新型冠状病毒2感染对一系列再次感染症状和严重程度所提供的保护。
Protection conferred by SARS-CoV-2 infection across a spectrum of reinfection symptoms and severities.
作者信息
Sukik Layan, Chemaitelly Hiam, Ayoub Houssein H, Coyle Peter, Tang Patrick, Hasan Mohammad R, Yassine Hadi M, Al Thani Asmaa A, Al-Kanaani Zaina, Al-Kuwari Einas, Jeremijenko Andrew, Kaleeckal Anvar Hassan, Latif Ali Nizar, Shaik Riyazuddin Mohammad, Abdul-Rahim Hanan F, Nasrallah Gheyath K, Al-Kuwari Mohamed Ghaith, Butt Adeel, Al-Romaihi Hamad Eid, Al-Thani Mohamed H, Al-Khal Abdullatif, Bertollini Roberto, Abu-Raddad Laith J
机构信息
Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar.
World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.
出版信息
BMJ Open Respir Res. 2025 Mar 26;12(1):e002718. doi: 10.1136/bmjresp-2024-002718.
BACKGROUND
SARS-CoV-2 infection is associated with protection against reinfection. This study analysed this protection across different reinfection symptoms and severities, comparing the preomicron and omicron eras.
METHODS
A nationwide, matched, test-negative, case-control study was conducted in Qatar from 5 February 2020 to 12 March 2024. The preomicron analysis used a sample of 509 949 positive and 8 494 782 negative tests, while the omicron analysis included 682 257 positive and 6 904 044 negative tests. Data were sourced from Qatar's national databases for COVID-19 laboratory testing, vaccination, hospitalisation and death.
RESULTS
Effectiveness of preomicron infection against preomicron reinfection was estimated at 80.9% (95% CI: 79.1% to 82.6%) for asymptomatic reinfection, 87.5% (95% CI: 86.1% to 88.9%) for symptomatic reinfection, 97.8% (95% CI: 95.7% to 98.9%) for severe COVID-19 reinfection, 100.0% (95% CI: 97.5% to 100.0%) for critical COVID-19 reinfection and 88.1% (95% CI: 50.3% to 97.2%) for fatal COVID-19 reinfection. For omicron infection against omicron reinfection, the estimates were 46.4% (95% CI: 36.9% to 54.4%) for asymptomatic reinfection, 52.8% (95% CI: 44.4% to 60.0%) for symptomatic reinfection, 100.0% (95% CI: 55.4% to 100.0%) for severe COVID-19 reinfection, 100.0% (95% CI: 15.1% to 100.0%) for critical COVID-19 reinfection, and 75.2% (95% CI: -58.8% to 97.5%) for fatal COVID-19 reinfection. Effectiveness over time since previous infection showed no discernible decline in protection against all forms of reinfection in the preomicron era, but a rapid decline against asymptomatic and symptomatic reinfections in the omicron era.
CONCLUSIONS
A gradient of protection against reinfection is evident, with the highest protection observed against severe forms of COVID-19. Over time, this gradient becomes more pronounced, as protection against asymptomatic and symptomatic reinfections decreases, while protection against severe outcomes remains strong.
背景
新型冠状病毒2型（SARS-CoV-2）感染与预防再次感染有关。本研究分析了不同再次感染症状和严重程度的这种保护作用，比较了奥密克戎毒株出现之前和奥密克戎毒株流行时期。
方法
2020年2月5日至2024年3月12日在卡塔尔进行了一项全国性、匹配、检测阴性的病例对照研究。奥密克戎毒株出现之前的分析使用了509949份阳性检测样本和8494782份阴性检测样本，而奥密克戎毒株流行时期的分析包括682257份阳性检测样本和6904044份阴性检测样本。数据来自卡塔尔的全国新冠病毒实验室检测、疫苗接种、住院和死亡数据库。
结果
奥密克戎毒株出现之前的感染对奥密克戎毒株出现之前再次感染的有效性估计为：无症状再次感染为80.9%（95%置信区间：79.1%至82.6%），有症状再次感染为87.5%（95%置信区间：86.1%至88.9%），重症新冠再次感染为97.8%（95%置信区间：95.7%至98.9%），危重症新冠再次感染为100.0%（95%置信区间：97.5%至100.0%），致命性新冠再次感染为88.1%（95%置信区间：50.3%至97.2%）。对于奥密克戎毒株感染对奥密克戎毒株再次感染的情况，估计分别为：无症状再次感染46.4%（95%置信区间：36.9%至54.4%），有症状再次感染52.8%（95%置信区间：44.4%至60.0%），重症新冠再次感染100.0%（95%置信区间：55.4%至100.0%），危重症新冠再次感染100.0%（95%置信区间：15.1%至100.0%），致命性新冠再次感染75.2%（95%置信区间：-58.8%至97.5%）。自上次感染后的时间内，奥密克戎毒株出现之前的时期对所有形式再次感染的保护作用没有明显下降，但在奥密克戎毒株流行时期，对无症状和有症状再次感染的保护作用迅速下降。
结论
预防再次感染的保护作用呈梯度变化，对重症新冠病毒感染的保护作用最高。随着时间推移，这种梯度变得更加明显，因为对无症状和有症状再次感染的保护作用下降，而对严重后果的保护作用仍然很强。
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