Rizza Stefano, Coppeta Luca, Ferrazza Gianluigi, Nucera Alessandro, Postorino Maria, Quatrana Andrea, Ferrari Cristiana, Menghini Rossella, Longo Susanna, Magrini Andrea, Federici Massimo
Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy.
Department of Occupational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy.
Vaccines (Basel). 2025 Jul 9;13(7):739. doi: 10.3390/vaccines13070739.
: The COVID-19 pandemic has caused sickness and death among many health care workers. However, the apparent resistance of health care workers to SARS-CoV-2 infection despite their high-risk work environment remains unclear. To investigate if inflammation and circadian disruption contribute to resistance or diminished susceptibility to the SARS-CoV-2 virus, we retrospectively evaluated a cohort of volunteer hospital nurses (VHNs). : A total of 246 apparently healthy VHNs (mean age 37.4 ± 5.9 years) who had received the BNT162b2 mRNA vaccine were asked to report their sleep quality, according to the Pittsburgh Sleep Quality Index, and number of SARS-CoV-2 infections during the observational study period (from the end of December 2020 to April 2025). The expression of inflammation-associated mediators and circadian transcription factors in peripheral blood mononuclear cells, as well as sleep quality, were examined. : Our findings revealed no anthropometric, biochemical, or inflammation-associated parameters but demonstrated significantly greater levels of NFE2L2, also known as nuclear factor erythroid-derived 2-like 2 (NFR2), gene expression in peripheral blood mononuclear cells among VHNs who had never been infected with SARS-CoV-2 ( = 97) than in VHNs with only one ( = 119) or with two or more ( = 35) prior SARS-CoV-2 infections ( < 0.01). This result was confirmed through one-to-one propensity score matching ( < 0.01). Moreover, NRF2 gene expression was not associated with the number of COVID-19 vaccinations ( = 0.598). Finally, NRF2 gene expression was higher among participants who reported better sleep quality ( < 0.01). : Our findings suggest possible interactions among NRF2 gene expression, protection against SARS-CoV-2 infection, and the modulation of COVID-19 vaccination efficacy.
2019年冠状病毒病（COVID-19）大流行已导致许多医护人员患病和死亡。然而，尽管医护人员工作环境风险高，但他们对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染表现出的明显抵抗力仍不清楚。为了研究炎症和昼夜节律紊乱是否有助于抵抗SARS-CoV-2病毒或降低易感性，我们对一组志愿医院护士（VHNs）进行了回顾性评估。
共有246名接种了BNT162b2信使核糖核酸（mRNA）疫苗的表面健康的VHNs（平均年龄37.4±5.9岁）被要求根据匹兹堡睡眠质量指数报告他们的睡眠质量，以及观察研究期间（从2020年12月底到2025年4月）的SARS-CoV-2感染次数。检测外周血单个核细胞中炎症相关介质和昼夜节律转录因子的表达以及睡眠质量。
我们的研究结果显示，在人体测量、生化或炎症相关参数方面没有差异，但从未感染过SARS-CoV-2的VHNs（n = 97）外周血单个核细胞中核因子红细胞衍生2样2（NFE2L2，也称为NFR2）基因表达水平显著高于仅有一次（n = 119）或两次及以上（n = 35）既往SARS-CoV-2感染的VHNs（P < 0.01）。通过一对一倾向评分匹配证实了这一结果（P < 0.01）。此外，NRF2基因表达与COVID-19疫苗接种次数无关（P = 0.598）。最后，报告睡眠质量较好的参与者中NRF2基因表达较高（P < 0.01）。
我们的研究结果提示NRF2基因表达、对SARS-CoV-2感染的保护作用以及COVID-19疫苗接种效果调节之间可能存在相互作用。
