Department of Virology, National Institute of Health, Islamabad, Pakistan.
Front Public Health. 2022 Sep 29;10:987452. doi: 10.3389/fpubh.2022.987452. eCollection 2022.
COVID-19 pandemic has severely affected Pakistan with 1,557,134 cases as of August 4, 2022. However, the data regarding breakthrough infections in Pakistan is scant. Hence, the objective was to analyze SARS-CoV-2 breakthrough infections with respect to vaccines and variants during the fifth wave in Pakistan. Therefore, the Department of Virology (NIH, Pakistan) genotyped 2,467 randomly selected individuals between November 2021 and February 2022 using the SNPsig SARS-CoV-2 (EscapePLEX) kit (PrimerDesign, UK). P681R and K417N mutations were used to distinguish delta and omicron. Data on the patient's age, gender, date of collection, variant, and vaccination status were analyzed using Statistical Package for Social Sciences (SPSS) software. Among 2,467 genotyped samples, Omicron was detected in 58.6% ( = 1445), Delta in 40.4% ( = 998) and undetermined/wildtype variant in 24 samples. The vaccination status of omicron-positive patients showed (49.7%; = 718/1445) and Delta-positive patients (39.67%; = 396/998) to be fully vaccinated. Of note, a high percentage 85% of breakthrough cases ( = 947) were identified among fully vaccinated individuals ( = 1114). Among them, 85.9% ( = 617/718) belonged to omicron and 83.3% ( = 330/396) to delta. Moreover, 76.7% ( = 855) of vaccinated individuals ( = 1114) received Sinopharm ( = 432) and Sinovac ( = 423) vaccines. The majority of breakthrough subjects who contracted Omicron were vaccinated with Sinopharm (93.0%, = 256) and delta with Cansino (100%, = 44). Individuals vaccinated with Sinovac showed the most frequent breakthrough cases for both Omicron and Delta variant between the 4th and 6th months ( = 278) after primary vaccination as compared to the 7th to 9th months ( = 24) category. While in case of Sinopharm, maximum breakthrough cases occurred between 7th to 9th months ( = 234) as compared to the 4th to 6th months ( = 120) after primary vaccination. Omicron and Delta breakthrough cases in men ( = 364 and 193) are more frequently seen than women ( = 253 and 138) respectively and breakthrough majority cases ( = 392) occurred in individuals aged 18-33 years. Breakthrough cases limiting monitoring in Pakistan impose a substantial constraint on policymakers' ability to take timely effective decisions. Since the current study consists of only a 2,467-genotyped sample, comprehensive data should be analyzed.
截至 2022 年 8 月 4 日，COVID-19 大流行已严重影响巴基斯坦，累计病例数为 1557134 例。然而，关于巴基斯坦突破性感染的数据很少。因此，本研究旨在分析第五波疫情期间巴基斯坦 COVID-19 突破性感染与疫苗和变异株的关系。因此，NIH 病毒学系（巴基斯坦）使用 SNPsig SARS-CoV-2（EscapePLEX）试剂盒（PrimerDesign，英国）对 2021 年 11 月至 2022 年 2 月期间随机选择的 2467 名个体进行了基因分型。使用 P681R 和 K417N 突变来区分 delta 和 omicron 变异株。使用社会科学统计软件包（SPSS）软件分析患者年龄、性别、采集日期、变异株和疫苗接种状态等数据。在 2467 个基因分型样本中，检测到 omicron 变异株 58.6%（=1445），delta 变异株 40.4%（=998），未确定/野生型变异株 24 例。omicron 阳性患者的疫苗接种情况为（49.7%；=718/1445），delta 阳性患者（39.67%；=396/998）为完全接种疫苗。值得注意的是，在完全接种疫苗的个体（=1114）中发现了 85%的突破性病例（=947）。其中，85.9%（=617/718）属于 omicron，83.3%（=330/396）属于 delta。此外，76.7%（=855）的接种个体（=1114）接种了国药（=432）和科兴（=423）疫苗。感染 omicron 的突破性病例大多数接种了国药（93.0%，=256），感染 delta 的突破性病例接种了康希诺（100%，=44）。与第 4 至 6 个月（=278）相比，接种科兴疫苗的个体在第 7 至 9 个月（=24）后发生 omicron 和 delta 变异株突破性病例的频率最高。而接种国药疫苗的个体，在第 7 至 9 个月（=234）发生突破性病例的频率最高，而第 4 至 6 个月（=120）后发生突破性病例的频率最低。男性（=364 和 193）的 omicron 和 delta 突破性病例比女性（=253 和 138）更常见，年龄在 18-33 岁的个体发生突破性病例的比例最高（=392）。巴基斯坦突破性感染监测受限，对决策者及时做出有效决策的能力构成重大限制。由于本研究仅包含 2467 个基因分型样本，因此应分析更全面的数据。
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