Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.
Epidemiologic Unit of the Local Health Authority of Vercelli - Osservatorio Epidemiologico, ASL Vercelli, Vercelli, Italy.
Sci Rep. 2023 Feb 3;13(1):2018. doi: 10.1038/s41598-023-28129-7.
The objective of our study was to determine the joint protective effect of a previous SARS-CoV-2 infection and vaccination on the risk of a new infection and hospitalization. Two case-control studies nested in a cohort of COVID-19 patients cared for by the Local Health Unit (LHU) of Vercelli, Italy, were performed, one to estimate the risk of infection and the second to estimate the risk of hospitalization. Each new infection and hospitalization was matched with up to 4 disease-free subjects who were the same age, sex and index date (i.e., controls). Study subjects were followed up from cohort entry date to disease outcome, end of follow-up or emigration. Vaccination was associated with a 36% (OR 0.64; 95%CI 0.62-0.66) and 90% (OR 0.10; 95%CI 0.07-0.14) reduction in the risk of infection and hospitalization, respectively. Prior infection was associated with a 65% (OR 0.35; 95%CI 0.30-0.40) and 90% (OR 0.10; 95%CI 0.07-0.14) reduction in the risk of infection and hospitalization, respectively. Vaccinated and recovered subjects showed a 63% (OR 0.37; 95%CI 0.34-0.14) and 98% (OR 0.02; 95%CI 0-0.13) reduction in the risk of infection and hospitalization, respectively. Vaccination remains an essential public health tool for preventing severe forms of COVID-19. Our study shows that vaccination or previous infection has a strong protective effect against Sars-CoV-2 hospitalization. The protective role against infection appears to be present although with a lower efficacy rate than that presented in the RCTs.
我们的研究目的是确定先前 SARS-CoV-2 感染和接种疫苗对新感染和住院风险的联合保护作用。在意大利韦尔切利当地卫生部门 (LHU) 护理的 COVID-19 患者队列中进行了两项病例对照研究，一项用于估计感染风险，另一项用于估计住院风险。每例新发感染和住院均与最多 4 名无病患者相匹配，这些患者年龄、性别和索引日期（即对照）相同。研究对象从队列入组日期开始随访至疾病结局、随访结束或移民。接种疫苗分别使感染和住院风险降低 36%（OR 0.64；95%CI 0.62-0.66）和 90%（OR 0.10；95%CI 0.07-0.14）。先前感染分别使感染和住院风险降低 65%（OR 0.35；95%CI 0.30-0.40）和 90%（OR 0.10；95%CI 0.07-0.14）。已接种疫苗且已康复的患者的感染和住院风险分别降低 63%（OR 0.37；95%CI 0.34-0.14）和 98%（OR 0.02；95%CI 0-0.13）。接种疫苗仍然是预防 COVID-19 严重形式的重要公共卫生工具。我们的研究表明，接种疫苗或先前感染对 SARS-CoV-2 住院有很强的保护作用。针对感染的保护作用似乎存在，尽管效力比 RCT 中报告的要低。
