Lu W Y, Chen X H, Zheng N, Yu H J
School of Public Health/Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai 200032, China.
Zhonghua Yi Xue Za Zhi. 2023 May 16;103(18):1429-1434. doi: 10.3760/cma.j.cn112137-20221221-02685.
To predict the protection probability of different clinical outcomes after reinfection with Omicron variant in symptomatic and unvaccinated COVID-19 patients who infected with prototype strain. The data used in this study were derived from a systematic review and meta-analysis which systematically searched PubMed, Embase, Web of Science, and Europe PMC databases, included published and uploaded studies of dynamic changes of neutralizing antibodies in symptomatic COVID-19 patients from 1 January 2020 to 2 October 2022 and extracted the literature information, study design, serological experiment information and antibody results. According to the scatter distribution characteristics of antibody titer data, a generalized additive model based on Gaussian distribution was used to fit the titer value of neutralizing antibody based on logarithmic conversion and the dynamic change pattern of neutralizing antibody in symptomatic and unvaccinated COVID-19 patients infected with prototype strain over time was obtained. In this study, the fitted antibody titers of patients on the 28th, 51st, and 261st day after symptom onset was selected to predict the protection probability. Neutralizing antibodies produced in symptomatic and unvaccinated patients infected with prototype strain could provide protection against Omicron reinfection, and the probability of protection gradually decreased with time. Neutralizing antibody level on day 28 after symptom onset provided protection probability of 30.3% (95%: 20.0%-45.5%) against reinfection, 51.5% (95%: 33.4%-75.9%) against symptomatic reinfection, and 91.2% (95%: 77.1%-97.7%) against severe reinfection caused by Omicron BA.5. The protection probability against Omicron BA.1, BA.4 and BA.5 reinfections decreased significantly 261 days after symptom onset, showing 9.6%-12.9%, 18.4%-23.9% and 63.1%-70.3% against three clinical outcomes, respectively. At the same time point and against the same clinical outcome, the protection probability of BA.1 was the highest, followed by BA.4 and BA.5. Neutralizing antibodies induced in symptomatic and unvaccinated COVID-19 patients previously infected with the prototype strain have limited protection probability against Omicron BA.5 reinfections and symptomatic reinfections. The protection probability against Omicron BA.5 reinfections is 30.3% 28 days after symptom onset and decreases to about 10% after 261 days. However, the protection probability against severe reinfections is considerable, with over 90% 28 days after symptom onset and still exceeding 60% after 261 days.
为预测感染原型毒株的有症状且未接种疫苗的新冠患者再次感染奥密克戎变异株后不同临床结局的保护概率。本研究使用的数据来自一项系统评价和荟萃分析，该分析系统检索了PubMed、Embase、Web of Science和欧洲生物医学与健康科学电子数据库（Europe PMC），纳入了2020年1月1日至2022年10月2日期间有症状新冠患者中和抗体动态变化的已发表和上传的研究，并提取了文献信息、研究设计、血清学实验信息和抗体结果。根据抗体滴度数据的散点分布特征，采用基于高斯分布的广义相加模型对中和抗体滴度值进行对数转换拟合，得到感染原型毒株的有症状且未接种疫苗的新冠患者中和抗体随时间的动态变化模式。在本研究中，选择症状出现后第28天、第51天和第261天患者的拟合抗体滴度来预测保护概率。感染原型毒株的有症状且未接种疫苗的患者产生的中和抗体可提供针对奥密克戎再感染的保护，且保护概率随时间逐渐降低。症状出现后第28天的中和抗体水平针对再感染提供的保护概率为30.3%（95%：20.0%-45.5%），针对有症状再感染为51.5%（95%：33.4%-75.9%），针对奥密克戎BA.5引起的严重再感染为91.2%（95%：77.1%-97.7%）。症状出现后261天，针对奥密克戎BA.1、BA.4和BA.5再感染的保护概率显著下降，针对三种临床结局分别为9.6%-12.9%、18.4%-23.9%和63.1%-70.3%。在同一时间点且针对相同临床结局时，BA.1的保护概率最高，其次是BA.4和BA.5。先前感染原型毒株的有症状且未接种疫苗的新冠患者诱导产生的中和抗体对奥密克戎BA.5再感染和有症状再感染的保护概率有限。症状出现后28天针对奥密克戎BA.5再感染的保护概率为30.3%，261天后降至约10%。然而，针对严重再感染的保护概率相当可观，症状出现后28天超过90%，261天后仍超过60%。
