马萨诸塞州一个城市社区队列中新冠病毒再次感染的可能性。
Likelihood of COVID-19 reinfection in an urban community cohort in Massachusetts.
作者信息
Casey Sharon M, Legler Aaron, Hanchate Amresh D, Perkins Rebecca B
机构信息
Department of Obstetrics and Gynecology, Boston University School of Medicine and Boston Medical Center, Boston, MA, United States of America.
Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, United States of America.
出版信息
Dialogues Health. 2022 Dec;1:100057. doi: 10.1016/j.dialog.2022.100057. Epub 2022 Oct 8.
BACKGROUND
Understanding the association of prior SARS-CoV-2 infection with subsequent reinfection has public health relevance.
OBJECTIVE
To explore COVID-19 severity and SARS-CoV-2 infection and reinfection rates.
DESIGN
Retrospective cohort study.
SETTING
Boston, Massachusetts, during the first COVID-19 surge (01/01/2020-05/31/2020; Period-1) and after the first surge (06/01/2020-02/28/2021; Period-2); Period-2 included the second surge (11/01/2020-02/28/2021).
PARTICIPANTS
Patients in an academic medical center and six community health centers who received a clinical diagnosis of COVID-19 between 01/01/2020 and 05/31/2020 or SARS-CoV-2 testing between 01/01/2020 and 02/28/2021.
MEASUREMENTS
COVID-19 severity was compared between Period-1 and Period-2. Poisson regression models adjusted for demographic variables, medical comorbidities, and census tract were used to assess reinfection risk among patients with COVID-19 diagnoses or SARS-CoV-2 testing during Period-1 and additional SARS-CoV-2 testing during Period-2.
RESULTS
Among 142,047 individuals receiving SARS-CoV-2 testing or clinical diagnoses during the study period, 15.8% were infected. Among COVID-19 patients, 22.5% visited the emergency department, 13% were hospitalized, and 4% received critical care. Healthcare utilization was higher during Period-1 than Period-2 (22.9% vs. 18.9% emergency department use, 14.7% vs. 9.9% hospitalization, 5.5% vs. 2.5% critical care; < 0.001). Reinfection was assessed among 8961 patients with a SARS-CoV-2 test or COVID-19 diagnosis in Period-1 who underwent additional testing in Period-2. A total of 2.7% ( = 65/2431) with SARS-CoV-2 in Period-1 tested positive in Period-2, compared with 12.6% ( = 821/6530) of those who initially tested negative (IRR of reinfection = 0.19, 95% CI: 0.15-0.25).
CONCLUSIONS
Prior SARS-CoV-2 infection among this observational cohort was associated with an 81% lower reinfection rate.
背景
了解既往感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）与后续再次感染之间的关联具有公共卫生意义。
目的
探讨新型冠状病毒肺炎（COVID-19）的严重程度以及SARS-CoV-2感染和再次感染率。
设计
回顾性队列研究。
地点
马萨诸塞州波士顿，在首次COVID-19疫情高峰期间（2020年1月1日至2020年5月31日；第1阶段）以及首次疫情高峰之后（2020年6月1日至2021年2月28日；第2阶段）；第2阶段包括第二次疫情高峰（2020年11月1日至2021年2月28日）。
参与者
在2020年1月1日至2020年5月31日期间接受COVID-19临床诊断或在2020年1月1日至2021年2月28日期间接受SARS-CoV-2检测的学术医疗中心和六个社区卫生中心的患者。
测量指标
比较第1阶段和第2阶段的COVID-19严重程度。采用经人口统计学变量、合并症和普查区调整的泊松回归模型，评估在第1阶段被诊断为COVID-19或接受SARS-CoV-2检测且在第2阶段接受额外SARS-CoV-2检测的患者的再次感染风险。
结果
在研究期间接受SARS-CoV-2检测或临床诊断的142,047名个体中，15.8%被感染。在COVID-19患者中，22.5%前往急诊科就诊，13%住院，4%接受重症监护。第1阶段的医疗服务利用率高于第2阶段（急诊科使用率分别为22.9%和18.9%，住院率分别为14.7%和9.9%，重症监护率分别为5.5%和2.5%；P<0.001）。在第1阶段接受SARS-CoV-2检测或被诊断为COVID-19且在第2阶段接受额外检测的8961名患者中评估再次感染情况。第1阶段SARS-CoV-2检测呈阳性的患者中，共有2.7%（n = 65/2431）在第2阶段检测再次呈阳性，而最初检测呈阴性的患者中这一比例为12.6%（n = 821/6530）（再次感染的发病率比为0.19，95%置信区间：0.15 - 0.25）。
结论
在这个观察性队列中，既往SARS-CoV-2感染与再次感染率降低81%相关。
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