2021年6月至2022年2月期间，在荷兰社区检测点接受检测的有症状的接种疫苗成年人中的新冠病毒危险因素。
SARS-CoV-2 risk factors among symptomatic vaccinated adults attending community testing locations in the Netherlands from June 2021 till February 2022.
作者信息
Laarman Claudia, Hahné Susan J, de Melker Hester E, Knol Mirjam J
机构信息
Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
出版信息
PLoS One. 2024 Dec 30;19(12):e0311229. doi: 10.1371/journal.pone.0311229. eCollection 2024.
INTRODUCTION
Most studies on risk factors for a SARS-CoV-2 infection were conducted in the pre-vaccination era with many non-pharmaceutical prevention measures in place. We investigated risk factors for symptomatic SARS-CoV-2 infections in vaccinated persons in a period with a varying degree of prevention measures.
METHODS
In a test-negative case control study among vaccinated adults attending community COVID-19 testing locations between June 1st 2021 till February 28th 2022, we compared symptomatic cases with symptomatic controls (to study risk factors specific for SARS-CoV-2) and with asymptomatic controls (to study risk factors that could apply to respiratory infections in general). We examined potential risk factors including household composition and mitigation behaviour by logistic regression, adjusting for age, sex, and week of testing.
RESULTS
Risk factors for a positive SARS-CoV-2 test when symptomatic cases were compared to symptomatic controls were: having a household size of more than 4 (adjusted odds ratio: 1.47; 95% CI 1.14-1.92), being a healthcare worker (1.27;1.18-1.47), and visiting busy locations outside (1.49;1.19-1.87). When symptomatic cases were compared to asymptomatic controls, a household size of more than 4 members (1.71;1.25-2.33), living with children aged 0-12 (1.59;1.12-2.26), visiting busy locations outside (1.64;1.24-2.17) were independent risk factors for a positive SARS-CoV-2 test. Risk factors for separate periods and waves differed from the study period as a whole.
CONCLUSION
This study was conducted in a period with a varying degree of prevention measures. Among vaccinated individuals, we identified several SARS-CoV-2 specific risk factors and SARS-CoV-2 risk factors that could be more general for respiratory infections. For SARS-CoV-2 transmission more attention could be given to visiting busy outdoor locations, having a household size that consists of more than 4 persons, being a healthcare worker, and living with children aged 0-12. Risk factors varied with different phases in the pandemic, emphasizing the importance of repeated assessment of risk factors.
引言
大多数关于新冠病毒感染风险因素的研究是在疫苗接种前的时代进行的，当时有许多非药物预防措施。我们调查了在预防措施程度不同的时期内，接种疫苗人群中出现症状的新冠病毒感染的风险因素。
方法
在一项针对2021年6月1日至2022年2月28日期间在社区新冠病毒检测点进行检测的接种疫苗成年人的检测阴性病例对照研究中，我们将出现症状的病例与出现症状的对照（以研究新冠病毒特有的风险因素）以及无症状对照（以研究可能适用于一般呼吸道感染的风险因素）进行了比较。我们通过逻辑回归分析了包括家庭构成和缓解行为在内的潜在风险因素，并对年龄、性别和检测周数进行了调整。
结果
当将出现症状的病例与出现症状的对照进行比较时，新冠病毒检测呈阳性的风险因素为：家庭规模超过4人（调整后的优势比：1.47；95%置信区间1.14 - 1.92）、是医护人员（1.27；1.18 - 1.47）以及前往室外人员密集场所（1.49；1.19 - 1.87）。当将出现症状的病例与无症状对照进行比较时，家庭规模超过4名成员（1.71；1.25 - 2.33）、与0至12岁儿童同住（1.59；1.12 - 2.26）、前往室外人员密集场所（1.64；1.24 - 2.17）是新冠病毒检测呈阳性的独立风险因素。不同时期和波次的风险因素与整个研究时期有所不同。
结论
本研究是在预防措施程度不同的时期进行的。在接种疫苗的个体中，我们确定了几个新冠病毒特有的风险因素以及可能更普遍适用于呼吸道感染的风险因素。对于新冠病毒传播，应更多关注前往室外人员密集场所、家庭规模超过4人、是医护人员以及与0至12岁儿童同住的情况。风险因素在疫情的不同阶段有所变化，强调了对风险因素进行反复评估的重要性。
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