Gopinath Shilpa, Ishak Angela, Dhawan Naveen, Poudel Sujan, Shrestha Prakriti Singh, Singh Prabhjeet, Xie Emily, Tahir Peggy, Marzaban Sima, Michel Jack, Michel George
Department of Internal Medicine, Division of Infectious Disease, Johns Hopkins University, Baltimore, MD 21205, USA.
Division of Research and Academic Affairs, Larkin Community Hospital, South Miami, FL 33143, USA.
Trop Med Infect Dis. 2022 May 22;7(5):81. doi: 10.3390/tropicalmed7050081.
We sought to assess breakthrough SARS-CoV-2 infections in vaccinated individuals by variant distribution and to identify the common risk associations. The PubMed, Web of Science, ProQuest, and Embase databases were searched from 2019 to 30 January 2022. The outcome of interest was breakthrough infections (BTIs) in individuals who had completed a primary COVID-19 vaccination series. Thirty-three papers were included in the review. BTIs were more common among variants of concern (VOC) of which Delta accounted for the largest number of BTIs (96%), followed by Alpha (0.94%). In addition, 90% of patients with BTIs recovered, 11.6% were hospitalized with mechanical ventilation, and 0.6% resulted in mortality. BTIs were more common in healthcare workers (HCWs) and immunodeficient individuals with a small percentage found in fully vaccinated healthy individuals. VOC mutations were the primary cause of BTIs. Continued mitigation approaches (e.g., wearing masks and social distancing) are warranted even in fully vaccinated individuals to prevent transmission. Further studies utilizing genomic surveillance and heterologous vaccine regimens to boost the immune response are needed to better understand and control BTIs.
我们试图通过变异株分布评估接种疫苗个体中的新冠病毒突破性感染情况，并确定常见的风险关联因素。检索了2019年至2022年1月30日的PubMed、Web of Science、ProQuest和Embase数据库。感兴趣的结果是完成新冠病毒初级疫苗接种系列的个体中的突破性感染（BTIs）。该综述纳入了33篇论文。突破性感染在关注变异株（VOC）中更为常见，其中德尔塔变异株导致的突破性感染数量最多（96%），其次是阿尔法变异株（0.94%）。此外，90%的突破性感染患者康复，11.6%的患者接受机械通气住院治疗，0.6%的患者死亡。突破性感染在医护人员（HCWs）和免疫缺陷个体中更为常见，在完全接种疫苗的健康个体中占比很小。关注变异株突变是突破性感染的主要原因。即使在完全接种疫苗的个体中，也有必要继续采取缓解措施（如戴口罩和保持社交距离）以防止传播。需要进一步开展利用基因组监测和异源疫苗接种方案来增强免疫反应的研究，以更好地理解和控制突破性感染。
