Journal of Infection最新文献

英文中文

Synergistic evolution: The dynamic adaptation of SARS-CoV-2 and human protective immunity in the real world 协同进化：SARS-CoV-2 和人类保护性免疫在现实世界中的动态适应。

IF 14.3 1区医学 Q1 INFECTIOUS DISEASES

Journal of Infection

Pub Date : 2024-10-10 DOI: 10.1016/j.jinf.2024.106310

Objectives

SARS-CoV-2 is continually evolving with new variants to evade protective immunity and cause new infections. This study aimed to assess infection-acquired immunity and hybrid immunity against re-infection or severe COVID-19.

Methods

During 2020–2023, we collected 890 serum samples from individuals infected with SARS-CoV-2 variants including wild type, D614G, Alpha, Delta, BA.1, BA.2, BA.2.76, BA.5.2, BF.7, XBB, and EG.5. The levels of serum neutralizing antibodies (NAbs) against 18 diverse SARS-CoV-2 variants were determined using a bead-based high-throughput broad neutralizing-antibody assay.

Results

In the initial wave of the COVID-19 pandemic, >75% of the patients demonstrated robust NAb responses against the ancestral SARS-CoV-2, during a period when vaccines were not yet available. After the emergence of the Omicron variant, the seroprevalence of anti-Omicron NAbs among the patients increased rapidly. By April 2023, when XBB variant was predominant, approximately 80% of the patients demonstrated >50% neutralization against the highly immune-evasive XBB lineages. Three serotypes of SARS-CoV-2, namely non-Omicron, Omicron, and XBB serotypes, were identified, with the strong likelihood of further changes occurring as the virus mutating. Generally, NAbs elicited by a previous serotype could not typically effectively protect against another serotype that emerges later in the evolutionary stages.

Conclusion

Our results firstly demonstrated the synergistic evolution between host immunity and SARS-CoV-2 variants in the real world, which would be helpful to develop future vaccines and public health strategies.

目的：SARS-CoV-2 不断演变出新的变种，以逃避保护性免疫并引起新的感染。本研究旨在评估感染获得的免疫力和针对再感染或严重 COVID-19 的混合免疫力：2020-2023年期间，我们收集了890份感染SARS-CoV-2变体的个体血清样本，包括野生型、D614G、Alpha、Delta、BA.1、BA.2、BA.2.76、BA.5.2、BF.7、XBB和EG.5。使用基于微珠的高通量广谱中和抗体检测法测定了针对 18 种不同 SARS-CoV-2 变体的血清中和抗体（NAbs）水平：结果：在 COVID-19 大流行的最初阶段，超过 75% 的患者对 SARS-CoV-2 的祖先表现出强烈的 NAb 反应，而当时还没有疫苗。欧米克隆变种出现后，患者中抗欧米克隆 NAb 的血清流行率迅速上升。到 2023 年 4 月，当 XBB 变体占主导地位时，约 80% 的患者对具有高度免疫侵袭性的 XBB 株系的中和率大于 50%。目前已确定 SARS-CoV-2 有三种血清型，即非 Omicron、Omicron 和 XBB 血清型，随着病毒的变异，极有可能发生进一步的变化。一般来说，由以前的血清型引起的NAbs通常不能有效保护进化阶段后期出现的另一种血清型：我们的研究结果首次证明了现实世界中宿主免疫力与 SARS-CoV-2 变种之间的协同进化，这将有助于未来疫苗和公共卫生策略的开发。

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引用次数: 0

Epidemiological comparison of emergency department presentations with seasonal influenza or COVID-19 and an outcome of intensive care admission or death: A population-based records linkage study in New South Wales, Australia 季节性流感或 COVID-19 与重症监护入院或死亡结果的急诊科就诊流行病学比较：澳大利亚新南威尔士州的一项基于人口的记录关联研究。

IF 14.3 1区医学 Q1 INFECTIOUS DISEASES

Journal of Infection

Pub Date : 2024-10-09 DOI: 10.1016/j.jinf.2024.106307

Background

COVID-19 and seasonal influenza are endemic causes of morbidity and mortality. This study aimed to compare the epidemiology of severe illness and risk of death among patients following emergency department (ED) presentation with either infection.

Methods

De-identified, population-based, emergency department records in New South Wales, Australia, were probabilistically linked to population-level health outcome databases for the period 1 January 2015 to 28 February 2023. Included were patients allocated an ED diagnosis consistent with an acute respiratory infection. Logistic regression was used to examine the association of infecting virus with risk of a severe outcome (intensive care unit admission or death).

Results

Influenza infection was notified in 2335 and COVID-19 in 5053 patients with a severe outcome. The age distribution was similar for both viruses, except in <15-year-olds, where severe influenza was nearly three times more frequent. Overall, the odds of death among patients with COVID-19 was 1.65 (95% CI 1.43, 1.89) times higher than among those with influenza. This declined to 1.49 (95% CI 1.08, 2.06) times during the COVID-19 Omicron variant period.

Conclusions

The Omicron variant arrived when background population COVID-19 vaccination coverage was >90%. Despite that, death was more frequent for COVID-19 than influenza.

背景：COVID-19和季节性流感是导致发病和死亡的地方性原因。本研究旨在比较在急诊科（ED）就诊的感染者中重症患者的流行病学和死亡风险：方法：将澳大利亚新南威尔士州基于人群的去身份化急诊科记录与人群健康结果数据库进行概率链接，时间跨度为 2015 年 1 月 1 日至 2023 年 2 月 28 日。研究对象包括急诊科诊断为急性呼吸道感染的患者。采用逻辑回归法检测感染病毒与严重后果（入住重症监护室或死亡）风险之间的关联：结果：2335 名患者感染了流感，5053 名出现严重后果的患者感染了 COVID-19。除结论外，两种病毒的年龄分布相似：当人群中 COVID-19 疫苗接种率大于 90% 时，Omicron 变种就会出现。尽管如此，与流感相比，COVID-19的致死率更高。

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引用次数: 0

Infant-derived human nasal organoids exhibit relatively increased susceptibility, epithelial responses, and cytotoxicity during RSV infection 在 RSV 感染期间，源自婴儿的人鼻腔器官组织显示出相对增加的易感性、上皮反应和细胞毒性。

IF 14.3 1区医学 Q1 INFECTIOUS DISEASES

Journal of Infection

Pub Date : 2024-10-09 DOI: 10.1016/j.jinf.2024.106305

Background

Respiratory syncytial virus (RSV) causes significant morbidity and mortality, especially in young children. Why RSV infection in children is more severe compared to healthy adults is not fully understood.

Methods

We used ex-vivo human nasal organoid platforms from infants and adults to investigate the underlying mechanism of this disease disparity at the initial site of RSV replication, the nasal epithelium.

Results

Infant-derived human nasal organoid-air liquid interface (HNO-ALIs) lines were more susceptible to early RSV replication. Moreover, infant-derived HNO-ALIs elicited a statistically significant greater overall cytokine response, enhanced mucous production, and greater cellular damage compared to their adult counterparts. Furthermore, the adult cytokine response was associated with a superior regulatory cytokine response, which could explain less cellular damage than in infant lines.

Conclusions

Our data highlights substantial differences in how infant and adult upper respiratory tract epithelium responds to RSV infection at the cellular level. These differences in epithelial cellular response can lead to impaired mucociliary clearance, a more dysregulated innate immune response predisposing infants to more severe RSV infection compared to adults.

背景：呼吸道合胞病毒（RSV）会导致严重的发病率和死亡率，尤其是在幼儿中。与健康成人相比，儿童感染 RSV 后病情更为严重的原因尚不完全清楚：方法：我们使用来自婴儿和成人的体外人类鼻腔类器官平台，研究在 RSV 复制的初始部位--鼻腔上皮--造成这种疾病差异的潜在机制：结果：婴儿来源的人鼻腔类器官-空气-液体界面（HNO-ALIs）系更容易受到早期RSV复制的影响。此外，与成人相比，婴儿来源的 HNO-ALIs 在统计学上显著引起更大的整体细胞因子反应、更多的粘液分泌和更大的细胞损伤。此外，成人的细胞因子反应与卓越的调节性细胞因子反应有关，这也是细胞损伤少于婴儿的原因：我们的数据凸显了婴儿和成人上呼吸道上皮细胞在细胞水平上对 RSV 感染反应的巨大差异。上皮细胞反应的这些差异可能会导致粘膜纤毛清除功能受损，先天免疫反应失调，从而使婴儿比成人更容易感染更严重的 RSV。

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引用次数: 0

Highly Pathogenic Avian Influenza A(H5N1) virus infection in dairy cattle: Threat of bird flu has expanded to open-air farmed livestock 奶牛感染高致病性甲型禽流感（H5N1）病毒：禽流感的威胁已扩大到露天饲养的牲畜。

IF 14.3 1区医学 Q1 INFECTIOUS DISEASES

Journal of Infection

Pub Date : 2024-10-08 DOI: 10.1016/j.jinf.2024.106311

引用次数: 0

CD151 identifies an NK cell subset that is enriched in COVID-19 patients and correlates with disease severity CD151 确定了一个 NK 细胞亚群，该亚群在 COVID-19 患者中富集，并与疾病严重程度相关。

IF 14.3 1区医学 Q1 INFECTIOUS DISEASES

Journal of Infection

Pub Date : 2024-10-05 DOI: 10.1016/j.jinf.2024.106304

Severe coronavirus disease 2019 (COVID-19) often leads to acute respiratory distress syndrome and multi-organ dysfunction, driven by a dysregulated immune response, including a cytokine storm with elevated proinflammatory cytokine levels. Natural killer (NK) cells are part of the innate immune system with a fundamental role in the defense against viral infections. However, during COVID-19 acute infection, they exhibit an altered phenotype and impaired functionality contributing to the immunopathogenesis of the disease. In this work, we have studied a cohort of patients with COVID-19 (ranging from mild to severe) by analyzing IL-15, TGF-β, PlGF and GDF-15 plasma levels and performing multiparametric flow cytometry studies. Our results revealed that severe COVID-19 patients exhibited high levels of IL-15, PlGF and GDF-15, along with an enrichment of an NK cell subset expressing the CD151 tetraspanin, which correlated with IL-15 plasma levels and disease severity. In patients, these CD151+ NK cells displayed a more activated phenotype characterized by an increased expression of HLA-DR, CD38 and granzyme B, a distinct receptor repertoire, with lower levels of CD160 and CD31 and higher levels of CD55 and, remarkably, a higher expression of tissue-resident markers CD103 and the NK cell decidual marker CD9. Last of all, in individuals with severe disease, we identified an expansion of a CD151^brightCD9+ NK cell subset, suggesting that these cells play a specific role in COVID-19. Altogether, our findings suggest that CD151+ NK cells may have a relevant role in COVID-19 immunopathogenesis.

严重的冠状病毒病2019年最新注册送彩金（COVID-19）通常会导致急性呼吸窘迫综合征和多器官功能障碍，其驱动因素是失调的免疫反应，包括细胞因子风暴和促炎细胞因子水平升高。自然杀伤（NK）细胞是先天性免疫系统的一部分，在抵御病毒感染方面发挥着重要作用。然而，在 COVID-19 急性感染期间，它们会表现出表型改变和功能受损，从而导致疾病的免疫发病机制。在这项工作中，我们通过分析 IL-15、TGF-β、PlGF 和 GDF-15 的血浆水平以及进行多参数流式细胞术研究，对 COVID-19 患者（从轻度到重度不等）进行了研究。我们的研究结果表明，COVID-19 重症患者的 IL-15、PlGF 和 GDF-15 水平较高，表达 CD151 四聚体蛋白的 NK 细胞亚群也较丰富，这与 IL-15 血浆水平和疾病严重程度相关。在患者体内，这些 CD151+ NK 细胞显示出更活化的表型，其特点是 HLA-DR、CD38 和颗粒酶 B 的表达增加，受体谱系独特，CD160 和 CD31 水平较低，CD55 水平较高，而且值得注意的是，组织驻留标记 CD103 和 NK 细胞蜕膜标记 CD9 的表达较高。最后，在病情严重的个体中，我们发现了 CD151brightCD9+ NK 细胞亚群的扩增，这表明这些细胞在 COVID-19 中发挥着特殊作用。总之，我们的研究结果表明，CD151+ NK 细胞可能在 COVID-19 免疫发病机制中发挥了相关作用。

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引用次数: 0

Recurrent Clostridioides difficile infections in solid organ transplant recipients: The international CALIPSO study 实体器官移植受者复发性艰难梭菌感染：国际 CALIPSO 研究。

IF 14.3 1区医学 Q1 INFECTIOUS DISEASES

Journal of Infection

Pub Date : 2024-10-05 DOI: 10.1016/j.jinf.2024.106306

Objective

To evaluate the risk of recurrent Clostridioides difficile infection (CDI) in solid-organ transplant (SOT) recipients.

Methods

Retrospective multicenter study including SOT recipients with a first CDI episode in the year after transplantation (Jan 2017-June 2020). The primary outcome measure was recurrence, defined as a new CDI ≤56 days from the first episode. A competing risk analysis was performed using the sub-distribution hazard model multivariable analysis.

Results

191 SOT recipients were included: 101 (52.9%) were kidney, 66 (34.6%) liver, 11 (5.8%) lung, 8 (4.2%) simultaneous pancreas-kidney, 4 (2.1%) heart and 1 (0.5%) pancreas alone recipients. Treatment for the first CDI were: vancomycin (n = 114,59.7%), vancomycin+metronidazole (n = 39,20.4%), metronidazole (n = 26,13.6%), fidaxomicin (n = 9,4.7%), 3 patients did not receive any therapy. After the first CDI, 17/191 (8.9%) patients died within 56-day mortality without having a recurrence, while 23/191 (12%) patients had a recurrence. Among patients with recurrent CDI, 56-day mortality rate was 30.4% (7/23 patients). On multivariable analysis, severe CDI (sHR4.01, 95% CI 1.77–9.08, p < .001) and metronidazole monotherapy (sHR 3.65, 95% CI 1.64–8.14, p = .001) were factors independently associated with recurrence.

Conclusions

Metronidazole monotherapy is associated with increased risk of recurrent CDI in SOT recipients. Therapeutic strategies aimed to reduce the risk of recurrence should be implemented in this setting.

目的：评估实体器官移植受者复发艰难梭菌感染（CDI）的风险：评估实体器官移植（SOT）受者复发艰难梭菌感染（CDI）的风险：回顾性多中心研究，包括移植后一年内（2017 年 1 月至 2020 年 6 月）首次发生 CDI 的 SOT 受者。主要结局指标为复发，定义为自首次发病后56天内再次发生CDI。采用亚分布危险模型多变量分析法进行竞争风险分析：共纳入 191 名 SOT 受者：101例（52.9%）为肾脏受者，66例（34.6%）为肝脏受者，11例（5.8%）为肺脏受者，8例（4.2%）为胰腺-肾脏同时受者，4例（2.1%）为心脏受者，1例（0.5%）为单纯胰腺受者。首次CDI的治疗方法为：万古霉素（114例，59.7%）、万古霉素+甲硝唑（39例，20.4%）、甲硝唑（26例，13.6%）、非达霉素（9例，4.7%），3名患者未接受任何治疗。首次感染 CDI 后，17/191（8.9%）名患者在 56 天内死亡，且未复发，23/191（12%）名患者复发。在复发 CDI 的患者中，56 天死亡率为 30.4%（7/23 名患者）。在多变量分析中，重症 CDI（sHR4.01，95% CI 1.77-9.08，pConclusions：甲硝唑单药治疗会增加SOT受者复发CDI的风险。在这种情况下应实施旨在降低复发风险的治疗策略。

{"title":"Recurrent Clostridioides difficile infections in solid organ transplant recipients: The international CALIPSO study","authors":"","doi":"10.1016/j.jinf.2024.106306","DOIUrl":"10.1016/j.jinf.2024.106306","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the risk of recurrent <em>Clostridioides difficile</em> infection (CDI) in solid-organ transplant (SOT) recipients.</div></div><div><h3>Methods</h3><div>Retrospective multicenter study including SOT recipients with a first CDI episode in the year after transplantation (Jan 2017-June 2020). The primary outcome measure was recurrence, defined as a new CDI ≤56 days from the first episode. A competing risk analysis was performed using the sub-distribution hazard model multivariable analysis.</div></div><div><h3>Results</h3><div>191 SOT recipients were included: 101 (52.9%) were kidney, 66 (34.6%) liver, 11 (5.8%) lung, 8 (4.2%) simultaneous pancreas-kidney, 4 (2.1%) heart and 1 (0.5%) pancreas alone recipients. Treatment for the first CDI were: vancomycin (n = 114,59.7%), vancomycin+metronidazole (n = 39,20.4%), metronidazole (n = 26,13.6%), fidaxomicin (n = 9,4.7%), 3 patients did not receive any therapy. After the first CDI, 17/191 (8.9%) patients died within 56-day mortality without having a recurrence, while 23/191 (12%) patients had a recurrence. Among patients with recurrent CDI, 56-day mortality rate was 30.4% (7/23 patients). On multivariable analysis, severe CDI (sHR4.01, 95% CI 1.77–9.08, p < .001) and metronidazole monotherapy (sHR 3.65, 95% CI 1.64–8.14, p = .001) were factors independently associated with recurrence.</div></div><div><h3>Conclusions</h3><div>Metronidazole monotherapy is associated with increased risk of recurrent CDI in SOT recipients. Therapeutic strategies aimed to reduce the risk of recurrence should be implemented in this setting.</div></div>","PeriodicalId":50180,"journal":{"name":"Journal of Infection","volume":null,"pages":null},"PeriodicalIF":14.3,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mpox Immune response elicited by MVA-BN vaccine over 12 months of follow-up 在 12 个月的随访中，MVA-BN 疫苗引起的 Mpox 免疫反应。

IF 14.3 1区医学 Q1 INFECTIOUS DISEASES

Journal of Infection

Pub Date : 2024-10-04 DOI: 10.1016/j.jinf.2024.106309

引用次数: 0

Expanding HIV-1 diversity in Russia: Novel circulating recombinant form between subtypes A6 and B (CRF147_A6B) 扩大俄罗斯 HIV-1 的多样性：A6 和 B 亚型之间的新型循环重组形式（CRF147_A6B）。

IF 14.3 1区医学 Q1 INFECTIOUS DISEASES

Journal of Infection

Pub Date : 2024-10-03 DOI: 10.1016/j.jinf.2024.106308

引用次数: 0

Relative contribution of hepatitis B and C viruses in primary liver cancer in China: A systematic review and meta-analysis 乙型肝炎病毒和丙型肝炎病毒在中国原发性肝癌中的相对作用：系统回顾和荟萃分析。

IF 14.3 1区医学 Q1 INFECTIOUS DISEASES

Journal of Infection

Pub Date : 2024-10-03 DOI: 10.1016/j.jinf.2024.106298

Objectives

China, which has the largest number of patients with primary liver cancer (PLCs), lacks data on the overall prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) in PLCs. We aimed to comprehensively assess the seroprevalence of HBV and HCV among PLCs in China.

Methods

We included and pooled observational studies reporting seroprevalence of HBsAg and anti-HCV antibodies among PLCs in China by searching PubMed, Web of Science, Cochrane, Scopus, Embase, CNKI, Wanfang, and CBM. Multivariate meta-regression and subgroup analyses were used to explore sources of heterogeneity, and publication bias was assessed by funnel plots and Egger's test. PROSPERO registration number is CRD42023450382.

Results

A total of 217 eligible studies were included in the meta-analysis. The estimated seroprevalence of HBV and HCV in PLCs was 75.09% (95% CI 73.12–77.02) and 11.82% (95% CI 9.79–14.00), respectively. After stratifying and analysing subgroups by region and study period, we found geographic differences in HBV and HCV prevalence among PLCs, with an overall increasing trend in the proportion of HBV and a decreasing trend in the proportion of HCV as well as co-infections in the last 40 years.

Conclusions

HBV and HCV infections still account for a high proportion of PLCs in China.

目的：中国是原发性肝癌（PLC）患者人数最多的国家：中国是原发性肝癌（PLC）患者人数最多的国家，但缺乏有关PLC中乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）总体流行率的数据。我们旨在全面评估中国原发性肝癌患者中 HBV 和 HCV 的血清流行率：通过检索 PubMed、Web of Science、Cochrane、Scopus、Embase、CNKI、万方和 CBM，我们纳入并汇总了报道中国 PLC 中 HBsAg 和抗 HCV 抗体血清流行率的观察性研究。采用多变量元回归和亚组分析探讨异质性的来源，并通过漏斗图和Egger检验评估发表偏倚。PROSPERO注册号为CRD42023450382：共有 217 项符合条件的研究被纳入荟萃分析。估计的 HBV 和 HCV 血清流行率分别为 75.09% (95% CI 73.12-77.02) 和 11.82% (95% CI 9.79-14.00)。按地区和研究时期进行分层和分组分析后，我们发现 PLC 中的 HBV 和 HCV 感染率存在地域差异，在过去 40 年中，HBV 感染率总体呈上升趋势，HCV 感染率和合并感染率呈下降趋势：结论：HBV 和 HCV 感染在中国 PLC 中仍占很高比例。

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引用次数: 0

Modelling multiplex testing for outbreak control 为控制疫情建立多重检测模型。

IF 14.3 1区医学 Q1 INFECTIOUS DISEASES

Journal of Infection

Pub Date : 2024-10-01 DOI: 10.1016/j.jinf.2024.106303

During the SARS-CoV-2 pandemic, polymerase chain reaction (PCR) and lateral flow device (LFD) tests were frequently deployed to detect the presence of SARS-CoV-2. Many of these tests were singleplex, and only tested for the presence of a single pathogen. Multiplex tests can test for the presence of several pathogens using only a single swab, which can allow for: surveillance of more pathogens, targeting of antiviral interventions, a reduced burden of testing, and lower costs. Test sensitivity, however, particularly in LFD tests, is highly conditional on the viral concentration dynamics of individuals. To inform the use of multiplex testing in outbreak detection it is therefore necessary to investigate the interactions between outbreak detection strategies and the differing viral concentration trajectories of key pathogens. Viral concentration trajectories are estimated for SARS-CoV-2 and Influenza A/B. Testing strategies for the first five symptomatic cases in an outbreak are then simulated and used to evaluate key performance indicators. Strategies that use a combination of multiplex LFD and PCR tests achieve; high levels of detection, detect outbreaks rapidly, and have the lowest burden of testing across multiple pathogens. Influenza B was estimated to have lower rates of detection due to its modelled viral concentration dynamics.

在 SARS-CoV-2 大流行期间，聚合酶链式反应（PCR）和侧流装置（LFD）测试经常被用来检测 SARS-CoV-2 的存在。其中许多检验是单倍检验，只能检测是否存在单一病原体。多重检测只需使用一个拭子就能检测是否存在多种病原体，这样就能监测更多的病原体，有针对性地采取抗病毒干预措施，减轻检测负担，降低检测成本。然而，检测灵敏度，尤其是低密度脂蛋白检测的灵敏度，在很大程度上取决于个体的病毒浓度动态。因此，为了给在疫情检测中使用多重检测提供信息，有必要研究疫情检测策略与主要病原体的不同病毒浓度轨迹之间的相互作用。对 SARS-CoV-2 和甲型/乙型流感的病毒浓度轨迹进行了估计。然后模拟疫情中前五个有症状病例的检测策略，并用于评估关键性能指标。结合使用多重 LFD 和 PCR 检测的策略可达到较高的检测水平，能迅速检测到疫情爆发，而且对多种病原体的检测负担最低。据估计，乙型流感的检出率较低，原因是其病毒浓度动态模型。数据可用性声明：SARS-CoV-2 病毒载量轨迹数据可通过联系 Killingley et al.甲型/乙型流感病毒载量轨迹可在 https://github.com/bcowling/pediatric-vaccine-trial/tree/master/data 上查阅。

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引用次数: 0

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