Duration of Severe Acute Respiratory Syndrome Coronavirus 2 Natural Immunity and Protection Against the Delta Variant: A Retrospective Cohort Study
Duration of Severe Acute Respiratory Syndrome Coronavirus 2 Natural Immunity and Protection Against the Delta Variant: A Retrospective Cohort Study
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DOI：
10.1093/cid/ciab999
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发表时间：
2022-01-08
影响因子：
11.8
通讯作者：
Rothberg, Michael B.
中科院分区：
文献类型：
--
作者：
Kim, Priscilla;Gordon, Steven M.;Rothberg, Michael B.
背景 严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 感染已被证明对防止再次感染和症状性疾病具有高度保护作用。然而，针对 Delta 变种的有效性和自然免疫的持续时间仍然未知。方法 这项回顾性队列研究包括 2020 年 3 月 9 日至 2020 年 12 月 31 日期间通过聚合酶链反应 (PCR) 对 325 157 名患者进行了 SARS-CoV-2 检测（Delta 变异分析），以及 2020 年 3 月 9 日至 2020 年 8 月 30 日期间对 152 656 名患者进行了检测（长期有效性分析），并在 2021 年 9 月 9 日进行了后续检测。主要结果是再感染，定义为初次阳性检测后 90 天以上的 PCR 检测呈阳性。结果 在 2020 年 12 月 31 日之前检测的 325 157 名患者中，50 327 名（15.5%）检测呈阳性。 2021 年 7 月 1 日（Delta 主导期）后，40 名（0.08%）最初呈阳性的患者和 1494 名（0.5%）最初呈阴性的患者检测呈阳性。 Delta 对先前感染的再感染保护率为 85.4%（95% 置信区间 [CI]，80.0-89.3）。就长期有效性分析而言，在 2020 年 8 月 30 日之前检测的 152 656 名患者中，11 186 名（7.3%）检测呈阳性。至少 90 天后，81 名（0.7%）最初呈阳性的患者和 7167 名（5.1%）最初呈阴性的患者检测呈阳性。对既往感染的总体保护率为 85.7%（95% CI，82.2-88.5），持续长达 13 个月。年龄>65岁的患者的保护程度略低。结论 SARS-CoV-2 感染对于 Delta 的再次感染具有高度保护作用。对先前感染的免疫力可持续至少 13 个月。面临疫苗短缺的国家应考虑推迟为先前感染的患者接种疫苗，以增加疫苗接种机会。先前感染的严重急性呼吸综合征冠状病毒 2 可以为 Delta 变种的症状性感染提供强有力的保护。此外，对先前感染的自然免疫力可持续至少 13 个月，这比之前报道的要长。
Background Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been shown to be highly protective against reinfection and symptomatic disease. However, effectiveness against the Delta variant and duration of natural immunity remain unknown. Methods This retrospective cohort study included 325 157 patients tested for SARS-CoV-2 via polymerase chain reaction (PCR) from 9 March 2020 to 31 December 2020 (Delta variant analysis) and 152 656 patients tested from 9 March 2020 to 30 August 2020 (long-term effectiveness analysis) with subsequent testing through 9 September 2021. The primary outcome was reinfection, defined as a positive PCR test >90 days after the initial positive test. Results Among 325 157 patients tested before 31 December 2020, 50 327 (15.5%) tested positive. After 1 July 2021 (Delta dominant period), 40 (0.08%) initially positive and 1494 (0.5%) initially negative patients tested positive. Protection of prior infection against reinfection with Delta was 85.4% (95% confidence interval [CI], 80.0-89.3). For the long-term effectiveness analysis, among 152 656 patients tested before 30 August 2020, 11 186 (7.3%) tested positive. After at least 90 days, 81 (0.7%) initially positive and 7167 (5.1%) initially negative patients tested positive. Overall protection of previous infection was 85.7% (95% CI, 82.2-88.5) and lasted up to 13 months. Patients aged >65 years had slightly lower protection. Conclusions SARS-CoV-2 infection is highly protective against reinfection with Delta. Immunity from prior infection lasts at least 13 months. Countries facing vaccine shortages should consider delaying vaccinations for previously infected patients to increase access.Previous severe acute respiratory syndrome coronavirus 2 infection offers strong protection against symptomatic infection with the Delta variant. Additionally, natural immunity from prior infection lasts for at least 13 months, which is longer than has been previously reported.