接种疫苗对感染 SARS-CoV-2（奥密克戎变异株 B.1.1.529，亚谱系 BA.1）住院患者症状的出现和严重程度的影响。
Impact of vaccination on the presence and severity of symptoms in hospitalized patients with an infection of the Omicron variant (B.1.1.529) of the SARS-CoV-2 (subvariant BA.1).
机构信息
Infectious Disease Department, University Hospital of Poitiers, Poitiers, France.
Assistance Publique des Hôpitaux de Paris, Hôpital Antoine Béclère, Service de Médecine Interne, Clamart, France; Université Paris-Saclay, Université de Versailles Saint-Quentin-en-Yvelines, INSERM U1018, Centre de Recherche en Épidémiologie et Santé des Populations, Le Kremlin-Bicêtre, France.
出版信息
Clin Microbiol Infect. 2023 May;29(5):642-650. doi: 10.1016/j.cmi.2022.12.020. Epub 2022 Dec 29.
OBJECTIVES
The emergence of SARS-CoV-2 variants raised questions about the extent to which vaccines designed in 2020 have remained effective. We aimed to assess whether vaccine status was associated with the severity of Omicron SARS-CoV-2 infection in hospitalized patients.
METHODS
We conducted an international, multi-centric, retrospective study in 14 centres (Bulgaria, Croatia, France, and Turkey). We collected data on patients hospitalized for ≥24 hours between 1 December 2021 and 3 March 2022 with PCR-confirmed infection at a time of exclusive Omicron circulation and hospitalization related or not related to the infection. Patients who had received prophylaxis by monoclonal antibodies were excluded. Patients were considered fully vaccinated if they had received at least two injections of either mRNA and/or ChAdOx1-S or one injection of Ad26.CoV2-S vaccines.
RESULTS
Among 1215 patients (median age, 73.0 years; interquartile range, 57.0-84.0; 51.3% men), 746 (61.4%) were fully vaccinated. In multivariate analysis, being vaccinated was associated with lower 28-day mortality (Odds Ratio [95% Confidence Interval] (OR [95CI]) = 0.50 [0.32-0.77]), intensive care unit admission (OR [95CI] = 0.40 [0.26-0.62]), and oxygen requirement (OR [95CI] = 0.34 [0.25-0.46]), independent of age and comorbidities. When co-analysing these patients with Omicron infection with 948 patients with Delta infection from a study we recently conducted, Omicron infection was associated with lower 28-day mortality (OR [95CI] = 0.53 [0.37-0.76]), intensive care unit admission (OR [95CI] = 0.19 [0.12-0.28]), and oxygen requirements (OR [95CI] = 0.50 [0.38-0.67]), independent of age, comorbidities, and vaccination status.
DISCUSSION
Originally designed vaccines have remained effective on the severity of Omicron SARS-CoV-2 infection. Omicron is associated with a lower risk of severe forms, independent of vaccination and patient characteristics.
目的
SARS-CoV-2 变异株的出现引发了人们对 2020 年设计的疫苗在多大程度上仍然有效的疑问。本研究旨在评估疫苗接种状况与住院患者感染奥密克戎（Omicron）SARS-CoV-2 的严重程度之间的关系。
方法
我们在 14 个中心（保加利亚、克罗地亚、法国和土耳其）开展了一项国际性、多中心、回顾性研究。我们收集了 2021 年 12 月 1 日至 2022 年 3 月 3 日期间 PCR 确诊感染期间仅为奥密克戎流行且与感染无关或相关的住院时间≥24 小时的患者的数据。排除接受单克隆抗体预防治疗的患者。如果患者至少接受过 2 剂 mRNA 和/或 ChAdOx1-S 或 1 剂 Ad26.CoV2-S 疫苗的接种，则被认为是完全接种疫苗。
结果
在 1215 例患者（中位年龄 73.0 岁；四分位间距 57.0-84.0；51.3%为男性）中，746 例（61.4%）为完全接种疫苗。多变量分析显示，接种疫苗与 28 天死亡率降低相关（比值比[95%置信区间]（OR [95CI]）=0.50 [0.32-0.77]）、入住重症监护病房（OR [95CI]）=0.40 [0.26-0.62]）和需要吸氧（OR [95CI]）=0.34 [0.25-0.46]）独立于年龄和合并症。当我们将这些奥密克戎感染患者与我们最近开展的一项研究中的 948 例德尔塔（Delta）感染患者进行联合分析时，奥密克戎感染与 28 天死亡率降低相关（OR [95CI]）=0.53 [0.37-0.76]）、入住重症监护病房（OR [95CI]）=0.19 [0.12-0.28]）和需要吸氧（OR [95CI]）=0.50 [0.38-0.67]）独立于年龄、合并症和疫苗接种状况。
讨论
最初设计的疫苗对奥密克戎 SARS-CoV-2 感染的严重程度仍然有效。奥密克戎与严重程度较低的风险相关，与疫苗接种和患者特征无关。
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