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NEJM:南非人群免疫与Omicron变异株的COVID-19严重程度

2022-03-06 小文子 MedSci原创

南非omicron变体流行期间,COVID-19病例的发病率与住院率和死亡率脱节,预示着COVID-19流行的转折。

2021年11月25日,南非豪登省首次鉴定出SARS-CoV-2的变异株B.1.1529(Omicron)。Omicron变体具有较高的传染性,可以很好地逃避先天免疫和中和抗体活性。The New England Journal of Medicine杂志的一项研究报告了COVID-19的流行趋势,包括从大流行开始到2022年1月12日的病例、住院、记录的死亡和非正常死亡。

2021年10月22日至12月9日在豪登省进行血清流行病学调查,评估SARS-CoV-2 IgG的血清阳性率。研究从之前血清流行病学调查(2020年11月至2021年1月)的家庭中抽样。获取参与者干血点样本,定量分析检测抗SARS-CoV-2棘突蛋白和核衣壳蛋白的IgG。

结果纳入3047个家庭的7010例患者,其中1319例(18.8%)接种过COVID-19疫苗。所有参与者中,总体血清阳性率为73.1%(95%CI, 72.0~74.1)。各年龄组血清阳性率有差异,12岁以下儿童的SARS-CoV-2 IgG的血清阳性率为56.2%(95% CI, 52.6~59.7),为最低;50岁以上成年人血清阳性率为79.7%(95%CI, 77.6~81.5),为最高。12~17岁儿童血清阳性的可能性高于12岁以下儿童(73.8% vs 56.2%; RR=1.31; 95%CI, 1.21~1.42)。接种过COVID-19疫苗者比未接种者更有可能出现血清阳性(93.1% vs 68.4%; RR=1.36; 95%CI, 1.33~1.39)。在接种疫苗的参与者中,各年龄组的血清阳性率始终较高;在18~50岁的成人中,接种疫苗者的血清阳性率高于未接种疫苗者。

流行病学数据显示,第四波记录的COVID-19病例数(226932例)高于第二波(182564例),低于第三波(511638例)。而第四波因COVID-19住院、记录的死亡和非正常死亡的发生率,始终低于早期的发生率。而且第四波SARS-CoV-2感染的发病率上升,随后下降的速度比前三波更快。

南非omicron变体流行期间,COVID-19病例的发病率与住院率和死亡率脱节,预示着COVID-19流行的转折,如果主要目标是预防严重疾病和死亡,而不是预防感染。

此前相关报道:

NEJM:南非人群免疫与Omicron变异株的COVID-19严重程度

如何在嘈杂的声音中应对Omicron带来的危机,南非公布Omicron最新数据

南非的新冠病毒突变B.1.1529,会是大BOSS,还是普通感冒样?

bioRxiv:应对全球新冠病毒变种,防御南非变种已成为重中之重!

NEJM:雪上加霜!阿斯利康疫苗对南非变种无效

原文出处:

Shabir A. Madhi, Gaurav Kwatra, et al, Population Immunity and Covid-19 Severity with Omicron Variant in South Africa, The New England Journal of Medicine, 2022, 10.1056/NEJMoa2119658.

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    2022-03-06 ms2000002016659512

    0

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    2022-03-04 hongbochen

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