具有混合免疫的人群中出现新冠后状况的可能性；来自德国国民队列（NAKO）的数据。

Likelihood of Post-COVID Condition in people with hybrid immunity; data from the German National Cohort (NAKO).

作者信息

Mikolajczyk Rafael, Diexer Sophie, Klee Bianca, Pfrommer Laura, Purschke Oliver, Fricke Julia, Ahnert Peter, Gabrysch Sabine, Gottschick Cornelia, Bohn Barbara, Brenner Hermann, Buck Christoph, Castell Stefanie, Gastell Sylvia, Greiser Karin Halina, Harth Volker, Heise Jana-Kristin, Holleczek Bernd, Kaaks Rudolf, Keil Thomas, Krist Lilian, Leitzmann Michael, Lieb Wolfgang, Meinke-Franze Claudia, Michels Karin B, Velásquez Ilais Moreno, Obi Nadia, Panreck Leo, Peters Annette, Pischon Tobias, Schikowski Tamara, Schmidt Börge, Standl Marie, Stang Andreas, Völzke Henry, Weber Andrea, Zeeb Hajo, Karch André

机构信息

Institute for Medical Epidemiology, Biometrics, and Informatics, Interdisciplinary Centre for Health Sciences, Medical Faculty of the Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.

出版信息

J Infect. 2024 Aug;89(2):106206. doi: 10.1016/j.jinf.2024.106206. Epub 2024 Jun 17.

DOI:10.1016/j.jinf.2024.106206

PMID:38897239

Abstract

OBJECTIVES

The risk of Post-COVID-19 condition (PCC) under hybrid immunity remains unclear.

METHODS

Using data from the German National Cohort (NAKO Gesundheitsstudie), we investigated risk factors for self-reported post-infection symptoms (any PCC is defined as having at least one symptom, and high symptom burden PCC as having nine or more symptoms).

RESULTS

Sixty percent of 109,707 participants reported at least one previous SARS-CoV-2 infection; 35% reported having had any symptoms 4-12 months after infection; among them 23% reported nine or more symptoms. Individuals, who did not develop PCC after their first infection, had a strongly reduced risk for PCC after their second infection (50%) and a temporary risk reduction, which waned over 9 months after the preceding infection. The risk of developing PCC strongly depended on the virus variant. Within variants, there was no effect of the number of preceding vaccinations, apart from a strong protection by the fourth vaccination compared to three vaccinations for the Omicron variant (odds ratio = 0.52; 95% confidence interval 0.45-0.61).

CONCLUSIONS

Previous infections without PCC and a fourth vaccination were associated with a lower risk of PCC after a new infection, indicating diminished risk under hybrid immunity. The two components of risk reduction after a preceding infection suggest different immunological mechanisms.

摘要

目的

新冠后状况（PCC）在混合免疫下的风险仍不明确。

方法

利用德国国家队列（NAKO健康研究）的数据，我们调查了自我报告的感染后症状的风险因素（任何PCC被定义为至少有一种症状，高症状负担PCC被定义为有九种或更多症状）。

结果

109,707名参与者中有60%报告至少有过一次SARS-CoV-2感染；35%报告在感染后4至12个月有任何症状；其中23%报告有九种或更多症状。首次感染后未出现PCC的个体，第二次感染后出现PCC的风险大幅降低（50%），且在前次感染后9个月内风险暂时降低。出现PCC的风险很大程度上取决于病毒变体。在各变体中，除了与三次疫苗接种相比，第四次疫苗接种对奥密克戎变体有很强的保护作用（优势比=0.52；95%置信区间0.45-0.61）外，之前接种疫苗的次数没有影响。