Epidemiology of Severe Acute Respiratory Syndrome Coronavirus 2 Emergence Amidst Community-Acquired Respiratory Viruses
Epidemiology of Severe Acute Respiratory Syndrome Coronavirus 2 Emergence Amidst Community-Acquired Respiratory Viruses
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DOI：
10.1093/infdis/jiaa464
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发表时间：
2020-10-15
影响因子：
6.4
通讯作者：
Hirsch, Hans H.
中科院分区：
文献类型：
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作者：
Leuzinger, Karoline;Roloff, Tim;Hirsch, Hans H.
背景。2019年12月，严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）作为2019冠状病毒病的病因在中国出现，并于2020年1月下旬到达欧洲，当时社区获得性呼吸道病毒（carv）处于年度高峰。我们验证了世界卫生组织（WHO）推荐的SARS-CoV-2检测方法，并分析了SARS-CoV-2和carv的流行病学。对7663例患者的鼻咽/口咽拭子（NOPS）进行巴塞尔s基因和基于世卫组织的e基因（罗氏）测定的前瞻性检测，同时使用巴塞尔n基因测定进行确认。对2394例NOPS的carv进行前瞻性多重核酸检测，其中1816例（75%）同时检测sars - cov -2。7475例（97.5%）巴塞尔s基因和罗氏e基因检测结果一致，其中825例（11%）呈SARS-CoV-2阳性。在188例（2.5%）不一致病例中，SARS-CoV-2载量显著低于一致阳性病例，确诊105例（1.4%）。成人更频繁地检测出SARS-CoV-2阳性，而儿童更频繁地检测出CARV阳性。CARV与SARS-CoV-2合并感染的发生率为1.8%。SARS-CoV-2在3周内取代了carv，占所有检测到的呼吸道病毒的48%，其次是鼻病毒/肠道病毒（13%）、流感病毒（12%）、冠状病毒（9%）、呼吸道合胞病毒（6%）和中肺病毒（6%）。在SARS-CoV-2大流行早期，冬季car - v占主导地位，影响了感染控制和治疗决策，但很快被取代，表明竞争性感染。我们假设先前存在的免疫记忆和先天免疫干扰导致成人和儿童中不同的SARS-CoV-2流行病学。
Background. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in China as the cause of coronavirus disease 2019 in December 2019 and reached Europe by late January 2020, when community-acquired respiratory viruses (CARVs) are at their annual peak. We validated the World Health Organization (WHO)-recommended SARS-CoV-2 assay and analyzed the epidemiology of SARS-CoV-2 and CARVs.Methods. Nasopharyngeal/oropharyngeal swabs (NOPS) from 7663 patients were prospectively tested by the Basel S-gene and WHO-based E-gene (Roche) assays in parallel using the Basel N-gene assay for confirmation. CARVs were prospectively tested in 2394 NOPS by multiplex nucleic acid testing, including 1816 (75%) simultaneously for SARS-CoV-2.Results. The Basel S-gene and Roche E-gene assays were concordant in 7475 cases (97.5%) including 825 (11%) SARS-CoV-2 positives. In 188 (2.5%) discordant cases, SARS-CoV-2 loads were significantly lower than in concordant positive ones and confirmed in 105 (1.4%). Adults were more frequently SARS-CoV-2 positive, whereas children tested more frequently CARV positive. CARV coinfections with SARS-CoV-2 occurred in 1.8%. SARS-CoV-2 replaced CARVs within 3 weeks, reaching 48% of all detected respiratory viruses followed by rhinovirus/enterovirus (13%), influenza virus (12%), coronavirus (9%), respiratory syncytial virus (6%), and metapneumovirus (6%).Conclusions. Winter CARVs were dominant during the early SARS-CoV-2 pandemic, impacting infection control and treatment decisions, but were rapidly replaced, suggesting competitive infection. We hypothesize that preexisting immune memory and innate immune interference contribute to the different SARS-CoV-2 epidemiology among adults and children.