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奥密克戎(Omicron)SARS-CoV-2 变异株与既往谱系相比的严重程度:一项系统评价。

Severity of the Omicron SARS-CoV-2 variant compared with the previous lineages: A systematic review.

机构信息

Medical Division, Weill Cornell Medicine-Qatar, Doha, Qatar.

Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota, USA.

出版信息

J Cell Mol Med. 2023 Jun;27(11):1443-1464. doi: 10.1111/jcmm.17747. Epub 2023 May 18.

DOI:10.1111/jcmm.17747
PMID:37203288
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10243162/
Abstract

The Omicron variant was first detected in October 2021, which evolved from the original SARS-CoV-2 strain and was found to possess many mutations. Immune evasion was one of the notable consequences of these mutations. Despite Omicron exhibiting increased transmissibility, the rates of hospitalizations and deaths among patients infected with this variant were substantially lower when compared to other strains. However, concluding that the Omicron variant is less severe than other variants of SARS-CoV-2 requires consideration of multiple factors, including the vaccination status of infected patients as well as any previous infections with other variants. This review compiled data about any reported indicators of severity in Omicron-infected patients, including studies comparing Omicron with other variants while adjusting for confounders. A comprehensive search was conducted using different databases to target any studies about Omicron. In total, 62 studies met our inclusion criteria and were included in this study. Many studies reported a significantly reduced risk of hospitalization, ICU admission, need for oxygenation/ventilation, and death in Omicron-infected patients compared to patients infected with other variants, such as Delta. Some studies, however, reported comparable severity in Omicron infected patients as to other variants emphasizing a substantial risk for severe illness. Furthermore, the COVID-19 vaccines were less effective against Omicron relative to previous lineages, except after receiving the booster dose. One study recommended vaccination during pregnancy, which may help prevent future cases of severe SARS-CoV-2 pneumonia in neonates and young infants due to the transfer of humoral response from the mother.

摘要

奥密克戎变异株于 2021 年 10 月首次被发现,它由原始 SARS-CoV-2 株进化而来,被发现具有许多突变。免疫逃逸是这些突变的显著后果之一。尽管奥密克戎表现出更高的传染性,但与其他株相比,感染该变异株的患者的住院率和死亡率明显较低。然而,认为奥密克戎变异株比 SARS-CoV-2 的其他变异株更温和需要考虑多种因素,包括感染患者的疫苗接种状况以及之前是否感染过其他变异株。本综述汇总了关于奥密克戎感染患者任何报告的严重程度指标的数据,包括比较奥密克戎与其他变异株的研究,同时调整了混杂因素。使用不同的数据库进行了全面搜索,以针对任何关于奥密克戎的研究。共有 62 项研究符合我们的纳入标准,并被纳入本研究。许多研究报告称,与感染其他变异株(如德尔塔)的患者相比,奥密克戎感染患者的住院、重症监护室入院、需要吸氧/通气和死亡风险显著降低。然而,一些研究报告称奥密克戎感染患者的严重程度与其他变异株相当,强调了严重疾病的风险很大。此外,与之前的谱系相比,COVID-19 疫苗对奥密克戎的有效性降低,除了接受加强剂量后。一项研究建议在怀孕期间接种疫苗,这可能有助于预防未来因母体抗体反应转移而导致新生儿和婴幼儿出现严重的 SARS-CoV-2 肺炎病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9ff/10243162/5f0445053c68/JCMM-27-1443-g002.jpg
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