Department of Clinical Gerontology, University Hospital Centre Bordeaux, Bordeaux, France.
Medical Information Department, Medical information Analysis and Coordination Unit (UCAIM-DIM), University Hospital Centre Bordeaux, Bordeaux, France.
J Clin Virol. 2022 Apr;149:105134. doi: 10.1016/j.jcv.2022.105134. Epub 2022 Mar 15.
To describe COVID-19 breakthrough infections in two nursing homes (NHs) sites of active COVID-19 clusters despite optimal vaccination coverage.
A cross-sectional study was conducted in two NHs of south-western France, following the investigation of COVID-19 clusters (February-March 2021). SARS-CoV-2-confirmed infection was defined by positive RT-PCR. Antibodies neutralization capacities were tested in a subgroup of fully-vaccinated and seropositive-residents.
Of the 152 residents, 66% were female with median age 87 years (IQR: 80.0-90.2). Overall, 132 (87%) residents received 2 doses of vaccine, 14 (9%) one dose and 6 (4%) were unvaccinated. Forty-seven (31%) residents had confirmed infection (45 (98%) with variant 20I/501Y.V1). All 6 non-vaccinated residents, 4 /14 who had one dose and 37/132 that had two doses, were infected. Of the 39 residents reporting symptoms, 12 and 3 presented severe and critical disease, respectively. One resident with a confirmed infection died. Infected-residents had a median anti-S IgG titre of 19 116.0 (IQR: 3 028.0-39 681.8 AU/mL), 19 times higher than that of non-infected vaccinated persons (1,207.0; IQR: 494.0-2,782.0). In the subgroup of 19 residents tested for neutralizing antibodies, the neutralizing titre (50%) was strongly positively correlated with the anti-S IgG titre (correlation coefficient = 0.83), and 1.5 times higher for the infected than non-infected residents [5.9 (IQR: 5.3-6.9) vs. 3.6 (2.9-3.8)].
Institutionalized elderly persons who undergo breakthrough infection develop higher titres of anti-S IgGs, which are strongly correlated with the neutralizing capacity of the antibodies. These results advocate for additional vaccine doses in this population.
尽管接种疫苗覆盖率很高，但仍描述两家养老院（NH）中 COVID-19 突破性感染的情况。
在法国西南部的两家 NH 中进行了一项横断面研究，该研究是在 COVID-19 集群调查（2021 年 2 月至 3 月）之后进行的。通过 RT-PCR 阳性来确定 SARS-CoV-2 确诊感染。对完全接种疫苗和血清阳性的居民进行了亚组的抗体中和能力测试。
152 名居民中，66%为女性，中位年龄为 87 岁（IQR：80.0-90.2）。总体而言，132 名（87%）居民接受了 2 剂疫苗，14 名（9%）接受了 1 剂，6 名（4%）未接种疫苗。47 名（31%）居民感染了 COVID-19（45 名（98%）为 20I/501Y.V1 变异）。所有 6 名未接种疫苗的居民，4 名接受 1 剂疫苗的居民和 37 名接受 2 剂疫苗的居民均感染。在报告有症状的 39 名居民中，12 名患有严重疾病，3 名患有危重病。一名确诊感染的居民死亡。感染居民的抗 S IgG 滴度中位数为 19 116.0（IQR：3 028.0-39 681.8 AU/mL），是未感染接种者的 19 倍（1 207.0；IQR：494.0-2 782.0）。在接受中和抗体测试的 19 名居民亚组中，中和滴度（50%）与抗 S IgG 滴度呈强正相关（相关系数=0.83），且感染居民比未感染居民高 1.5 倍[5.9（IQR：5.3-6.9）比 3.6（2.9-3.8）]。
发生突破性感染的机构化老年人产生更高滴度的抗 S IgGs，与抗体的中和能力密切相关。这些结果支持在该人群中接种额外的疫苗剂量。
