儿童感染前奥密克戎变异株后对关注的 SARS-CoV-2 变异株的抗体反应：一项观察性队列研究。
Antibody response against SARS-CoV-2 variants of concern in children infected with pre-Omicron variants: An observational cohort study.
机构信息
Instituto de Investigaciones Biomédicas en Retrovirus y SIDA (INBIRS). Facultad de Medicina. UBA-CONICET, Paraguay 2155, C1121ABG Caba, Argentina.
Hospital General de Niños Pedro de Elizalde, Av. Montes de Oca 40, C1270 CABA, Argentina.
出版信息
EBioMedicine. 2022 Sep;83:104230. doi: 10.1016/j.ebiom.2022.104230. Epub 2022 Aug 18.
BACKGROUND
Despite that pediatric COVID-19 is usually asymptomatic or mild, SARS-CoV-2 infection typically results in the development of an antibody response. Contradictory observations have been reported when the antibody response of children and adults were compared in terms of strength, specificity and perdurability.
METHODS
This observational study includes three cohorts infected with SARS-CoV-2 between March 2020-July 2021: unvaccinated infected children (n=115), unvaccinated infected adults (n=62), and vaccinated infected children (n=76). Plasma anti-spike IgG antibodies and neutralising activity against Wuhan, Delta and Omicron variants after 7-17 months post-infection were analysed.
FINDINGS
More than 95% of unvaccinated infected children and adults remained seropositive when evaluated at 382-491 and 386-420 days after infection, respectively. Anti-spike IgG titers and plasma neutralising activity against Wuhan, Delta and Omicron variants were higher in children compared to adults. No differences were found when unvaccinated infected children were stratified by age, gender or presence/absence of symptoms in the acute phase of SARS-CoV-2 infection, but a slight decrease in the antibody response was observed in those with comorbidities. Vaccination of previously infected children with two doses of the inactivated BBIBP-CorV or the mRNA vaccines, BNT162b2 and/or mRNA-1273, further increased anti-spike IgG titers and neutralising activity against Wuhan, Delta and Omicron variants.
INTERPRETATION
Unvaccinated infected children mount a more potent and sustained antibody response compared with adults, which is significantly increased after vaccination. Further studies including not only the analysis of the immune response but also the effectiveness to prevent reinfections by the different Omicron lineages are required to optimise vaccination strategy in children.
FUNDING
National Agency for Scientific and Technological Promotion from Argentina (PICTO-COVID-SECUELAS-00007 and PMO-BID-PICT2018-2548).
背景
尽管儿童 COVID-19 通常无症状或轻症，但 SARS-CoV-2 感染通常会导致抗体反应的产生。在比较儿童和成人的抗体反应的强度、特异性和持久性时，已经有相互矛盾的观察结果报告。
方法
本观察性研究纳入了 2020 年 3 月至 2021 年 7 月期间感染 SARS-CoV-2 的三个队列：未接种疫苗的感染儿童（n=115）、未接种疫苗的感染成人（n=62）和接种疫苗的感染儿童（n=76）。分析了感染后 7-17 个月时血浆抗刺突 IgG 抗体和针对武汉、Delta 和奥密克戎变异株的中和活性。
结果
在感染后 382-491 天和 386-420 天，分别评估时，超过 95%的未接种疫苗的感染儿童和成人仍为血清阳性。与成人相比，儿童的抗刺突 IgG 滴度和针对武汉、Delta 和奥密克戎变异株的血浆中和活性更高。在未接种疫苗的感染儿童中，按年龄、性别或 SARS-CoV-2 感染急性期症状的有无进行分层，未发现差异，但在伴有合并症的儿童中，抗体反应略有下降。先前感染的儿童接种两剂灭活的 BBIBP-CorV 或 mRNA 疫苗（BNT162b2 和/或 mRNA-1273），进一步增加了针对武汉、Delta 和奥密克戎变异株的抗刺突 IgG 滴度和中和活性。
结论
与成人相比，未接种疫苗的感染儿童产生更强大和持久的抗体反应，接种疫苗后显著增加。需要进一步研究，不仅包括对免疫反应的分析，还包括对不同奥密克戎谱系预防再感染的有效性，以优化儿童的疫苗接种策略。
资助
阿根廷国家科学技术促进局（PICTO-COVID-SECUELAS-00007 和 PMO-BID-PICT2018-2548）。
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