SARS-CoV-2 reinfection in a cohort of 43,000 antibody-positive individuals followed for up to 35 weeks
SARS-CoV-2 reinfection in a cohort of 43,000 antibody-positive individuals followed for up to 35 weeks
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对 43,000 名抗体阳性个体的 SARS-CoV-2 再次感染进行了长达 35 周的随访
DOI：
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
R. Bertollini
中科院分区：
文献类型：
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作者：
L. Abu;H. Chemaitelly;P. Coyle;J. Malek;A. A. Ahmed;Y. Mohamoud;S. Younuskunju;H. Ayoub;Z. Al Kanaani;E. Al Kuwari;A. Butt;A. Jeremijenko;A. Kaleeckal;A. Latif;R. Shaik;H. A. Abdul Rahim;Gheyath K Nasrallah;H. Yassine;M. A. Al Kuwari;H. A. Al Romaihi;M. Al;A. Al Khal;R. Bertollini
背景：严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的再感染已被记录在案，引起了公众健康问题。在卡塔尔的一个大型抗体阳性人群队列中评估了SARS-CoV-2再感染的风险和发病率。研究方法：对首次抗体检测阳性后PCR拭子阳性[≥]14天的所有SARS-CoV-2抗体阳性者进行单独调查，以确定是否存在再感染证据。对配对病毒标本进行病毒基因组测序以确认再感染。结果如下：在43，044名抗SARS-CoV-2阳性者中，随访时间中位数为16.3周（范围：0-34.6周），314名个体（0.7%）在首次阳性抗体检测后至少有一次PCR阳性拭子[≥]14天。在这些人中，129人（41.1%）有支持再感染的流行病学证据。接下来使用病毒基因组测序研究再感染。应用病毒基因组测序确认率，再感染风险估计为0.10%（95%CI：0.08-0.11%）。再感染的发生率估计为0.66/10，000人-周（95% CI：0.56-0.78）。再感染发生率与随访月数的关系在7个月以上的随访中未显示出任何免疫力减弱的证据。自然感染对再感染的有效性估计> 90%。再感染的严重程度低于原发感染。只有一个再感染是严重的，两个是中度的，没有一个是致命的或致命的。大多数再感染（66.7%）是通过随机或常规检测或通过接触者追踪偶然诊断的。结论：再感染是罕见的。自然感染似乎引起对再感染的强保护，效力>90%，持续至少7个月。
Background: Reinfection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been documented, raising public health concerns. Risk and incidence rate of SARS-CoV-2 reinfection were assessed in a large cohort of antibody-positive persons in Qatar. Methods: All SARS-CoV-2 antibody-positive persons with a PCR-positive swab [≥]14 days after the first-positive antibody test were individually investigated for evidence of reinfection. Viral genome sequencing was conducted for paired viral specimens to confirm reinfection. Results: Among 43,044 anti-SARS-CoV-2 positive persons who were followed for a median of 16.3 weeks (range: 0-34.6), 314 individuals (0.7%) had at least one PCR positive swab [≥]14 days after the first-positive antibody test. Of these individuals, 129 (41.1%) had supporting epidemiological evidence for reinfection. Reinfection was next investigated using viral genome sequencing. Applying the viral-genome-sequencing confirmation rate, the risk of reinfection was estimated at 0.10% (95% CI: 0.08-0.11%). The incidence rate of reinfection was estimated at 0.66 per 10,000 person-weeks (95% CI: 0.56-0.78). Incidence rate of reinfection versus month of follow-up did not show any evidence of waning of immunity for over seven months of follow-up. Efficacy of natural infection against reinfection was estimated at >90%. Reinfections were less severe than primary infections. Only one reinfection was severe, two were moderate, and none were critical or fatal. Most reinfections (66.7%) were diagnosed incidentally through random or routine testing, or through contact tracing. Conclusions: Reinfection is rare. Natural infection appears to elicit strong protection against reinfection with an efficacy >90% for at least seven months.