Protective effectiveness of previous SARS-CoV-2 infection and hybrid immunity against the omicron variant and severe disease: a systematic review and meta-regression.
Protective effectiveness of previous SARS-CoV-2 infection and hybrid immunity against the omicron variant and severe disease: a systematic review and meta-regression.
复制标题
既往 SARS-CoV-2 感染和混合免疫对 omicron 变异和严重疾病的保护有效性：系统评价和荟萃回归。
DOI：
10.1016/s1473-3099(22)00801-5
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发表时间：
2023-05
影响因子：
56.3
通讯作者：
Subissi, Lorenzo
中科院分区：
文献类型：
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作者：
Bobrovitz, Niklas;Ware, Harriet;Ma, Xiaomeng;Li, Zihan;Hosseini, Reza;Cao, Christian;Selemon, Anabel;Whelan, Mairead;Premji, Zahra;Issa, Hanane;Cheng, Brianna;Abu Raddad, Laith J.;Buckeridge, David L.;Van Kerkhove, Maria D.;Piechotta, Vanessa;Higdon, Melissa M.;Wilder-Smith, Annelies;Bergeri, Isabel;Feikin, Daniel R.;Arora, Rahul K.;Patel, Minal K.;Subissi, Lorenzo
omicron (B.1.1.529) 变种的全球激增导致许多个体具有混合免疫（通过 SARS-CoV-2 感染和疫苗接种相结合而产生的免疫）。我们的目的是系统地回顾以前的 SARS-CoV-2 感染和混合免疫对 omicron 变体引起的感染和严重疾病的保护有效性的程度和持续时间。对于本次系统评价和荟萃回归，我们使用与 SARS-CoV-2、再感染、保护有效性、先前相关的关键词，检索了 MEDLINE、Embase、Web of Science、ClinicalTrials.gov、Cochrane 对照试验中央注册库、WHO COVID-19 数据库和 Europe PubMed Central 中 2020 年 1 月 1 日至 2022 年 6 月 1 日期间的队列、横断面和病例对照研究。 感染、抗体的存在和混合免疫。主要结果是混合免疫对再感染、入院或严重疾病的保护效果、相对于单独感染的混合免疫、相对于单独接种疫苗的混合免疫、以及相对于较少疫苗剂量的混合免疫的混合免疫。使用干预工具的非随机研究中的偏倚风险评估偏倚风险。我们使用对数几率随机效应元回归来估计 1 个月间隔的保护程度。本研究已在 PROSPERO 注册（CRD42022318605）。其中包括 11 项报告先前 SARS-CoV-2 感染的保护有效性的研究和 15 项报告混合免疫的保护有效性的研究。对于既往感染，有 97 个估计（27 个具有中等偏倚风险，70 个具有严重偏倚风险）。 12 个月时，既往感染对入院或严重疾病的有效性为 74·6% (95% CI 63·1–83·5)。 12 个月时，先前感染对再感染的有效性下降至 24·7% (95% CI 16·4–35·5)。对于混合免疫，有 153 个估计值（78 个具有中等偏倚风险，75 个具有严重偏倚风险）。初次系列疫苗接种后 12 个月时，混合免疫对入院或严重疾病的有效性为 97·4% (95% CI 91·4–99·2)，最近一次感染或疫苗接种后首次加强疫苗接种的 6 个月时，混合免疫有效性为 95·3% (81·9–98·9)。针对再感染，初次系列疫苗接种后的混合免疫有效性在 12 个月时下降至 41·8% (95% CI 31·5–52·8)，而首次加强免疫后的混合免疫有效性在 6 个月时下降至 46·5% (36·0–57·3)。所有对防止再次感染的保护作用的估计值在几个月内都下降了，但仍然很高，并且在住院或患有严重疾病时仍保持较高水平。具有混合免疫的个体具有最高程度和持久的保护，因此与从未感染过的个体相比，可能能够延长需要加强疫苗接种的时间。世卫组织 COVID-19 团结应对基金和流行病防范创新联盟。
The global surge in the omicron (B.1.1.529) variant has resulted in many individuals with hybrid immunity (immunity developed through a combination of SARS-CoV-2 infection and vaccination). We aimed to systematically review the magnitude and duration of the protective effectiveness of previous SARS-CoV-2 infection and hybrid immunity against infection and severe disease caused by the omicron variant. For this systematic review and meta-regression, we searched for cohort, cross-sectional, and case–control studies in MEDLINE, Embase, Web of Science, ClinicalTrials.gov, the Cochrane Central Register of Controlled Trials, the WHO COVID-19 database, and Europe PubMed Central from Jan 1, 2020, to June 1, 2022, using keywords related to SARS-CoV-2, reinfection, protective effectiveness, previous infection, presence of antibodies, and hybrid immunity. The main outcomes were the protective effectiveness against reinfection and against hospital admission or severe disease of hybrid immunity, hybrid immunity relative to previous infection alone, hybrid immunity relative to previous vaccination alone, and hybrid immunity relative to hybrid immunity with fewer vaccine doses. Risk of bias was assessed with the Risk of Bias In Non-Randomized Studies of Interventions Tool. We used log-odds random-effects meta-regression to estimate the magnitude of protection at 1-month intervals. This study was registered with PROSPERO (CRD42022318605). 11 studies reporting the protective effectiveness of previous SARS-CoV-2 infection and 15 studies reporting the protective effectiveness of hybrid immunity were included. For previous infection, there were 97 estimates (27 with a moderate risk of bias and 70 with a serious risk of bias). The effectiveness of previous infection against hospital admission or severe disease was 74·6% (95% CI 63·1–83·5) at 12 months. The effectiveness of previous infection against reinfection waned to 24·7% (95% CI 16·4–35·5) at 12 months. For hybrid immunity, there were 153 estimates (78 with a moderate risk of bias and 75 with a serious risk of bias). The effectiveness of hybrid immunity against hospital admission or severe disease was 97·4% (95% CI 91·4–99·2) at 12 months with primary series vaccination and 95·3% (81·9–98·9) at 6 months with the first booster vaccination after the most recent infection or vaccination. Against reinfection, the effectiveness of hybrid immunity following primary series vaccination waned to 41·8% (95% CI 31·5–52·8) at 12 months, while the effectiveness of hybrid immunity following first booster vaccination waned to 46·5% (36·0–57·3) at 6 months. All estimates of protection waned within months against reinfection but remained high and sustained for hospital admission or severe disease. Individuals with hybrid immunity had the highest magnitude and durability of protection, and as a result might be able to extend the period before booster vaccinations are needed compared to individuals who have never been infected. WHO COVID-19 Solidarity Response Fund and the Coalition for Epidemic Preparedness Innovations.