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Vaccine effectiveness of CanSino (Adv5-nCoV) COVID-19 vaccine among childcare workers – Mexico, March–December 2021 CanSino (Adv5-nCoV) COVID-19疫苗在托儿工作者中的疫苗有效性-墨西哥,2021年3月至12月
Vesta L Richardson, Martín Alejandro Camacho Franco, Aurora Bautista Márquez, Libny Martínez Valdez, Luis Enrique Castro Ceronio, Vicente Cruz Cruz, R. Gharpure, K. Lafond, Tat S. Yau, E. Azziz‐Baumgartner, M. H. Ávila
Background: Beginning in March 2021, Mexico vaccinated childcare workers with a single-dose CanSino Biologics (Adv5-nCoV) COVID-19 vaccine. Although CanSino is currently approved for use in 10 Latin American, Asian, and European countries, little information is available about its vaccine effectiveness (VE). Methods: We evaluated CanSino VE within a childcare worker cohort that included 1,408 childcare facilities. Participants were followed during March-December 2021 and tested through SARS-CoV-2 RT-PCR or rapid antigen test if they developed any symptom compatible with COVID-19. Vaccination status was obtained through worker registries. VE was calculated as 100% x (1-hazard ratio for SARS-CoV-2 infection in fully vaccinated vs. unvaccinated participants), using an Andersen-Gill model adjusted for age, sex, state, and local viral circulation. Results: The cohort included 43,925 persons who were mostly (96%) female with a median age of 32 years; 37,646 (86%) were vaccinated with CanSino. During March-December 2021, 2,250 (5%) participants had laboratory-confirmed COVID-19, of whom 25 were hospitalized and 6 died. Adjusted VE was 20% (95% CI = 10-29%) against illness, 76% (42-90%) against hospitalization, and 94% (66-99%) against death. VE against illness declined from 48% (95% CI = 33-61) after 14-60 days following full vaccination to 20% (95% CI = 9-31) after 61-120 days. Conclusions: CanSino vaccine was effective at preventing COVID-19 illness and highly effective at preventing hospitalization and death. It will be useful to further evaluate duration of protection and assess the value of booster doses to prevent COVID-19 and severe outcomes.
背景:从2021年3月开始,墨西哥为儿童保育工作者接种了单剂量cansio Biologics (Adv5-nCoV) COVID-19疫苗。尽管CanSino目前已被批准在10个拉丁美洲、亚洲和欧洲国家使用,但关于其疫苗有效性(VE)的信息很少。方法:我们在包括1,408个托儿机构的托儿工作者队列中评估了CanSino VE。在2021年3月至12月期间对参与者进行随访,并通过SARS-CoV-2 RT-PCR或快速抗原检测对他们是否出现任何与COVID-19相容的症状进行检测。通过工人登记获得了疫苗接种状况。VE计算为100% x(完全接种疫苗的受试者与未接种疫苗的受试者感染SARS-CoV-2的1-风险比),使用调整了年龄、性别、州和当地病毒循环的Andersen-Gill模型。结果:该队列包括43,925人,其中大多数(96%)为女性,中位年龄为32岁;37646例(86%)接种了CanSino疫苗。在2021年3月至12月期间,2250名(5%)参与者患有实验室确诊的COVID-19,其中25人住院,6人死亡。对疾病的校正VE为20% (95% CI = 10-29%),对住院的校正VE为76%(42-90%),对死亡的校正VE为94%(66-99%)。在完全接种疫苗后14-60天,疾病预防率从48% (95% CI = 33-61)下降到61-120天后的20% (95% CI = 9-31)。结论:CanSino疫苗预防COVID-19疾病有效,预防住院和死亡效果显著。这将有助于进一步评估保护持续时间和评估加强剂量对预防COVID-19和严重后果的价值。
{"title":"Vaccine effectiveness of CanSino (Adv5-nCoV) COVID-19 vaccine among childcare workers – Mexico, March–December 2021","authors":"Vesta L Richardson, Martín Alejandro Camacho Franco, Aurora Bautista Márquez, Libny Martínez Valdez, Luis Enrique Castro Ceronio, Vicente Cruz Cruz, R. Gharpure, K. Lafond, Tat S. Yau, E. Azziz‐Baumgartner, M. H. Ávila","doi":"10.1101/2022.04.14.22273413","DOIUrl":"https://doi.org/10.1101/2022.04.14.22273413","url":null,"abstract":"Background: Beginning in March 2021, Mexico vaccinated childcare workers with a single-dose CanSino Biologics (Adv5-nCoV) COVID-19 vaccine. Although CanSino is currently approved for use in 10 Latin American, Asian, and European countries, little information is available about its vaccine effectiveness (VE). Methods: We evaluated CanSino VE within a childcare worker cohort that included 1,408 childcare facilities. Participants were followed during March-December 2021 and tested through SARS-CoV-2 RT-PCR or rapid antigen test if they developed any symptom compatible with COVID-19. Vaccination status was obtained through worker registries. VE was calculated as 100% x (1-hazard ratio for SARS-CoV-2 infection in fully vaccinated vs. unvaccinated participants), using an Andersen-Gill model adjusted for age, sex, state, and local viral circulation. Results: The cohort included 43,925 persons who were mostly (96%) female with a median age of 32 years; 37,646 (86%) were vaccinated with CanSino. During March-December 2021, 2,250 (5%) participants had laboratory-confirmed COVID-19, of whom 25 were hospitalized and 6 died. Adjusted VE was 20% (95% CI = 10-29%) against illness, 76% (42-90%) against hospitalization, and 94% (66-99%) against death. VE against illness declined from 48% (95% CI = 33-61) after 14-60 days following full vaccination to 20% (95% CI = 9-31) after 61-120 days. Conclusions: CanSino vaccine was effective at preventing COVID-19 illness and highly effective at preventing hospitalization and death. It will be useful to further evaluate duration of protection and assess the value of booster doses to prevent COVID-19 and severe outcomes.","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80871336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Effectiveness of COVID-19 vaccines against hospitalization and death in Canada: A multiprovincial test-negative design study 加拿大COVID-19疫苗预防住院和死亡的有效性:一项多省阴性试验设计研究
S. Nasreen, Y. Febriani, H. V. Velásquez García, Geng Zhang, M. Tadrous, S. Buchan, C. Righolt, S. Mahmud, N. Janjua, M. Krajden, G. De Serres, J. Kwong
Background: A major goal of COVID-19 vaccination is to prevent severe outcomes (hospitalizations and deaths). We estimated the effectiveness of mRNA and ChAdOx1 COVID-19 vaccines against severe outcomes in four Canadian provinces between December 2020 and September 2021. Methods: We conducted this multiprovincial retrospective test-negative study among community-dwelling adults aged [≥]18 years in Ontario, Quebec, British Columbia, and Manitoba using linked provincial databases and a common study protocol. Multivariable logistic regression was used to estimate province-specific vaccine effectiveness against COVID-19 hospitalization and/or death. Estimates were pooled using random effects models. Results: We included 2,508,296 tested subjects, with 31,776 COVID-19 hospitalizations and 5,842 deaths. Vaccine effectiveness was 83% after a first dose, and 98% after a second dose, against both hospitalization and death (separately). Against severe outcomes (hospitalization or death), effectiveness was 87% (95%CI: 71%-94%) [≥]84 days after a first dose of mRNA vaccine, increasing to 98% (95%CI: 96%-99%) [≥]112 days after a second dose. Vaccine effectiveness against severe outcomes for ChAdOx1 was 88% (95%CI: 75%-94%) [≥]56 days after a first dose, increasing to 97% (95%CI: 91%-99%) [≥]56 days after a second dose. Lower one-dose effectiveness was observed for adults aged [≥]80 years and those with comorbidities, but effectiveness became comparable after a second dose. Two doses of vaccines provided very high protection for both homologous and heterologous schedules, and against Alpha, Gamma, and Delta variants. Conclusions: Two doses of mRNA or ChAdOx1 vaccines provide excellent protection against severe outcomes of hospitalization and death.
背景:COVID-19疫苗接种的一个主要目标是预防严重后果(住院和死亡)。我们估计了mRNA和ChAdOx1 COVID-19疫苗在2020年12月至2021年9月期间在加拿大四个省预防严重后果的有效性。方法:我们在安大略省、魁北克省、不列颠哥伦比亚省和马尼托巴省的社区居住的18岁以上的成年人中进行了这项多省回顾性检测阴性研究,使用了相关的省级数据库和共同的研究方案。采用多变量logistic回归估计各省特定疫苗预防COVID-19住院和/或死亡的有效性。使用随机效应模型汇总估计。结果:我们纳入了2,508,296名受试者,其中31,776人因COVID-19住院,5,842人死亡。在预防住院和死亡(分别)方面,第一次接种疫苗后的有效性为83%,第二次接种疫苗后的有效性为98%。对于严重结局(住院或死亡),首次接种mRNA疫苗后84天的有效性为87% (95%CI: 71%-94%)[≥],第二次接种后112天的有效性增加到98% (95%CI: 96%-99%)[≥]。ChAdOx1疫苗预防严重后果的有效性在第一次接种56天后为88% (95%CI: 75%-94%)[≥],在第二次接种56天后增加到97% (95%CI: 91%-99%)[≥]。在80岁以上和有合并症的成年人中,单剂量有效性较低,但在第二次给药后,有效性变得相当。两剂疫苗对同源和异源时间表以及α、γ和δ变体都提供了非常高的保护。结论:两剂mRNA或ChAdOx1疫苗对住院和死亡的严重后果提供了极好的保护。
{"title":"Effectiveness of COVID-19 vaccines against hospitalization and death in Canada: A multiprovincial test-negative design study","authors":"S. Nasreen, Y. Febriani, H. V. Velásquez García, Geng Zhang, M. Tadrous, S. Buchan, C. Righolt, S. Mahmud, N. Janjua, M. Krajden, G. De Serres, J. Kwong","doi":"10.1101/2022.04.13.22273825","DOIUrl":"https://doi.org/10.1101/2022.04.13.22273825","url":null,"abstract":"Background: A major goal of COVID-19 vaccination is to prevent severe outcomes (hospitalizations and deaths). We estimated the effectiveness of mRNA and ChAdOx1 COVID-19 vaccines against severe outcomes in four Canadian provinces between December 2020 and September 2021. Methods: We conducted this multiprovincial retrospective test-negative study among community-dwelling adults aged [≥]18 years in Ontario, Quebec, British Columbia, and Manitoba using linked provincial databases and a common study protocol. Multivariable logistic regression was used to estimate province-specific vaccine effectiveness against COVID-19 hospitalization and/or death. Estimates were pooled using random effects models. Results: We included 2,508,296 tested subjects, with 31,776 COVID-19 hospitalizations and 5,842 deaths. Vaccine effectiveness was 83% after a first dose, and 98% after a second dose, against both hospitalization and death (separately). Against severe outcomes (hospitalization or death), effectiveness was 87% (95%CI: 71%-94%) [≥]84 days after a first dose of mRNA vaccine, increasing to 98% (95%CI: 96%-99%) [≥]112 days after a second dose. Vaccine effectiveness against severe outcomes for ChAdOx1 was 88% (95%CI: 75%-94%) [≥]56 days after a first dose, increasing to 97% (95%CI: 91%-99%) [≥]56 days after a second dose. Lower one-dose effectiveness was observed for adults aged [≥]80 years and those with comorbidities, but effectiveness became comparable after a second dose. Two doses of vaccines provided very high protection for both homologous and heterologous schedules, and against Alpha, Gamma, and Delta variants. Conclusions: Two doses of mRNA or ChAdOx1 vaccines provide excellent protection against severe outcomes of hospitalization and death.","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":"404 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79479120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Associations Between Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Variants and Risk of Coronavirus Disease 2019 (COVID-19) Hospitalization Among Confirmed Cases in Washington State: A Retrospective Cohort Study 华盛顿州确诊病例中严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)变异与2019冠状病毒病(COVID-19)住院风险之间的关系:一项回顾性队列研究
M. Paredes, Stephanie M Lunn, M. Famulare, L. Frisbie, I. Painter, R. Burstein, Pavitra Roychoudhury, H. Xie, S. A. Mohamed Bakhash, R. Perez, Maria Lukes, S. Ellis, Saraswathi Sathees, P. Mathias, A. Greninger, L. Starita, C. Frazar, E. Ryke, W. Zhong, L. Gamboa, M. Threlkeld, Jover Lee, E. McDermot, M. Truong, D. Nickerson, Daniel L Bates, M. Hartman, E. Haugen, Truong Nguyen, J. Richards, Jacob L Rodriguez, J. Stamatoyannopoulos, Eric Thorland, G. Melly, P. Dykema, Drew Mackellar, Hannah K. Gray, Avi Singh, J. Peterson, Denny Russell, L. M. Torres, S. Lindquist, T. Bedford, Krisandra J. Allen, H. Oltean
Abstract Background The coronavirus disease 2019 (COVID-19) pandemic is dominated by variant viruses; the resulting impact on disease severity remains unclear. Using a retrospective cohort study, we assessed the hospitalization risk following infection with 7 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants. Methods Our study includes individuals with positive SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) in the Washington Disease Reporting System with available viral genome data, from 1 December 2020 to 14 January 2022. The analysis was restricted to cases with specimens collected through sentinel surveillance. Using a Cox proportional hazards model with mixed effects, we estimated hazard ratios (HR) for hospitalization risk following infection with a variant, adjusting for age, sex, calendar week, and vaccination. Results In total, 58 848 cases were sequenced through sentinel surveillance, of which 1705 (2.9%) were hospitalized due to COVID-19. Higher hospitalization risk was found for infections with Gamma (HR 3.20, 95% confidence interval [CI] 2.40–4.26), Beta (HR 2.85, 95% CI 1.56–5.23), Delta (HR 2.28 95% CI 1.56–3.34), or Alpha (HR 1.64, 95% CI 1.29–2.07) compared to infections with ancestral lineages; Omicron (HR 0.92, 95% CI .56–1.52) showed no significant difference in risk. Following Alpha, Gamma, or Delta infection, unvaccinated patients show higher hospitalization risk, while vaccinated patients show no significant difference in risk, both compared to unvaccinated, ancestral lineage cases. Hospitalization risk following Omicron infection is lower with vaccination. Conclusions Infection with Alpha, Gamma, or Delta results in a higher hospitalization risk, with vaccination attenuating that risk. Our findings support hospital preparedness, vaccination, and genomic surveillance.
背景2019冠状病毒病(COVID-19)大流行以变异病毒为主;由此产生的对疾病严重程度的影响尚不清楚。通过一项回顾性队列研究,我们评估了感染7种严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)变体后的住院风险。方法研究对象为华盛顿疾病报告系统中具有可用病毒基因组数据的SARS-CoV-2逆转录聚合酶链反应(RT-PCR)阳性个体,时间为2020年12月1日至2022年1月14日。分析仅限于通过哨点监测收集标本的病例。使用混合效应的Cox比例风险模型,在调整了年龄、性别、日历周和疫苗接种等因素后,我们估计了感染变异后住院风险的风险比(HR)。结果通过哨点监测共获得58 848例病例,其中1705例(2.9%)因COVID-19住院。与具有祖先血统的感染相比,Gamma (HR 3.20, 95%可信区间[CI] 2.40-4.26)、Beta (HR 2.85, 95% CI 1.56-5.23)、Delta (HR 2.28, 95% CI 1.56-3.34)或Alpha (HR 1.64, 95% CI 1.29-2.07)感染的住院风险更高;Omicron组(HR 0.92, 95% CI 0.56 ~ 1.52)的风险差异无统计学意义。在Alpha、Gamma或Delta感染后,未接种疫苗的患者显示出更高的住院风险,而接种疫苗的患者与未接种疫苗的祖系病例相比,在风险方面没有显着差异。接种疫苗后,感染欧米克隆后住院的风险较低。结论:α、γ或Delta感染可导致较高的住院风险,接种疫苗可降低这种风险。我们的研究结果支持医院准备、疫苗接种和基因组监测。
{"title":"Associations Between Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Variants and Risk of Coronavirus Disease 2019 (COVID-19) Hospitalization Among Confirmed Cases in Washington State: A Retrospective Cohort Study","authors":"M. Paredes, Stephanie M Lunn, M. Famulare, L. Frisbie, I. Painter, R. Burstein, Pavitra Roychoudhury, H. Xie, S. A. Mohamed Bakhash, R. Perez, Maria Lukes, S. Ellis, Saraswathi Sathees, P. Mathias, A. Greninger, L. Starita, C. Frazar, E. Ryke, W. Zhong, L. Gamboa, M. Threlkeld, Jover Lee, E. McDermot, M. Truong, D. Nickerson, Daniel L Bates, M. Hartman, E. Haugen, Truong Nguyen, J. Richards, Jacob L Rodriguez, J. Stamatoyannopoulos, Eric Thorland, G. Melly, P. Dykema, Drew Mackellar, Hannah K. Gray, Avi Singh, J. Peterson, Denny Russell, L. M. Torres, S. Lindquist, T. Bedford, Krisandra J. Allen, H. Oltean","doi":"10.1093/cid/ciac279","DOIUrl":"https://doi.org/10.1093/cid/ciac279","url":null,"abstract":"Abstract Background The coronavirus disease 2019 (COVID-19) pandemic is dominated by variant viruses; the resulting impact on disease severity remains unclear. Using a retrospective cohort study, we assessed the hospitalization risk following infection with 7 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants. Methods Our study includes individuals with positive SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) in the Washington Disease Reporting System with available viral genome data, from 1 December 2020 to 14 January 2022. The analysis was restricted to cases with specimens collected through sentinel surveillance. Using a Cox proportional hazards model with mixed effects, we estimated hazard ratios (HR) for hospitalization risk following infection with a variant, adjusting for age, sex, calendar week, and vaccination. Results In total, 58 848 cases were sequenced through sentinel surveillance, of which 1705 (2.9%) were hospitalized due to COVID-19. Higher hospitalization risk was found for infections with Gamma (HR 3.20, 95% confidence interval [CI] 2.40–4.26), Beta (HR 2.85, 95% CI 1.56–5.23), Delta (HR 2.28 95% CI 1.56–3.34), or Alpha (HR 1.64, 95% CI 1.29–2.07) compared to infections with ancestral lineages; Omicron (HR 0.92, 95% CI .56–1.52) showed no significant difference in risk. Following Alpha, Gamma, or Delta infection, unvaccinated patients show higher hospitalization risk, while vaccinated patients show no significant difference in risk, both compared to unvaccinated, ancestral lineage cases. Hospitalization risk following Omicron infection is lower with vaccination. Conclusions Infection with Alpha, Gamma, or Delta results in a higher hospitalization risk, with vaccination attenuating that risk. Our findings support hospital preparedness, vaccination, and genomic surveillance.","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":"9 1","pages":"e536 - e544"},"PeriodicalIF":0.0,"publicationDate":"2022-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77238867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 22
Correction to: Epidemiology and Outcome of Fungemia in a Cancer Cohort of the Infectious Diseases Group (IDG) of the European Organization for Research and Treatment of Cancer (EORTC 65031). 更正:欧洲癌症研究和治疗组织(EORTC 65031)传染病组(IDG)癌症队列中真菌血症的流行病学和结果。
O. Cornely, B. Gachot, H. Akan, M. Bassetti, O. Uzun, C. Kibbler, O. Marchetti, Peter de Burghgraeve, Safaa Ramadan, L. Pylkkanen, L. Ameye, M. Paesmans, J. Donnelly
{"title":"Correction to: Epidemiology and Outcome of Fungemia in a Cancer Cohort of the Infectious Diseases Group (IDG) of the European Organization for Research and Treatment of Cancer (EORTC 65031).","authors":"O. Cornely, B. Gachot, H. Akan, M. Bassetti, O. Uzun, C. Kibbler, O. Marchetti, Peter de Burghgraeve, Safaa Ramadan, L. Pylkkanen, L. Ameye, M. Paesmans, J. Donnelly","doi":"10.1093/cid/ciac144","DOIUrl":"https://doi.org/10.1093/cid/ciac144","url":null,"abstract":"","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":"94 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90381101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The impact of universal glove and gown use on Clostridioides difficile acquisition, a cluster randomized trial 通用手套和长袍的使用对艰难梭菌获取的影响,一项集群随机试验
D. Morgan, M. M. Erik R. Dubberke, BS MT Tiffany Hink, BS Gwen Paszkiewicz, C. D. Burnham, MA Lisa Pineles, PhD Larry Magder, PhD J. Kristie Johnson, Mbbs Mph Surbhi Leekha, A. D. H. M. Mph
Importance: Clostridioides difficile is the most common cause of healthcare-associated infections (HAI) in the US. It is unknown whether universal gown and glove use in intensive care units (ICUs) decreases acquisition of C. difficile. Objective: To assess whether wearing gloves and gowns for all patient contact in the ICU decreases acquisition of C. difficile compared with usual care. Design, setting, and Participants: Secondary analysis of a cluster-randomized trial in 20 medical and surgical ICUs in 20 US hospitals from January 4, 2012, to October 4, 2012. Interventions: After a baseline period, ICUs were randomized to standard practice for glove and gown use vs. the intervention of all healthcare workers being required to wear gloves and gowns for all patient contact and when entering any patient room (contact precautions). Main outcomes and measures: The primary outcome was acquisition of toxigenic C. difficile determined by surveillance cultures collected on admission and discharge from the ICU. Secondary outcomes included ribotype 027-like C. difficile acquisition and the impact of other factors on acquisition. Results: From the 26,749 patients enrolled in the study, a total of 21,845 patients had both admission and discharge perianal swabs cultured for toxigenic C. difficile. On admission, 9.43% (2,060/21,845) of patients were colonized with toxigenic C. difficile. No significant difference was observed in the rate of toxigenic C. difficile acquisition with universal gown and glove use. Differences in acquisition rates in the study period compared to baseline period in control ICUs were 1.49 per 100 patient days vs 1.68 per 100 patient days in universal gown and glove ICUs, (rate difference -0.28, generalized linear mixed model, p=0.091). Similarly, there was no difference in rates of ribotype 027-like C. difficile acquisition: control ICUs 0.13 per 100 patient days vs. 0.16 per 100 patient days in universal gown and glove ICUs during the study period, (rate difference -0.03, generalized linear mixed model, p=0.35). Secondary analyses identified C. difficile colonization was associated with acquisition, p=0.014). Conclusions and relevance: Glove and gown use for all patient contact in medical and surgical ICUs did not result in a reduction in the acquisition of C. difficile compared with usual care.
重要性:艰难梭菌是美国医疗保健相关感染(HAI)的最常见原因。目前尚不清楚重症监护病房(icu)普遍使用长袍和手套是否会减少艰难梭菌的感染。目的:评估与常规护理相比,在ICU与所有患者接触时佩戴手套和防护服是否能减少艰难梭菌的感染。设计、环境和参与者:2012年1月4日至2012年10月4日在美国20家医院的20个内科和外科icu中进行的一项集群随机试验的二次分析。干预措施:基线期后,icu被随机分配到使用手套和防护服的标准做法与所有医护人员在所有患者接触和进入任何病房时都被要求戴手套和防护服的干预(接触预防措施)。主要结果和措施:主要结果是通过ICU入院和出院时收集的监测培养物来确定产毒艰难梭菌的获得。次要结局包括027样艰难梭菌的获得以及其他因素对获得的影响。结果:在纳入研究的26749名患者中,共有21845名患者在入院和出院时都进行了产毒艰难梭菌的肛周拭子培养。入院时,9.43%(2,060/21,845)的患者被产毒艰难梭菌定植。使用通用的工作服和手套,在产毒艰难梭菌获得率方面没有观察到显著差异。与基线期相比,对照组icu在研究期间的感染率差异为1.49 / 100患者日,而通用病号服和手套icu为1.68 / 100患者日(率差-0.28,广义线性混合模型,p=0.091)。同样,027型样艰难梭菌的感染率也没有差异:在研究期间,对照组每100患者日感染0.13例icu,而通用长袍和手套组每100患者日感染0.16例icu(率差-0.03,广义线性混合模型,p=0.35)。二次分析发现艰难梭菌定殖与获得相关,p=0.014)。结论和相关性:与常规护理相比,在内科和外科icu中所有患者接触时使用手套和长袍并没有导致艰难梭菌感染的减少。
{"title":"The impact of universal glove and gown use on Clostridioides difficile acquisition, a cluster randomized trial","authors":"D. Morgan, M. M. Erik R. Dubberke, BS MT Tiffany Hink, BS Gwen Paszkiewicz, C. D. Burnham, MA Lisa Pineles, PhD Larry Magder, PhD J. Kristie Johnson, Mbbs Mph Surbhi Leekha, A. D. H. M. Mph","doi":"10.1101/2022.04.11.22273721","DOIUrl":"https://doi.org/10.1101/2022.04.11.22273721","url":null,"abstract":"Importance: Clostridioides difficile is the most common cause of healthcare-associated infections (HAI) in the US. It is unknown whether universal gown and glove use in intensive care units (ICUs) decreases acquisition of C. difficile. Objective: To assess whether wearing gloves and gowns for all patient contact in the ICU decreases acquisition of C. difficile compared with usual care. Design, setting, and Participants: Secondary analysis of a cluster-randomized trial in 20 medical and surgical ICUs in 20 US hospitals from January 4, 2012, to October 4, 2012. Interventions: After a baseline period, ICUs were randomized to standard practice for glove and gown use vs. the intervention of all healthcare workers being required to wear gloves and gowns for all patient contact and when entering any patient room (contact precautions). Main outcomes and measures: The primary outcome was acquisition of toxigenic C. difficile determined by surveillance cultures collected on admission and discharge from the ICU. Secondary outcomes included ribotype 027-like C. difficile acquisition and the impact of other factors on acquisition. Results: From the 26,749 patients enrolled in the study, a total of 21,845 patients had both admission and discharge perianal swabs cultured for toxigenic C. difficile. On admission, 9.43% (2,060/21,845) of patients were colonized with toxigenic C. difficile. No significant difference was observed in the rate of toxigenic C. difficile acquisition with universal gown and glove use. Differences in acquisition rates in the study period compared to baseline period in control ICUs were 1.49 per 100 patient days vs 1.68 per 100 patient days in universal gown and glove ICUs, (rate difference -0.28, generalized linear mixed model, p=0.091). Similarly, there was no difference in rates of ribotype 027-like C. difficile acquisition: control ICUs 0.13 per 100 patient days vs. 0.16 per 100 patient days in universal gown and glove ICUs during the study period, (rate difference -0.03, generalized linear mixed model, p=0.35). Secondary analyses identified C. difficile colonization was associated with acquisition, p=0.014). Conclusions and relevance: Glove and gown use for all patient contact in medical and surgical ICUs did not result in a reduction in the acquisition of C. difficile compared with usual care.","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":"100 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83343612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
COVID-19 Disease Severity in Children Infected with the Omicron Variant 感染组粒变异的儿童COVID-19疾病严重程度
A. Butt, S. Dargham, Srusvin Loka, R. Shaik, H. Chemaitelly, P. Tang, M Zahid Hasan, P. Coyle, H. Yassine, H. Al-Khatib, M. Smatti, A. Kaleeckal, A. Latif, Ahmed Zaqout, M. Almaslamani, A. Al Khal, R. Bertollini, A. Abou-Samra, L. Abu-Raddad
Abstract Background There are limited data assessing COVID-19 disease severity in children/adolescents infected with the Omicron variant. Methods We identified children and adolescents <18 years with SARS-CoV-2 infection with Delta and propensity-score matched controls with Omicron variant infection from the National COVID-19 Database in Qatar. Primary outcome was disease severity, determined by hospital admission, admission to ICU, or mechanical ventilation within 14 days of diagnosis, or death within 28 days. Results Among 1,735 cases with Delta variant infection between June 1 and November 6, 2021 and 32 635 cases with Omicron variant infection between January 1 and January 15, 2022 who did not have prior infection and were not vaccinated, we identified 985 propensity-score matched pairs. Among Delta infected, 84.2% had mild, 15.7% had moderate, and 0.1% had severe/critical disease. Among Omicron infected, 97.8% had mild, 2.2% had moderate, and none had severe/critical disease (P < .001). Omicron variant infection (vs. Delta) was associated with significantly lower odds of moderate or severe/critical disease (adjusted odds ratio, 0.12; 95% CI 0.07-0.18). Those aged 6–11, and 12-<18 years had lower odds of developing moderate or severe/critical disease compared with those younger than six years (aOR, 95% CI 0.47; 0.33-0.66 for 6-11 year old; aOR 0.45, 95% CI 0.21-0.94 for 12-<18 years old). Conclusions Omicron variant infection in children/adolescents is associated with less severe disease than Delta variant infection as measured by hospitalization rates and need for ICU care or mechanical ventilation. Those 6 to <18 years also have less severe disease than those <6 years old.
背景评估感染Omicron变异的儿童/青少年COVID-19疾病严重程度的数据有限。方法:我们从卡塔尔国家COVID-19数据库中筛选了δ型SARS-CoV-2感染的儿童和<18岁的青少年,并将倾向评分匹配的对照组与Omicron变体感染进行比对。主要结局是疾病严重程度,由入院、入住ICU或诊断14天内的机械通气或28天内的死亡决定。结果在2021年6月1日至11月6日期间的1735例德尔塔变异感染病例和2022年1月1日至1月15日期间的32635例无既往感染且未接种疫苗的欧米克隆变异感染病例中,我们确定了985对倾向评分匹配。在三角洲感染人群中,84.2%为轻度,15.7%为中度,0.1%为重度/危重型。感染Omicron的患者中,97.8%为轻度,2.2%为中度,无重症/危重症(P < 0.001)。组粒变异感染(相对于δ)与中度或重度/危重性疾病的几率显著降低相关(调整后的优势比,0.12;95% ci 0.07-0.18)。6-11岁和12-<18岁的患者与6岁以下的患者相比,发生中度或重度/危重性疾病的几率较低(aOR, 95% CI 0.47;6-11岁0.33-0.66;12-<18岁的aOR 0.45, 95% CI 0.21-0.94)。结论从住院率和ICU护理或机械通气的需求来衡量,儿童/青少年Omicron变异感染与Delta变异感染的严重程度较低。6岁至18岁以下儿童的疾病严重程度也低于6岁以下儿童。
{"title":"COVID-19 Disease Severity in Children Infected with the Omicron Variant","authors":"A. Butt, S. Dargham, Srusvin Loka, R. Shaik, H. Chemaitelly, P. Tang, M Zahid Hasan, P. Coyle, H. Yassine, H. Al-Khatib, M. Smatti, A. Kaleeckal, A. Latif, Ahmed Zaqout, M. Almaslamani, A. Al Khal, R. Bertollini, A. Abou-Samra, L. Abu-Raddad","doi":"10.1093/cid/ciac275","DOIUrl":"https://doi.org/10.1093/cid/ciac275","url":null,"abstract":"Abstract Background There are limited data assessing COVID-19 disease severity in children/adolescents infected with the Omicron variant. Methods We identified children and adolescents <18 years with SARS-CoV-2 infection with Delta and propensity-score matched controls with Omicron variant infection from the National COVID-19 Database in Qatar. Primary outcome was disease severity, determined by hospital admission, admission to ICU, or mechanical ventilation within 14 days of diagnosis, or death within 28 days. Results Among 1,735 cases with Delta variant infection between June 1 and November 6, 2021 and 32 635 cases with Omicron variant infection between January 1 and January 15, 2022 who did not have prior infection and were not vaccinated, we identified 985 propensity-score matched pairs. Among Delta infected, 84.2% had mild, 15.7% had moderate, and 0.1% had severe/critical disease. Among Omicron infected, 97.8% had mild, 2.2% had moderate, and none had severe/critical disease (P < .001). Omicron variant infection (vs. Delta) was associated with significantly lower odds of moderate or severe/critical disease (adjusted odds ratio, 0.12; 95% CI 0.07-0.18). Those aged 6–11, and 12-<18 years had lower odds of developing moderate or severe/critical disease compared with those younger than six years (aOR, 95% CI 0.47; 0.33-0.66 for 6-11 year old; aOR 0.45, 95% CI 0.21-0.94 for 12-<18 years old). Conclusions Omicron variant infection in children/adolescents is associated with less severe disease than Delta variant infection as measured by hospitalization rates and need for ICU care or mechanical ventilation. Those 6 to <18 years also have less severe disease than those <6 years old.","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78460418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 80
Corrigendum to: Guidance for Systematic Integration of Undernutrition in Attributing Cause of Death in Children 营养不良归因儿童死亡原因系统整合指南的勘误表
Christina R Paganelli, N. Kassebaum, Kathleen L Strong, P. Suchdev, W. Voskuijl, Q. Bassat, D. Blau, D. Denno
{"title":"Corrigendum to: Guidance for Systematic Integration of Undernutrition in Attributing Cause of Death in Children","authors":"Christina R Paganelli, N. Kassebaum, Kathleen L Strong, P. Suchdev, W. Voskuijl, Q. Bassat, D. Blau, D. Denno","doi":"10.1093/cid/ciac084","DOIUrl":"https://doi.org/10.1093/cid/ciac084","url":null,"abstract":"","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":"35 1","pages":"1891 - 1891"},"PeriodicalIF":0.0,"publicationDate":"2022-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81711203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Midline Destructive Lesions in Previously Healthy Adult. 先前健康成人中线破坏性病变。
E. Gómez-Moyano, S. M. García, M. Ayala-Blanca, F. Oñate, L. Pilar
{"title":"Midline Destructive Lesions in Previously Healthy Adult.","authors":"E. Gómez-Moyano, S. M. García, M. Ayala-Blanca, F. Oñate, L. Pilar","doi":"10.1093/cid/ciz559","DOIUrl":"https://doi.org/10.1093/cid/ciz559","url":null,"abstract":"","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":"23 1","pages":"1257-1259"},"PeriodicalIF":0.0,"publicationDate":"2022-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83945125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
High Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Household Transmission Rates Detected by Dense Saliva Sampling 密集唾液取样检测严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)家庭传播率
L. Kolodziej, S. V. van Lelyveld, Mildred E Haverkort, R. Mariman, Judith G. C. Sluiter-Post, P. Badoux, E. M. de Koff, Jeffrey C D Koole, W. Miellet, Adriaan N Swart, E. Coipan, A. Meijer, E. Sanders, K. Trzciński, S. Euser, D. Eggink, M. V. van Houten
Abstract Background Understanding the dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) household transmission is important for adequate infection control measures in this ongoing pandemic. Methods Households were enrolled upon a polymerase chain reaction–confirmed index case between October and December 2020, prior to the coronavirus disease 2019 vaccination program. Saliva samples were obtained by self-sampling at days 1, 3, 5, 7, 10, 14, 21, 28, 35, and 42 from study inclusion. Nasopharyngeal swabs (NPS) and oropharyngeal swabs (OPS) were collected by the research team at day 7 and capillary blood samples at day 42. Household secondary attack rate (SAR) and per-person SAR were calculated based on at least 1 positive saliva, NPS, OPS, or serum sample. Whole genome sequencing was performed to investigate the possibility of multiple independent SARS-CoV-2 introductions within a household. Results Eighty-five households were included consisting of 326 (unvaccinated) individuals. Comparable numbers of secondary cases were identified by saliva (133/241 [55.2%]) and serum (127/213 [59.6%]). The household SAR was 88.2%. The per-person SAR was 64.3%. The majority of the secondary cases tested positive in saliva at day 1 (103/150 [68.7%]). Transmission from index case to household member was not affected by age or the nature of their relationship. Phylogenetic analyses suggested a single introduction for the investigated households. Conclusions Households have a pivotal role in SARS-CoV-2 transmission. By repeated saliva self-sampling combined with NPS, OPS, and serology, we found the highest SARS-CoV-2 household transmission rates reported to date. Salivary (self-) sampling of adults and children is suitable and attractive for near real-time monitoring of SARS-CoV-2 transmission in this setting.
背景了解严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)家庭传播的动态对于在这场持续的大流行中采取适当的感染控制措施具有重要意义。方法在2019冠状病毒病疫苗接种计划前,对2020年10月至12月聚合酶链反应确诊的指标病例进行住户登记。在研究纳入后的第1、3、5、7、10、14、21、28、35和42天,通过自采样获得唾液样本。研究组于第7天采集鼻咽拭子(NPS)和口咽拭子(OPS),第42天采集毛细血管血样。根据至少1份唾液、NPS、OPS或血清阳性样本计算家庭二次发作率(SAR)和人均SAR。进行了全基因组测序,以调查在一个家庭中多次独立引入SARS-CoV-2的可能性。结果纳入85户家庭,其中326人(未接种)。唾液(133/241[55.2%])和血清(127/213[59.6%])检出的继发病例数量相当。家庭SAR为88.2%。人均SAR为64.3%。大多数继发性病例在第1天唾液检测呈阳性(103/150[68.7%])。从指示病例到家庭成员的传播不受年龄或其关系性质的影响。系统发育分析表明,被调查的家庭只引进了一种。结论家庭在SARS-CoV-2传播中起着关键作用。通过重复唾液自采样,结合NPS、OPS和血清学,我们发现了迄今为止报告的最高SARS-CoV-2家庭传播率。在这种情况下,对成人和儿童进行唾液(自我)取样适合且有吸引力地用于近实时监测SARS-CoV-2的传播。
{"title":"High Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Household Transmission Rates Detected by Dense Saliva Sampling","authors":"L. Kolodziej, S. V. van Lelyveld, Mildred E Haverkort, R. Mariman, Judith G. C. Sluiter-Post, P. Badoux, E. M. de Koff, Jeffrey C D Koole, W. Miellet, Adriaan N Swart, E. Coipan, A. Meijer, E. Sanders, K. Trzciński, S. Euser, D. Eggink, M. V. van Houten","doi":"10.1093/cid/ciac261","DOIUrl":"https://doi.org/10.1093/cid/ciac261","url":null,"abstract":"Abstract Background Understanding the dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) household transmission is important for adequate infection control measures in this ongoing pandemic. Methods Households were enrolled upon a polymerase chain reaction–confirmed index case between October and December 2020, prior to the coronavirus disease 2019 vaccination program. Saliva samples were obtained by self-sampling at days 1, 3, 5, 7, 10, 14, 21, 28, 35, and 42 from study inclusion. Nasopharyngeal swabs (NPS) and oropharyngeal swabs (OPS) were collected by the research team at day 7 and capillary blood samples at day 42. Household secondary attack rate (SAR) and per-person SAR were calculated based on at least 1 positive saliva, NPS, OPS, or serum sample. Whole genome sequencing was performed to investigate the possibility of multiple independent SARS-CoV-2 introductions within a household. Results Eighty-five households were included consisting of 326 (unvaccinated) individuals. Comparable numbers of secondary cases were identified by saliva (133/241 [55.2%]) and serum (127/213 [59.6%]). The household SAR was 88.2%. The per-person SAR was 64.3%. The majority of the secondary cases tested positive in saliva at day 1 (103/150 [68.7%]). Transmission from index case to household member was not affected by age or the nature of their relationship. Phylogenetic analyses suggested a single introduction for the investigated households. Conclusions Households have a pivotal role in SARS-CoV-2 transmission. By repeated saliva self-sampling combined with NPS, OPS, and serology, we found the highest SARS-CoV-2 household transmission rates reported to date. Salivary (self-) sampling of adults and children is suitable and attractive for near real-time monitoring of SARS-CoV-2 transmission in this setting.","PeriodicalId":10421,"journal":{"name":"Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America","volume":"33 1","pages":"e10 - e19"},"PeriodicalIF":0.0,"publicationDate":"2022-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84621010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
SARS-CoV-2 Naturally Acquired Immunity vs. Vaccine-induced Immunity, Reinfections versus Breakthrough Infections: a Retrospective Cohort Study. SARS-CoV-2自然获得性免疫与疫苗诱导免疫、再感染与突破性感染:一项回顾性队列研究
S. Gazit, R. Shlezinger, G. Perez, Roni Lotan, A. Peretz, A. Ben-Tov, E. Herzel, H. Alapi, D. Cohen, K. Muhsen, G. Chodick, T. Patalon
BACKGROUNDWaning of protection against infection with SARS-CoV-2 conferred by 2 doses of the BNT162b2 vaccine begins shortly after inoculation and becomes substantial within four months. With that, the impact of prior infection on incident SARS-CoV-2 reinfection is unclear. Therefore, we examined the long-term protection of naturally acquired immunity (protection conferred by previous infection) compared to vaccine-induced immunity.METHODSA retrospective observational study of 124,500 persons, compared two groups: (1) SARS-CoV-2-naïve individuals who received a two-dose regimen of the BioNTech/Pfizer mRNA BNT162b2 vaccine, and (2) previously infected individuals who have not been vaccinated. Two multivariate logistic regression models were applied, evaluating four SARS-CoV-2-related outcomes - infection, symptomatic disease (COVID-19), hospitalization and death - between June 1 to August 14, 2021, when the Delta variant was dominant in Israel.RESULTSSARS-CoV-2-naïve vaccinees had a 13.06-fold (95% CI, 8.08-21.11) increased risk for breakthrough infection with the Delta variant compared to unvaccinated-previously-infected individuals, when the first event (infection or vaccination) occurred during January and February of 2021. The increased risk was significant for symptomatic disease as well. When allowing the infection to occur at any time between March 2020 to February 2021, evidence of waning naturally acquired immunity was demonstrated, though SARS-CoV-2 naïve vaccinees still had a 5.96-fold (95% CI, 4.85-7.33) increased risk for breakthrough infection and a 7.13-fold (95% CI, 5.51-9.21) increased risk for symptomatic disease.CONCLUSIONSNaturally acquired immunity confers stronger protection against infection and symptomatic disease caused by the Delta variant of SARS-CoV-2, compared to the BNT162b2 two-dose vaccine-induced immunity.
背景:2剂BNT162b2疫苗对SARS-CoV-2感染的保护作用在接种后不久开始减弱,并在4个月内变得明显。因此,既往感染对SARS-CoV-2再感染的影响尚不清楚。因此,我们比较了自然获得性免疫与疫苗诱导免疫的长期保护作用(由既往感染产生的保护作用)。方法回顾性观察研究124,500人,比较两组:(1)SARS-CoV-2-naïve接受双剂量BioNTech/Pfizer mRNA BNT162b2疫苗方案的个体,(2)先前未接种疫苗的感染个体。应用了两个多变量logistic回归模型,评估了2021年6月1日至8月14日期间与sars - cov -2相关的四种结局——感染、症状性疾病(COVID-19)、住院和死亡,当时Delta变体在以色列占主导地位。当第一次事件(感染或接种)发生在2021年1月和2月期间时,RESULTSSARS-CoV-2-naïve疫苗接种者与未接种疫苗的先前感染个体相比,突破性感染Delta变体的风险增加了13.06倍(95% CI, 8.08-21.11)。对于有症状的疾病,增加的风险也很显著。当允许感染在2020年3月至2021年2月之间的任何时间发生时,证明了自然获得性免疫力减弱的证据,尽管SARS-CoV-2 naïve疫苗接种者发生突破性感染的风险仍增加5.96倍(95% CI, 4.85-7.33),出现症状性疾病的风险仍增加7.13倍(95% CI, 5.51-9.21)。结论与BNT162b2双剂量疫苗诱导的免疫相比,自然获得性免疫对δ型SARS-CoV-2感染和症状性疾病具有更强的保护作用。
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引用次数: 76
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Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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