Transmission and Infectious SARS-CoV-2 Shedding Kinetics in Vaccinated and Unvaccinated Individuals.
Transmission and Infectious SARS-CoV-2 Shedding Kinetics in Vaccinated and Unvaccinated Individuals.
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DOI：
10.1001/jamanetworkopen.2022.13606
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发表时间：
2022-05-02
影响因子：
13.8
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中科院分区：
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与部分接种疫苗或未接种疫苗的个体相比，完全接种了 COVID-19 疫苗的个体的 SARS-CoV-2 病毒脱落持续时间是否较短，二次传播率是否较低？在这项对 173 名医护人员、住院病人和监护人以及社区设施中的 45 名参与者进行的队列研究中，SARS-CoV-2 的二次传播明显较少见，并且在完全接种疫苗的个体中检测到活病毒的持续时间比在部分接种疫苗或未接种疫苗的个体中检测到的时间更短。与部分接种疫苗或未接种疫苗的个体相比，完全接种疫苗的个体的可行病毒脱落持续时间较短，二次传播率较低。该队列研究比较了完全接种疫苗的个体与部分接种疫苗和未接种疫苗的个体中 SARS-CoV-2 的继发发病率和传染性病毒脱落动力学。关于突破性 COVID-19 感染的患者是否有可能显着促进 SARS-CoV-2 的传播，数据有限。比较完全接种疫苗的个体（突破性感染组）和部分或未接种疫苗的个体（非突破性感染组）之间 SARS-CoV-2 的继发发病率和传染性病毒脱落动力学。这项队列研究通过分析 2020 年 3 月 1 日至 2021 年 11 月 6 日期间在三级甲等医院住院或住院期间被诊断为 COVID-19 的医护人员、住院患者和护理人员的流行病学数据来评估二次传播。为了评估病毒脱落动力学，使用聚合酶链式反应测量了 SARS-CoV-2 的基因组 RNA，并对感染 Delta 变种的轻度 COVID-19 患者的日常唾液样本进行了病毒培养。 2021 年 7 月 20 日至 8 月 20 日期间在韩国首尔的一个社区设施中被隔离。接种了 COVID-19 疫苗。根据 COVID-19 疫苗接种状况的二次攻击率和传染性病毒脱落动力学。二次传播研究共纳入了 173 名 COVID-19 患者（中位 [IQR] 年龄，47 [32-59] 岁；100 名女性 [58%]），其中 50 名（29%）出现突破性感染。突破性感染组的继发性传播明显低于非突破性感染组（43 例中的 3 例 [7%] vs 110 例中的 29 例 [26%]；P = .008）。在病毒脱落动力学研究中，纳入了 45 名感染 Delta 变种的患者（中位年龄 37 岁 [IQR，25-49 岁]；14 名女性 [31%]），其中 6 名（13%）完全接种疫苗，39 名（87%）部分接种或未接种疫苗。尽管两组之间的初始基因组病毒载量相当，但与完全接种疫苗的个体（症状出现后 4 天）相比，部分接种疫苗（症状出现后 8 天）或未接种疫苗（症状出现后 10 天）的个体在细胞培养物中检测到活病毒的持续时间明显更长。在这项队列研究中，尽管接种疫苗和未接种疫苗的个体之间的初始基因组病毒载量相似，但与部分接种疫苗或未接种疫苗的个体相比，完全接种疫苗的个体的可行病毒脱落持续时间较短，继发性攻击率较低。这项研究的数据提供了重要证据，表明尽管有可能出现突破性感染，但 COVID-19 疫苗接种对于控制 SARS-CoV-2 的传播仍然至关重要。
Do individuals fully vaccinated against COVID-19 have a shorter duration of viable SARS-CoV-2 viral shedding and a lower rate of secondary transmission than in partially vaccinated or unvaccinated individuals? In this cohort study of 173 health care workers, inpatients, and guardians and 45 participants in a community facility, secondary transmission of SARS-CoV-2 was significantly less common, and viable virus was detected for a shorter duration in fully vaccinated individuals than in partially vaccinated or unvaccinated individuals. Fully vaccinated individuals had a shorter duration of viable viral shedding and a lower rate of secondary transmission than partially vaccinated or unvaccinated individuals. This cohort study compares the secondary attack rate and infectious viral shedding kinetics of SARS-CoV-2 in fully vaccinated vs partially vaccinated and unvaccinated individuals. Data are limited on whether patients with breakthrough COVID-19 infection have the potential to significantly contribute to the spread of SARS-CoV-2. To compare the secondary attack rate and infectious viral shedding kinetics of SARS-CoV-2 between fully vaccinated individuals (breakthrough infection group) and partially or unvaccinated individuals (nonbreakthrough infection group). This cohort study assessed secondary transmission by analyzing the epidemiologic data of health care workers, inpatients, and caregivers diagnosed with COVID-19 during hospitalization or residence in a tertiary care hospital between March 1, 2020, and November 6, 2021. To evaluate viral shedding kinetics, the genomic RNA of SARS-CoV-2 was measured using polymerase chain reaction and performed virus culture from daily saliva samples of individuals with mild COVID-19 infected with the Delta variant who were isolated in a community facility in Seoul, South Korea, between July 20 and August 20, 2021. COVID-19 vaccination. The secondary attack rate and infectious viral shedding kinetics according to COVID-19 vaccination status. A total of 173 individuals (median [IQR] age, 47 [32-59] years; 100 female [58%]) with COVID-19 were included in the secondary transmission study, of whom 50 (29%) had a breakthrough infection. Secondary transmission was significantly less common in the breakthrough infection group than in the nonbreakthrough infection group (3 of 43 [7%] vs 29 of 110 [26%]; P = .008). In the viral shedding kinetics study, 45 patients (median age, 37 years [IQR, 25-49 years]; 14 female [31%]) infected with the Delta variant were included, of whom 6 (13%) were fully vaccinated and 39 (87%) were partially or unvaccinated. Although the initial genomic viral load was comparable between the 2 groups, viable virus in cell culture was detected for a notably longer duration in partially vaccinated (8 days after symptom onset) or unvaccinated (10 days after symptom onset) individuals compared with fully vaccinated individuals (4 days after symptom onset). In this cohort study, although the initial genomic viral load was similar between vaccinated and unvaccinated individuals, fully vaccinated individuals had a shorter duration of viable viral shedding and a lower secondary attack rate than partially vaccinated or unvaccinated individuals. Data from this study provide important evidence that despite the possibility of breakthrough infections, COVID-19 vaccinations remain critically useful for controlling the spread of SARS-CoV-2.