Chemaitelly Hiam, Ayoub Houssein H, Bobrovitz Niklas, 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, Al-Romaihi Hamad Eid, Al-Thani Mohamed H, Al-Khal Abdullatif, Bertollini Roberto, Butt Adeel A, Abu-Raddad Laith J
Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar.
Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, USA.
Commun Med (Lond). 2025 Jul 1;5(1):262. doi: 10.1038/s43856-025-00974-9.
Past immunological events can either enhance or compromise an individual's future immune protection. This study investigated how different severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) natural infection histories before an omicron infection, with or without vaccination, influence protection against subsequent omicron reinfection.
Three national, matched, retrospective cohort studies were conducted in Qatar from February 28, 2020, to August 12, 2024 to compare incidence of omicron reinfection between individuals with two omicron infections (omicron double-infection cohort) and those with one (omicron single-infection cohort); the omicron double-infection cohort with individuals who had a pre-omicron infection followed by an omicron reinfection (pre-omicron-omicron double-infection cohort); and the pre-omicron-omicron double-infection cohort with the omicron single-infection cohort.
Here we show that, in the first study, comparing the omicron double-infection cohort to the omicron single-infection cohort, the adjusted hazard ratio (aHR) is 1.27 (95% CI: 1.13-1.43); 0.93 (95% CI: 0.68-1.28) for the unvaccinated and 1.34 (95% CI: 1.18-1.52) for the vaccinated. In the second study, comparing the omicron double-infection cohort to the pre-omicron-omicron double-infection cohort, the aHR is 1.37 (95% CI: 1.13-1.65); 1.12 (95% CI: 0.63-1.97) for the unvaccinated and 1.42 (95% CI: 1.16-1.74) for the vaccinated. In the third study, comparing the pre-omicron-omicron double-infection cohort to the omicron single-infection cohort, the aHR is 0.97 (95% CI: 0.92-1.03); 0.75 (95% CI: 0.66-0.85) for the unvaccinated and 1.03 (95% CI: 0.97-1.09) for the vaccinated.
Immune history shapes protection against omicron reinfection, with pre-omicron-omicron immunity enhancing protection, while repeated similar exposures reduce protection against new variants.
既往免疫事件可增强或损害个体未来的免疫保护。本研究调查了在感染奥密克戎之前，不同的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）自然感染史（无论是否接种疫苗）如何影响对随后奥密克戎再感染的防护。
2020年2月28日至2024年8月12日在卡塔尔进行了三项全国性、匹配的回顾性队列研究，以比较两次感染奥密克戎的个体（奥密克戎双重感染队列）和一次感染奥密克戎的个体（奥密克戎单一感染队列）之间奥密克戎再感染的发生率；将奥密克戎双重感染队列与在奥密克戎感染前有过感染并随后再次感染奥密克戎的个体（奥密克戎前-奥密克戎双重感染队列）进行比较；以及将奥密克戎前-奥密克戎双重感染队列与奥密克戎单一感染队列进行比较。
在此我们表明，在第一项研究中，将奥密克戎双重感染队列与奥密克戎单一感染队列进行比较，调整后的风险比（aHR）为1.27（95%置信区间：1.13 - 1.43）；未接种疫苗者为0.93（95%置信区间：0.68 - 1.28），接种疫苗者为1.34（95%置信区间：1.18 - 1.52）。在第二项研究中，将奥密克戎双重感染队列与奥密克戎前-奥密克戎双重感染队列进行比较，aHR为1.37（95%置信区间：1.13 - 1.65）；未接种疫苗者为1.12（95%置信区间：0.63 - 1.97），接种疫苗者为1.42（95%置信区间：1.16 - 1.74）。在第三项研究中，将奥密克戎前-奥密克戎双重感染队列与奥密克戎单一感染队列进行比较，aHR为0.97（95%置信区间：0.92 - 1.03）；未接种疫苗者为0.75（95%置信区间：0.66 - 0.85），接种疫苗者为1.03（95%置信区间：0.97 - 1.09）。
免疫史决定了对奥密克戎再感染的防护，奥密克戎前-奥密克戎免疫可增强防护，而反复的类似暴露会降低对新变种的防护。
