社区自然人群新型冠状病毒低水平中和抗体情况及其相关因素分析

Seroprevalence and influencing factors of low-level neutralizing antibodies against SARS-CoV-2 in community residents

  • 摘要:
    目的 了解社区自然人群新型冠状病毒(简称“新冠病毒”)中和抗体阳性率及低水平中和抗体情况,探讨新冠病毒疫苗接种和新冠病毒感染对于人群血清中和抗体水平的影响。
    方法 基于上海市社区自然人群急性传染病监测队列,采用比例分层抽样方法,按0~14、15~24、25~59岁和60岁及以上4个年龄段各20%比例纳入研究对象,在2023年3—4月期间开展血液标本采集和血清新冠病毒中和抗体浓度检测,中和抗体浓度低于第25百分位数判定为低水平中和抗体。
    结果 共纳入2 230例研究对象,中和抗体阳性率为97.58%,低水平中和抗体比例为25.02%(558/2 230)。多因素logistic回归分析显示年龄、感染次数和疫苗接种状态与低水平中和抗体状态相关联(均P<0.05)。60岁及以上人群低水平中和抗体占比最高。加强免疫和一次感染交互作用具有统计学意义(aOR=0.38,95%CI:0.19~0.77)。与未接种相比,曾感染过一次新冠病毒的人群中基础免疫(aOR=0.23,95%CI:0.16~0.35)、加强免疫(aOR=0.12,95%CI:0.08~0.17)与低水平中和抗体负相关;无感染人群中,仅加强免疫(aOR=0.28,95%CI:0.14~0.52)有关联。
    结论 60岁及以上老年人群低水平中和抗体风险最高。无论是否有既往感染,加强免疫可降低出现低水平中和抗体的风险,建议符合接种条件的人群,尤其是老年人群应及时接种疫苗,发挥中和抗体的保护作用。

     

    Abstract:
    Objective To understand the seropositivity of neutralizing antibodies (NAb) and low-level NAb against SARS-CoV-2 infection in the community residents, and to explore the impact of COVID-19 vaccination and SARS-CoV-2 infection on the levels of NAb in human serum.
    Methods On the ground of surveillance cohort for acute infectious diseases in community populations in Shanghai, a proportional stratified sampling method was used to enroll the subjects at a 20% proportion for each age group (0‒14, 15‒24, 25‒59, and ≥60 years old). Blood samples collection and serum SARS-CoV-2 NAb concentration testing were conducted from March to April 2023. Low-level NAb were defined as below the 25th percentile of NAb.
    Results A total of 2 230 participants were included, the positive rate of NAb was 97.58%, and the proportion of low-level NAb was 25.02% (558/2 230). Multivariate logistic regression analysis indicated that age, infection history and vaccination status were correlated with low-level NAb (all P<0.05). Individuals aged 60 years and above had the highest risk of low-level NAb. There was a statistically significant interaction between booster vaccination and one single infection (aOR=0.38, 95%CI: 0.19‒0.77). Compared to individuals without vaccination, among individuals infected with SARS-CoV-2 once, both primary immunization (aOR=0.23, 95%CI: 0.16‒0.35) and booster immunization (aOR=0.12, 95%CI: 0.08‒0.17) significantly reduced the risk of low-level NAb; among individuals without infections, only booster immunization (aOR=0.28, 95%CI: 0.14‒0.52) showed a negative correlation with the risk of low-level NAb.
    Conclusions The population aged 60 and above had the highest risk of low-level NAb. Regardless of infection history, a booster immunization could reduce the risk of low-level NAb. It is recommended that eligible individuals, especially the elderly, should get vaccinated in a timely manner to exert the protective role of NAb.

     

/

返回文章
返回