431v2-f0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3505/8686047/9e7f715349bd/nihpp-2021.12.07.21267431v2-f0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3505/8686047/d82c33f072b2/nihpp-2021.12.07.21267431v2-f0005.jpg

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