BCG vaccination history associates with decreased SARS-CoV-2 seroprevalence across a diverse cohort of health care workers
BCG vaccination history associates with decreased SARS-CoV-2 seroprevalence across a diverse cohort of health care workers
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DOI：
10.1172/jci145157
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发表时间：
2021-01-19
影响因子：
15.9
通讯作者：
Arditi, Moshe
中科院分区：
文献类型：
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作者：
Noval Rivas, Magali;Ebinger, Joseph E.;Arditi, Moshe
背景资料。严重急性呼吸综合征冠状病毒2(SARS-CoV-2)已在全球造成100多万人死亡；因此，迫切需要制定预防和治疗战略。卡介苗(BCG)抗结核疫苗表现出非特异性、保护性的天然免疫增强作用。在这里，我们对不同的卫生保健工作者进行了一项纵向的、回顾性的观察研究，确定了接种卡介苗的历史是否与SARS-CoV-2感染和血清转换的减少有关。方法：我们评估了SARS-CoV-2血清阳性率，并从洛杉矶一家多地点卫生保健组织的观察队列中收集了医学问卷，其中包括卡介苗接种状况以及先前存在的人口和临床特征的信息。结果：在6201名医务人员中，29.6%的人报告有过卡介苗接种史，68.9%的人没有接种过卡介苗。与没有接种卡介苗的人群相比，有卡介苗接种史的医务人员的抗SARS-CoV-2免疫球蛋白抗体阳性率以及自报的与2019年冠状病毒病相关的临床症状(新冠肺炎)的发生率显著降低。在调整了年龄和性别后，我们发现卡介苗接种史，而不是脑膜炎球菌、肺炎球菌或流感疫苗接种史，与SARS-CoV-2IgG血清转换率的下降有关。结论：在这群医务工作者中，卡介苗接种史与抗SARS-CoV-2IgG血清阳性率的下降和自我报告经历新冠肺炎相关临床症状的参与者的数量较少相关。因此，迫切需要进行卡介苗接种的大规模随机、前瞻性临床试验，以确定卡介苗接种是否具有预防SARS-CoV-2感染的作用。
BACKGROUND. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused more than 1 million deaths worldwide; thus, there is an urgent need to develop preventive and therapeutic strategies. The antituberculosis vaccine bacillus Calmette-Guerin (BCG) demonstrates nonspecific, protective innate immune-boosting effects. Here, we determined whether a history of BCG vaccination was associated with decreased SARS-CoV-2 infection and seroconversion in a longitudinal, retrospective observational study of a diverse cohort of health care workers (HCWs).METHODS. We assessed SARS-CoV-2 seroprevalence and collected medical questionnaires, which included information on BCG vaccination status and preexisting demographic and clinical characteristics, from an observational cohort of HCWs in a multisite Los Angeles health care organization. We used multivariate analysis to determine whether a history of BCG vaccination was associated with decreased rates of SARS-CoV-2 infection and seroconversion.RESULTS. Of the 6201 HCWs, 29.6% reported a history of BCG vaccination, whereas 68.9% had not received BCG vaccination. Seroprevalence of anti-SARS-CoV-2 IgG as well as the incidence of self-reported clinical symptoms associated with coronavirus disease 2019 (COVID-19) were markedly decreased among HCWs with a history of BCG vaccination compared with those without BCG vaccination. After adjusting for age and sex, we found that a history of BCG vaccination, but not meningococcal, pneumococcal, or influenza vaccination, was associated with decreased SARS-CoV-2 IgG seroconversion.CONCLUSIONS. A history of BCG vaccination was associated with a decrease in the seroprevalence of anti-SARS-CoV-2 IgG and a lower number of participants who self-reported experiencing COVID-19-related clinical symptoms in this cohort of HCWs. Therefore, large randomized, prospective clinical trials of BCG vaccination are urgently needed to confirm whether BCG vaccination can confer a protective effect against SARS-CoV-2 infection.