Delta Variants of SARS-CoV-2 Cause Significantly Increased Vaccine Breakthrough COVID-19 Cases in Houston, Texas.
Delta Variants of SARS-CoV-2 Cause Significantly Increased Vaccine Breakthrough COVID-19 Cases in Houston, Texas.
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DOI：
10.1016/j.ajpath.2021.10.019
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发表时间：
2022-03
期刊：
影响因子：
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通讯作者：
Musser JM
中科院分区：
文献类型：
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作者：
Christensen PA;Olsen RJ;Long SW;Subedi S;Davis JJ;Hodjat P;Walley DR;Kinskey JC;Ojeda Saavedra M;Pruitt L;Reppond K;Shyer MN;Cambric J;Gadd R;Thakur RM;Batajoo A;Mangham R;Pena S;Trinh T;Yerramilli P;Nguyen M;Olson R;Snehal R;Gollihar J;Musser JM
严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)的基因变异一再改变了冠状病毒病2019年(新冠肺炎)大流行的进程。Delta变种现在成为国际社会密切关注的焦点，因为它们正在全球引发广泛的新冠肺炎，并与疫苗突破病例有关。我们从2021年3月15日至2021年9月20日在休斯顿卫理公会医院系统获得的样本中对16,965个SARS-CoV-2基因组进行了测序。这一样本占研究期间卫理公会系统新冠肺炎患者总数的91%。从4月下旬开始，达美航空的变异体迅速增加，导致99.9%的新冠肺炎病例，并蔓延到整个休斯顿大都市。与所有其他变种的总和相比，Delta导致疫苗突破病例的比率明显更高(Delta的23.7%，而所有其他变种的总和为6.6%)。重要的是，需要住院的完全接种疫苗的人明显减少。Delta导致的疫苗突破病例的PCR周期阈值中值较低(代表高病毒载量)。这一值与未接种德尔塔变种导致的新冠肺炎患者的周期中位数阈值相似，表明完全接种疫苗的个体可以将SARS-CoV-2传播给其他人。感染Alpha和Delta变种的患者有几个显著的差异。综合分析表明，美国使用的疫苗在减少严重新冠肺炎、住院和死亡方面非常有效。
Genetic variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have repeatedly altered the course of the coronavirus disease 2019 (COVID-19) pandemic. Delta variants are now the focus of intense international attention because they are causing widespread COVID-19 globally and are associated with vaccine breakthrough cases. We sequenced 16,965 SARS-CoV-2 genomes from samples acquired March 15, 2021, through September 20, 2021, in the Houston Methodist hospital system. This sample represents 91% of all Methodist system COVID-19 patients during the study period. Delta variants increased rapidly from late April onward to cause 99.9% of all COVID-19 cases and spread throughout the Houston metroplex. Compared with all other variants combined, Delta caused a significantly higher rate of vaccine breakthrough cases (23.7% for Delta compared with 6.6% for all other variants combined). Importantly, significantly fewer fully vaccinated individuals required hospitalization. Vaccine breakthrough cases caused by Delta had a low median PCR cycle threshold value (a proxy for high virus load). This value was similar to the median cycle threshold value for unvaccinated patients with COVID-19 caused by Delta variants, suggesting that fully vaccinated individuals can transmit SARS-CoV-2 to others. Patients infected with Alpha and Delta variants had several significant differences. The integrated analysis indicates that vaccines used in the United States are highly effective in decreasing severe COVID-19, hospitalizations, and deaths.