基于2023年深圳市一起校园新型冠状病毒XBB株暴发疫情分析混合免疫与再次感染的关系  

Analysis on the relationship of hybrid immunity and reinfection based on a school outbreak of SARS-CoV-2 omicron XBB variants in Shenzhen 2023

作　　者：李雪梅[1] 林凯[1] 刘雅文 徐震东 黄仁湛 张陈欢 龚泽龙 肖娜[1] 洪文腾 LI Xuemei;LIN Kai;LIU Yawen;XU Zhendong;HUANG Renzhan;ZHANG Chenhuan;GONG Zelong;XIAO Na;HONG Wenteng(Yantian District Center for Disease Control and Prevention,Shenzhen 518000,Guangdong Province,China)

机构地区：[1]深圳市盐田区疾病预防控制中心,广东深圳518000

出　　处：《预防医学情报杂志》2024年第9期1062-1067,共6页Journal of Preventive Medicine Information

摘　　要：目的评估新型冠状病毒(以下简称“新冠病毒”)首次感染和疫苗接种产生的混合免疫对预防再次感染的保护效果,为应对下一波流行高峰提供参考。方法运用现场流行病学按照回顾性队列研究方法对2023年深圳市1起校园新冠病毒感染疫情进行调查,计数资料采用频数、构成比描述,组间率的比较采用χ^(2)或Fisher精确检验,采用非条件Logistic回归分析探讨混合免疫对新冠病毒再次感染的保护效果,以P<0.05为差异有统计学意义。结果本起疫情基因测序结果为新冠病毒XBB.1.9.1株。共持续10 d,累计报告个案28例,均为某班学生,罹患率46.67%。核心、一般密接的感染率分别为72.22%、35.71%,差异有统计学意义(χ^(2)=5.36,P=0.021)。本起疫情的病例中,再次、首次感染者占比分别为85.71%和14.29%。再次感染者在再次感染时以咽痛(54.17%)等局部上呼吸道感染症状为主,发热(12.50%)等全身中毒症状轻,首次感染时以发热为主(83.33%)。免疫情况方面,完成全程基础免疫90.00%,有既往新冠病毒感染史88.33%,混合免疫组、非混合免疫组此次感染率为43.14%和66.67%,差异无统计意义(Fisher精确检验P>0.05)。Logistic回归分析校正接触程度后,非混合免疫组发病风险是混合免疫组的5.33倍(95%CI:1.10~25.99),混合免疫预防再感染的保护效果35.29%。结论新冠病毒再次感染症状较首次感染轻,从自然感染恢复和通过接种疫苗获得的混合免疫可有效预防新冠病毒再次感染,建议各学校保持呼吸道症状监测系统的敏感性,早发现早报告,降低疫情暴发风险,提高学生新冠免疫力,鼓励有既往感染史的学生接种新冠病毒疫苗加强针。Objective This study aimed to analyze the characteristics of a school outbreak SARS-CoV-2 Omicron XBB variants in Shenzhen,to evaluate the effectiveness of hybrid immunity resulting from the first wave of COVID-19 infection and vaccination against reinfection,and to provide response strategy for the next wave of the epidemic.Methods Field epidemiology method were used to investigate and control the COVID-19 outbreak in a school.Counting data was described by frequency and component ratio,the rates between groups were compared by usingχ^(2)or Fisher exact tests.The protective effect of hybrid immunity and COVID-19 reinfection was analyzed by using unconditional logistic regression analysis,the difference P<0.05 was considered statistically significant.Results The XBB.1.9.1 strain identified by genetic sequencing.The outbreak lasted for 10 days,with a total of 28 cases reported among students in a class,the incidence rate was 46.67%.The infection rates for close contacts and general contacts were 72.22%and 35.71%,respectively,the difference was considered statistically significant(χ^(2)=5.36,P=0.021).Among cases,85.71%were reinfections and 14.29%were first infections.Symptoms of reinfection were mainly upper respiratory tract infections like sore throat(54.17%).Symptoms of systemic poisoning such as fever were mild in reinfection(12.50%),the symptom of first infection was mainly fever(83.33%).In terms of immunization status,90.00%of the whole basic immunization was fully vaccinated.Additionally,88.33%had a history of previous COVID-19 infection.The infection rates in the hybrid immunity group and non-hybrid immunity group during this outbreak were 43.13%and 66.67%,respectively,the difference was no statistically significant(Fisher′s exact test P>0.05).After adjusting for contact intensity,the non-hybrid immunity group had a higher risk of infection compared to the hybrid immunity group(OR=5.333,95%CI:1.10-25.99),with an protective effectiveness rate of 35.29%against reinfection in the hybrid immunity group.Conc

关 键 词：新型冠状病毒感染 再次感染 混合免疫 奥密克戎变异株 免疫保护效果 

分 类 号：R511[医药卫生—内科学]