Antibody Status and Incidence of SARS-CoV-2 Infection in Health Care Workers.
Antibody Status and Incidence of SARS-CoV-2 Infection in Health Care Workers.
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DOI：
10.1056/nejmoa2034545
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发表时间：
2021-02-11
期刊：
影响因子：
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通讯作者：
Oxford University Hospitals Staff Testing Group
中科院分区：
文献类型：
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作者：
Lumley SF;O'Donnell D;Stoesser NE;Matthews PC;Howarth A;Hatch SB;Marsden BD;Cox S;James T;Warren F;Peck LJ;Ritter TG;de Toledo Z;Warren L;Axten D;Cornall RJ;Jones EY;Stuart DI;Screaton G;Ebner D;Hoosdally S;Chand M;Crook DW;O'Donnell AM;Conlon CP;Pouwels KB;Walker AS;Peto TEA;Hopkins S;Walker TM;Jeffery K;Eyre DW;Oxford University Hospitals Staff Testing Group
严重急性呼吸综合征冠状病毒2 （SARS-CoV-2）抗体的存在与随后再感染风险之间的关系尚不清楚。我们调查了在英国牛津大学医院参加无症状和有症状工作人员检测的血清阳性和血清阴性医护人员中经聚合酶链反应（PCR）确诊的SARS-CoV-2感染的发生率。通过抗刺突（初步分析）和抗核衣壳IgG检测确定基线抗体状态，并对工作人员进行长达31周的随访。我们根据抗体状态估计pcr阳性检测结果和新症状感染的相对发生率，并根据年龄、参与者报告的性别和发生率随时间的变化进行调整。共有12541名医护人员参与并检测了抗刺突IgG；抗体阴性随访11364例，阳性随访1265例，其中随访期间发生血清转化88例。抗钉螺血清阴性医务人员PCR检测阳性223人（1.09 /万日危险），无症状筛查时阳性100人，有症状筛查时阳性123人，而抗钉螺血清阳性医务人员PCR检测阳性2人（0.13 /万日危险），检测时均无症状（校正发病率比0.11,95%可信区间0.03 ~ 0.44，P=0.002）。抗刺突抗体工人无症状性感染。当单独使用抗核衣壳IgG检测或与抗尖刺IgG检测联合使用以确定基线状态时，检出率相似。抗刺突或抗核衣壳IgG抗体的存在与随后6个月内SARS-CoV-2再感染风险显著降低相关。（由英国政府卫生和社会保障部等机构资助。）
The relationship between the presence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the risk of subsequent reinfection remains unclear. We investigated the incidence of SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR) in seropositive and seronegative health care workers attending testing of asymptomatic and symptomatic staff at Oxford University Hospitals in the United Kingdom. Baseline antibody status was determined by anti-spike (primary analysis) and anti-nucleocapsid IgG assays, and staff members were followed for up to 31 weeks. We estimated the relative incidence of PCR-positive test results and new symptomatic infection according to antibody status, adjusting for age, participant-reported gender, and changes in incidence over time. A total of 12,541 health care workers participated and had anti-spike IgG measured; 11,364 were followed up after negative antibody results and 1265 after positive results, including 88 in whom seroconversion occurred during follow-up. A total of 223 anti-spike–seronegative health care workers had a positive PCR test (1.09 per 10,000 days at risk), 100 during screening while they were asymptomatic and 123 while symptomatic, whereas 2 anti-spike–seropositive health care workers had a positive PCR test (0.13 per 10,000 days at risk), and both workers were asymptomatic when tested (adjusted incidence rate ratio, 0.11; 95% confidence interval, 0.03 to 0.44; P=0.002). There were no symptomatic infections in workers with anti-spike antibodies. Rate ratios were similar when the anti-nucleocapsid IgG assay was used alone or in combination with the anti-spike IgG assay to determine baseline status. The presence of anti-spike or anti-nucleocapsid IgG antibodies was associated with a substantially reduced risk of SARS-CoV-2 reinfection in the ensuing 6 months. (Funded by the U.K. Government Department of Health and Social Care and others.)