一项病例确诊家庭传播研究中急性SARS-CoV-2或流感感染后的持续症状：美国7个地点，2021年至2023年

Ongoing Symptoms After Acute SARS-CoV-2 or Influenza Infection in a Case-Ascertained Household Transmission Study: 7 US Sites, 2021-2023.

作者信息

Bullock Ayla, Dalton Alexandra F, Stockwell Melissa S, McLaren Son H, Sano Ellen, Nguyen Huong Q, Rao Suchitra, Asturias Edwin, Lutrick Karen, Ellingson Katherine D, Maldonado Yvonne, Mellis Alexandra M, Smith-Jeffcoat Sarah E, Grijalva Carlos G, Talbot H Keipp, Rolfes Melissa A R, Biddle Jessica E, Zhu Yuwei, Ledezma Karla, Pryor Kathleen, Valdez de Romero Ana, Vargas Celibell, Petrie Joshua G, Floris-Moore Michelle, Bowman Natalie

机构信息

Institute for Global Health and Infectious Disease, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA.

National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

出版信息

Clin Infect Dis. 2025 Jun 4;80(5):1032-1044. doi: 10.1093/cid/ciaf026.

DOI:10.1093/cid/ciaf026

PMID:40036243

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12159730/

Abstract

BACKGROUND

The prevalence and risk factors for ongoing symptoms following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [SCV2]) or influenza infection are not well characterized. We conducted a prospective cohort study of households wherein ≥1 individual was infected with SCV2 or influenza to evaluate prevalence of and factors associated with ongoing symptoms at 90 days.

METHODS

Index cases and their household contacts provided baseline health and sociodemographic information and collected daily respiratory specimens for 10 days following enrollment. Participants completed a follow-up survey 90 days after enrollment to characterize ongoing symptoms.

RESULTS

We analyzed 1967 participants enrolled between December 2021 and May 2023. The risk of ongoing symptoms did not differ by infection status in SCV2 (SCV2-positive: 15.6%; SCV2-negative: 13.9%; odds ratio [OR]: 1.14; 95% CI: .7-1.69) or influenza (influenza-positive: 8.8%; influenza-negative: 10.0%; OR: .87; 95% CI: .45-1.72) households. However, among study participants with a documented infection, SCV2-positive participants had nearly twice the odds of ongoing symptoms as influenza-positive participants (OR: 1.92; 95% CI: 1.27-2.97).

CONCLUSIONS

These results suggest that SCV2 households have a significantly higher prevalence of ongoing symptoms compared with influenza households (OR: 1.78; 95% CI: 1.28-2.47). Among participants with SCV2 infection, underlying conditions (adjusted OR [aOR]: 2.65; 95% CI: 1.80-3.90) and coronavirus disease 2019 (COVID-19)-like symptoms (aOR: 2.92; 95% CI: 1.15-7.43) during acute infection increased odds of ongoing symptoms at 90 days, whereas hybrid immunity reduced the odds of ongoing symptoms (aOR: 0.44; 95% CI: .22-.90).

摘要

背景

严重急性呼吸综合征冠状病毒2（SARS-CoV-2）[SCV2]）或流感感染后持续症状的患病率及危险因素尚未得到充分描述。我们对至少有1人感染SCV2或流感的家庭进行了一项前瞻性队列研究，以评估90天时持续症状的患病率及相关因素。

方法

索引病例及其家庭接触者提供基线健康和社会人口学信息，并在入组后10天每天采集呼吸道标本。参与者在入组90天后完成随访调查，以确定持续症状。

结果

我们分析了2021年12月至2023年5月期间入组的1967名参与者。在SCV2感染家庭（SCV2阳性：15.6%；SCV2阴性：13.9%；比值比[OR]：1.14；95%置信区间：0.7-1.69）或流感感染家庭（流感阳性：8.8%；流感阴性：10.0%；OR：0.87；95%置信区间：0.45-1.72）中，持续症状的风险在感染状态之间没有差异。然而，在有记录感染的研究参与者中，SCV2阳性参与者出现持续症状的几率几乎是流感阳性参与者的两倍（OR：1.92；95%置信区间：1.27-2.97）。

结论

这些结果表明，与流感感染家庭相比，SCV2感染家庭中持续症状的患病率显著更高（OR：1.78；95%置信区间：1.28-2.47）。在感染SCV2的参与者中，潜在疾病（调整后OR[aOR]：2.65；95%置信区间：1.80-3.90）和急性感染期间的2019冠状病毒病（COVID-19）样症状（aOR：2.92；95%置信区间：1.15-7.43）增加了90天时出现持续症状的几率，而混合免疫则降低了出现持续症状的几率（aOR：0.44；95%置信区间：0.22-0.90）。