2020 年 1 月至 2021 年 7 月期间，英格兰一项针对儿童 SARS-CoV-2 再感染风险的全国前瞻性监测研究。
Risk of SARS-CoV-2 reinfections in children: a prospective national surveillance study between January, 2020, and July, 2021, in England.
机构信息
Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London, UK.
Immunisation and Vaccine Preventable Diseases Division, UK Health Security Agency, London, UK.
出版信息
Lancet Child Adolesc Health. 2022 Jun;6(6):384-392. doi: 10.1016/S2352-4642(22)00059-1. Epub 2022 Mar 28.
BACKGROUND
Reinfection after primary SARS-CoV-2 infection is uncommon in adults, but little is known about the risks, characteristics, severity, or outcomes of reinfection in children. We aimed to assess the risk of SARS-CoV-2 reinfection in children and compare this with the risk in adults, by analysis of national testing data for England.
METHODS
In our prospective, national surveillance study to assess reinfection of SARS-CoV-2 in children in England, we used national SARS-CoV-2 testing data to estimate the risk of reinfection at least 90 days after primary infection from Jan 27, 2020, to July, 31, 2021, which encompassed the alpha (B.1.1.7) and delta (B.1.617.2) variant waves in England. Data from children up to age 16 years who met the criteria for reinfection were included. Disease severity was assessed by linking reinfection cases to national hospital admission data, intensive care admission, and death registration datasets.
FINDINGS
Reinfection rates closely followed community infection rates, with a small peak during the alpha wave and a larger peak during the delta wave. In children aged 16 years and younger, 688 418 primary infections and 2343 reinfections were identified. The overall reinfection rate was 66·88 per 100 000 population, which was higher in adults (72·53 per 100 000) than children (21·53 per 100 000). The reinfection rate after primary infection was 0·68% overall, 0·73% in adults compared with 0·18% in children age younger than 5 years, 0·24% in those aged 5-11 years, and 0·49% in those aged 12-16 years. Of the 109 children admitted to hospital with reinfection, 78 (72%) had comorbidities. Hospital admission rates were similar for the first (64 [2·7%] of 2343) and second episode (57 [2·4%] of 2343) and intensive care admissions were rare (seven children for the first episode and four for reinfections). There were 44 deaths within 28 days after primary infection (0·01%) and none after reinfection.
INTERPRETATION
The risk of SARS-CoV-2 reinfection is strongly related to exposure due to community infection rates, especially during the delta variant wave. Children had a lower risk of reinfection than did adults, but reinfections were not associated with more severe disease or fatal outcomes.
FUNDING
UK Health Security Agency.
背景
成人初次感染 SARS-CoV-2 后再次感染的情况并不常见，但儿童再次感染的风险、特征、严重程度或结局知之甚少。我们旨在通过分析英格兰全国性的 SARS-CoV-2 检测数据，评估儿童再次感染 SARS-CoV-2 的风险，并与成人进行比较。
方法
在我们针对英格兰儿童再次感染 SARS-CoV-2 的前瞻性全国性监测研究中，我们使用全国性的 SARS-CoV-2 检测数据，从 2020 年 1 月 27 日至 2021 年 7 月 31 日，至少在初次感染后 90 天，评估了再次感染的风险，该时间段涵盖了英国的 alpha（B.1.1.7）和 delta（B.1.617.2）变体波。符合再次感染标准的儿童纳入研究。通过将再次感染病例与国家住院登记、重症监护入院和死亡登记数据集进行关联，评估疾病严重程度。
结果
再次感染率与社区感染率密切相关，在 alpha 波期间略有高峰，在 delta 波期间出现较大高峰。在 16 岁及以下的儿童中，共确定了 688418 例初次感染和 2343 例再次感染。总体再次感染率为每 10 万人中 66.88 例，成人（每 10 万人中 72.53 例）高于儿童（每 10 万人中 21.53 例）。初次感染后的总体再次感染率为 0.68%，成人中为 0.73%，而 5 岁以下儿童为 0.18%，5-11 岁儿童为 0.24%，12-16 岁儿童为 0.49%。在因再次感染而住院的 109 名儿童中，78 名（72%）有合并症。首次（2343 例中的 64 例，2.7%）和第二次（2343 例中的 57 例，2.4%）发病的住院率相似，重症监护入院率较低（首次发病 7 例，再次感染 4 例）。初次感染后 28 天内有 44 例死亡（0.01%），再次感染后无死亡病例。
结论
SARS-CoV-2 再次感染的风险与社区感染率密切相关，尤其是在 delta 变体波期间。儿童再次感染的风险低于成人，但再次感染与更严重的疾病或致命结局无关。
资金来源
英国卫生安全局。
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