加强剂对康复的 COVID-19 患者血清中和针对奥密克戎变异株的活性：BNT162b2 和科兴疫苗的效果。
Boosting of serum neutralizing activity against the Omicron variant among recovered COVID-19 patients by BNT162b2 and CoronaVac vaccines.
机构信息
State Key Laboratory for Emerging Infectious Diseases, Carol Yu Centre for Infection, Department of Microbiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China.
Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China.
出版信息
EBioMedicine. 2022 May;79:103986. doi: 10.1016/j.ebiom.2022.103986. Epub 2022 Apr 8.
BACKGROUND
SARS-CoV-2 Omicron variant evades immunity from past infection or vaccination and is associated with a greater risk of reinfection among recovered COVID-19 patients. We assessed the serum neutralizing antibody (NAb) activity against Omicron variant (Omicron NAb) among recovered COVID-19 patients with or without vaccination.
METHODS
In this prospective cohort study with 135 recovered COVID-19 patients, we determined the serum NAb titers against ancestral virus or variants using a live virus NAb assay. We used the receiver operating characteristic analysis to determine the optimal cutoff for a commercially-available surrogate NAb assay.
FINDINGS
Among recovered COVID-19 patients, the serum live virus geometric mean Omicron NAb titer was statistically significantly higher among BNT162b2 recipients compared to non-vaccinated individuals (85.4 vs 5.6,P < 0.0001). The Omicron seropositive rates in live virus NAb test (NAb titer ≥10) were statistically significantly higher among BNT162b2 (90.6% [29/32];P < 0.0001) or CoronaVac (36.7% [11/30]; P = 0.0115) recipients when compared with non-vaccinated individuals (12.3% [9/73]). Subgroup analysis of CoronaVac recipients showed that the Omicron seropositive rates were higher among individuals with two doses than those with one dose (85.7% vs 21.7%; P = 0.0045). For the surrogate NAb assay, a cutoff of 109.1 AU/ml, which is 7.3-fold higher than the manufacturer's recommended cutoff, could achieve a sensitivity and specificity of 89.5% and 89.8%, respectively, in detecting Omicron NAb.
INTERPRETATION
Among individuals with prior COVID-19, one dose of BNT162b2 or two doses of CoronaVac could induce detectable serum Omicron NAb. Our result would be particularly important for guiding vaccine policies in countries with COVID-19 vaccine shortage.
FUNDING
Health and Medical Research Fund, Richard and Carol Yu, Michael Tong (see acknowledgments for full list).
背景
SARS-CoV-2 奥密克戎变异株逃避了既往感染或接种疫苗产生的免疫，并且与 COVID-19 康复患者的再感染风险增加相关。我们评估了既往 COVID-19 患者在接种或未接种疫苗的情况下针对奥密克戎变异株的血清中和抗体（NAb）活性。
方法
在这项前瞻性队列研究中，我们纳入了 135 例 COVID-19 康复患者，使用活病毒 NAb 测定法测定针对原始病毒或变异株的血清 NAb 滴度。我们使用受试者工作特征分析来确定商业上可用的替代 NAb 测定法的最佳截断值。
结果
在 COVID-19 康复患者中，与未接种疫苗的个体相比，接受 BNT162b2 接种的个体的血清活病毒奥密克戎 NAb 几何平均滴度显著更高（85.4 比 5.6，P<0.0001）。与未接种疫苗的个体相比，BNT162b2（90.6%[29/32]；P<0.0001）或科兴疫苗（36.7%[11/30]；P=0.0115）接种者的活病毒 NAb 检测（NAb 滴度≥10）中奥密克戎血清阳性率显著更高。科兴疫苗接种者的亚组分析显示，两剂接种者的奥密克戎血清阳性率高于一剂接种者（85.7%比 21.7%；P=0.0045）。对于替代 NAb 测定法，截断值为 109.1 AU/ml，比制造商推荐的截断值高 7.3 倍，可分别达到 89.5%和 89.8%的灵敏度和特异性，以检测奥密克戎 NAb。
结论
在既往 COVID-19 患者中，一剂 BNT162b2 或两剂科兴疫苗可诱导可检测到的血清奥密克戎 NAb。我们的研究结果对于指导 COVID-19 疫苗短缺国家的疫苗接种政策尤为重要。
资助
卫生署医药卫生研究基金、余振强及余黄美璇伉俪、唐伟章（详见致谢）。
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