重建 COVID-19 对意大利伦巴第地区呼吸道合胞病毒免疫差距和传播的影响。

Reconstructing the impact of COVID-19 on the immunity gap and transmission of respiratory syncytial virus in Lombardy, Italy.

机构信息

Medical Research Council Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, London, United Kingdom.

Center for Health Emergencies, Fondazione Bruno Kessler, Trento, Italy; Department of Mathematics, University of Trento, Trento, Italy.

出版信息

EBioMedicine. 2023 Sep;95:104745. doi: 10.1016/j.ebiom.2023.104745. Epub 2023 Aug 9.

DOI:10.1016/j.ebiom.2023.104745

PMID:37566927

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10432612/

Abstract

BACKGROUND

Respiratory syncytial virus (RSV) is a leading cause of hospitalisation and mortality in young children globally. The social distancing measures implemented against COVID-19 in Lombardy (Italy) disrupted the typically seasonal RSV circulation during 2019-2021 and caused substantially more hospitalisations during 2021-2022. The primary aim of this study is to quantify the immunity gap-defined as the increased proportion of the population naïve to RSV infection following the relaxation of COVID-19 restrictions in Lombardy, which has been hypothesised to be a potential cause of the increased RSV burden in 2021-2022.

METHODS

We developed a catalytic model to reconstruct changes in the age-dependent susceptibility profile of the Lombardy population throughout the COVID-19 pandemic. The model is calibrated to routinely collected hospitalisation, syndromic, and virological surveillance data and tested for alternative assumptions on age-dependencies in the risk of RSV infection throughout the pandemic.

FINDINGS

We estimate that the proportion of the Lombardy population naïve to RSV infection increased by 60.8% (95% CrI: 55.2-65.4%) during the COVID-19 pandemic: from 1.4% (95% CrI: 1.3-1.6%) in 2018-2019 to 2.3% (95% CrI: 2.2-2.5%) before the 2021-2022 season, corresponding to an immunity gap of 0.87% (95% CrI: 0.87-0.88%). We found evidence of heterogeneity in RSV transmission by age, suggesting that the COVID-19 restrictions had variable impact on the contact patterns and risk of RSV infection across ages.

INTERPRETATION

We estimate a substantial increase in the population-level susceptibility to RSV in Lombardy during 2019-2021, which contributed to an increase in primary RSV infections in 2021-2022.

FUNDING

UK Medical Research Council (MRC), UK Foreign, Commonwealth & Development Office (FCDO), EDCTP2 programme, European Union, Wellcome Trust, Royal Society, EU-MUR PNRR INF-ACT.

摘要

背景

呼吸道合胞病毒（RSV）是导致全球幼儿住院和死亡的主要原因。在伦巴第（意大利）实施的 COVID-19 社交距离措施破坏了 2019-2021 年期间 RSV 的典型季节性传播，并导致 2021-2022 年期间住院人数大幅增加。本研究的主要目的是量化免疫差距-定义为 COVID-19 限制放松后对 RSV 感染缺乏免疫力的人群比例增加，这被假设是 2021-2022 年 RSV 负担增加的潜在原因。

方法

我们开发了一个催化模型，以重建 COVID-19 大流行期间伦巴第人口年龄相关易感性特征的变化。该模型经过常规收集的住院、综合征和病毒学监测数据进行校准，并针对大流行期间 RSV 感染风险的年龄相关性的替代假设进行了测试。

发现

我们估计，在 COVID-19 大流行期间，伦巴第人口对 RSV 感染缺乏免疫力的比例增加了 60.8%（95%置信区间：55.2-65.4%）：从 2018-2019 年的 1.4%（95%置信区间：1.3-1.6%）增加到 2021-2022 年赛季前的 2.3%（95%置信区间：2.2-2.5%），对应于 0.87%（95%置信区间：0.87-0.88%）的免疫差距。我们发现年龄与 RSV 传播之间存在异质性的证据，表明 COVID-19 限制对不同年龄组的接触模式和 RSV 感染风险产生了不同的影响。