| 岳勇,梁娴,毛毅,胡敏,韩德琳,速丽媛,陈恒,范双凤,张晓春,杨非,袁齐武,刘竹.新型冠状病毒疫苗接种对成都市境外输入病例流行病学及临床特征的影响分析[J].中华流行病学杂志,2021,42(8):1365-1370 |
| 新型冠状病毒疫苗接种对成都市境外输入病例流行病学及临床特征的影响分析 |
| Influence of SARS-CoV-2 vaccination on the epidemiological and clinical characteristics of imported COVID-19 cases in Chengdu |
| 收稿日期:2021-03-30 出版日期:2021-08-19 |
| DOI：10.3760/cma.j.cn112338-20210330-00261 |
| 中文关键词: 新型冠状病毒肺炎 新型冠状病毒 疫苗接种 接种后感染 |
| 英文关键词: COVID-19 SARS-CoV-2 Vaccination Infection after vaccination |
| 基金项目:中国医学科学院中央级公益性科研院所基本科研业务费专项（2020-PT330-005）；成都市科技局重点研发支撑计划技术创新研发项目（2020-YF05-00133-SN） |
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| 中文摘要: |
| 目的 分析新型冠状病毒（新冠病毒）疫苗接种对成都市境外输入病例流行病学及临床特征的影响，为新型冠状病毒肺炎疫情防控提供参考依据。方法 截至2021年4月15日，经成都市入境的新冠病毒感染病例，根据新冠病毒疫苗接种史被分为疫苗接种组和疫苗未接种组。回顾性收集和分析病例的流行病学及临床特征资料。实验室检测项目包括新冠病毒核酸检测、临床指标、血清抗体和淋巴细胞检测。采用WPS 2019软件整理数据，采用R 4.0.3软件进行统计学分析。结果 75例新冠病毒感染病例包括疫苗接种组20例（出现临床症状4例）和疫苗未接种组55例（出现临床症状16例）。疫苗接种组的首针接种时间分布为2020年7-11月，其中接种2剂次疫苗采用一次性接种方式有10例，采取2次间隔接种方式有10例，2次接种间隔14~57 d，完成疫苗接种与发病时间间隔87~224 d。两组病例的分类和临床分型的差异有统计学意义（P<0.05），其中，疫苗接种组病例分类为无症状感染者的比例较高（40.00%，8/20），而疫苗未接种组的临床分型以普通型的比例较高（76.36%，42/55）。两组病例的新冠病毒核酸检测2个靶标（ORF1ab和N基因）Ct值、淋巴细胞亚型、降钙素原及C反应蛋白的差异无统计学意义（P>0.05），疫苗接种组的血清淀粉样蛋白A水平低于疫苗未接种组（P<0.05），但新冠病毒血清抗体IgM、IgG及总抗体水平均明显高于疫苗未接种组（P<0.05）。结论 新冠病毒疫苗接种后，仍存在感染的风险，但新冠病毒侵入人体后，体内可迅速产生特异性IgM和IgG抗体，对感染者产生一定保护作用，已接种新冠病毒疫苗的病例分类以无症状感染者为主。 |
| 英文摘要: |
| Objective To analyze the epidemiological and clinical characteristics of imported COVID-19 cases after SARS-CoV-2 vaccination and to provide evidence for the prevention and control of COVID-19. Methods The imported COVID-19 cases in Chengdu as of April 15, 2021 were divided into the vaccinated group and unvaccinated group according to the history of SARS-CoV-2 vaccination. The epidemiological and clinical data of the cases were collected retrospectively, and the differences in epidemiological and clinical characteristics of the two groups were compared. Laboratory tests consisted of nucleic acid test, clinical index test, serum antibody test and lymphocyte test. Software WPS2019 was used for data management and software R 4.0.3 was used for statistical analysis. Results A total of 75 COVID-19 cases were included in the analysis, in which 20 had received SARS-CoV-2 vaccination and only 4 with clinical symptoms, 55 patients did not receive SARS-CoV-2 vaccination, and 16 had clinical symptoms. In vaccinated group, the first injection time of vaccination ranged from July to November 2020, and 10 cases received two doses of vaccine simultaneously and 10 cases received two doses of vaccine at intervals of 14-57 days. The intervals between the completion of vaccination and the onset ranged from 87 days to 224 days. The differences in classification and clinical type between the two groups were significant. Significant differences were observed in case classification and clinical type between vaccinated group and unvaccinated group (P<0.05). The vaccinated group had a relatively high proportion of asymptomatic infections (40.00%, 8/20), while mild infections were mainly observed in the unvaccinated group(76.36%,42/55). The differences in Ct values (ORF1ab gene and N gene) at the diagnosis were not significant between vaccinated group and unvaccinated group (P>0.05), similar results were also observed in lymphocyte subtypes, procalcitonin and C-reactive protein level comparisons. Serum amyloid A level was higher in unvaccinated group than in vaccinated group (P<0.05). However, the SARS-CoV-2 related serum antibody of IgM, IgG and total antibody levels were significantly higher in vaccinated group (P<0.05). Conclusions Risk of infection still exists with SARS-CoV-2 after vaccination, which can facilitate the production of specific serum antibody of IgM and IgG when people are exposed to the virus. It has a certain protective effect on SARS-CoV-2 infected persons. Vaccination can reduce the clinical symptoms and mitigate disease severity. |
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