奥密克戎时期新型冠状病毒再次感染的发病率、严重程度、风险因素及结局：一项系统评价和荟萃分析

Incidence, severity, risk factors and outcomes of SARS-CoV-2 reinfections during the Omicron period: a systematic review and meta-analysis.

作者信息

Kulkarni Durga, Lee Bohee, Ismail Nabihah Farhana, Rahman Ahmed Ehsanur, Spinardi Julia, Kyaw Moe H, Nair Harish

机构信息

Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK.

National Heart & Lung Institute, Imperial College, London, UK.

出版信息

J Glob Health. 2025 Feb 7;15:04032. doi: 10.7189/jogh.15.04032.

DOI:10.7189/jogh.15.04032

PMID:39916552

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11803431/

Abstract

BACKGROUND

Our previous systematic review estimated the cumulative incidence of SARS-CoV-2 reinfections as 1.16% (95% CI = 1.01-1.33%) during the pre-Omicron period. The Omicron variant that emerged in November 2021 was significantly genetically distinct from the previous SARS-CoV-2 variants and thus, more transmissible and posed an increased risk of SARS-CoV-2 reinfections in the population. We, therefore, conducted a fresh systematic review and meta-analysis to estimate the SARS-CoV-2 reinfection burden during the Omicron period.

METHODS

We searched CINAHL, Medline, Global Health, Embase, and WHO COVID-19 in October 2023 for studies reporting the SARS-CoV-2 reinfection incidence during the Omicron period. The quality of the included studies was assessed using the Joanna Briggs Institute checklists. Random effects meta-analyses were conducted to estimate the incidence, and requirement of hospitalisation of SARS-CoV-2 reinfections. Symptomatic severity of reinfections and case fatality rates were analysed narratively.

RESULTS

Thirty-six studies were included. The reinfection cumulative incidence during the Omicron period was 3.35% (95% CI = 1.95-5.72%) based on data from 28 studies. The cumulative incidence was higher in 18-59-year-old adults (6.62% (95% CI = 3.22-13.12%)) compared to other age groups and in health care workers (9.88% (95% CI = 5.18-18.03%)) compared to the general population (2.48% (95% CI = 1.34-4.54%)). We estimated about 1.81% (95% CI = 0.18-15.87%) of the reinfected cases required hospitalisation based on limited and highly variable data.

CONCLUSIONS

There was an increased risk of reinfections during the Omicron period compared to the pre-Omicron period. The incidence was higher in 18-59-year-old adults and health care workers and generally less severe during the Omicron period. However, data were limited on disease severity and long-term outcomes.

REGISTRATION

PROSPERO: CRD42023482598.

摘要

背景

我们之前的系统评价估计，在奥密克戎毒株出现之前的时期，SARS-CoV-2再次感染的累积发病率为1.16%（95%置信区间=1.01-1.33%）。2021年11月出现的奥密克戎变异株在基因上与之前的SARS-CoV-2变异株有显著差异，因此传播性更强，且增加了人群中SARS-CoV-2再次感染的风险。因此，我们进行了一项新的系统评价和荟萃分析，以估计奥密克戎毒株流行期间SARS-CoV-2再次感染的负担。

方法

我们于2023年10月在CINAHL、Medline、Global Health、Embase和世界卫生组织COVID-19数据库中检索报告奥密克戎毒株流行期间SARS-CoV-2再次感染发病率的研究。使用乔安娜·布里格斯研究所的清单评估纳入研究的质量。进行随机效应荟萃分析以估计SARS-CoV-2再次感染的发病率和住院需求。对再次感染的症状严重程度和病死率进行叙述性分析。

结果

纳入36项研究。根据28项研究的数据，奥密克戎毒株流行期间再次感染的累积发病率为3.35%（95%置信区间=1.95-5.72%）。与其他年龄组相比，18至59岁成年人的累积发病率更高（6.62%（95%置信区间=3.22-13.12%）），与普通人群（2.48%（95%置信区间=1.34-4.54%））相比，医护人员的累积发病率更高（9.88%（95%置信区间=5.18-18.03%））。根据有限且高度可变的数据，我们估计约1.81%（95%置信区间=0.18-15.87%）的再次感染病例需要住院治疗。