成都市新冠病毒既往感染者重复感染Omicron变异株情况分析

戴映雪; 王瑶; 杜训波; 严可; 张双; 刘辉; 范双凤; 王亮

doi:10.11847/zgggws1141316

成都市新冠病毒既往感染者重复感染Omicron变异株情况分析

doi: 10.11847/zgggws1141316

成都市疾病预防控制中心，成都 610041

基金项目: 成都市科技重点研发支持计划重大及应用示范项目（2021 – YF09 – 00061 – SN）

详细信息

作者简介:
戴映雪（1989 – ），女，重庆人，副主任医师，硕士，主要从事传染病预防控制工作

通讯作者:
王亮，E-mail：363686849@qq.com

中图分类号: R 511
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出版历程
- 接收日期: 2023-01-16
- 网络出版日期: 2023-02-03
- 刊出日期: 2023-04-10

Characteristics of Omicron variant-induced SARS-CoV-2 reinfections in Chengdu, China

Chengdu Municipal Center for Disease Control and Prevention, Chengdu, Sichuan Province 610041, China

摘要

摘要: 目的了解新冠病毒既往感染者重复感染Omicron变异株情况，为新冠病毒重复感染防控策略提供参考。方法以2022年2 — 9月成都市5轮本土疫情涉及的2567例感染者为调查对象，于2022年12月18 — 22日进行电话随访调查，内容主要包括感染者基本人口学特征、近1个月内核酸及抗原检测情况、临床表现等。通过四川省免疫规划信息管理系统查询感染者新冠病毒疫苗接种情况。采用SPSS 19.0统计软件进行不同特征人群重复感染率分析。结果 2263例既往感染者完成调查，应答率为88.16%。男性占44.68%，女性占55.32%；年龄最小1月龄，最大90岁，平均年龄（34.88 ± 19.22）岁；初次感染以轻型病例（61.82%）和无症状感染者（31.64%）居多。接种3剂次疫苗者占55.86%，接种2剂次疫苗者占29.56%，初次感染毒株主要为Omicron BA.2分支（98.89%），2022年11 — 12月高峰感染疫情之前未报告新冠病毒重复感染者。在流行毒株为BA.5.2高峰感染疫情中重复感染197例，重复感染率为8.71%，时间间隔M（P₂₅～P₇₅）为98（93～104）d；其中193例（97.97%）自报有临床症状，主要包括发热、咽痛、头痛等；113例（57.36%）未就诊自行用药。未接种疫苗者重复感染率均高于接种2或3剂者（P = 0.006）。结论奥密克戎变异株的重复感染率整体较低，但重复感染者中临床症状明显，由于检测机会的的减少重复感染有可能被低估，建议扩大研究覆盖面，同时进一步加强人群免疫接种和新冠病毒感染疫情防控健康教育。
- 新型冠状病毒 /
- Omicron变异株 /
- 重复感染
Abstract: Objective To explore the characteristics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfections caused by Omicron variant for providing a reference to the containment of SARS-CoV-2 reinfection. Methods From China Information System for Disease Control and Prevention, we extracted 2 567 registered cases of 5 local coronavirus disease 2019 (COVID-19) epidemics in Chengdu city from February to September, 2022. Telephone follow-up surveys were conducted among the cases and their family members to collect the information on demographic characteristics, clinical symptoms, and viral nucleic acid or antigen tests in previous one month. The information on participants' COVID-19 vaccination were extracted from Immunization Program Information Management System of Sichuan Province. Data analyses were performed with SPSS 19.0. Results For the 2 263 eligible respondents (88.16% of all the participants), 44.68% were male and 55.32% were female; the ages of the respondents ranged from one month to 90 years, with the mean age of 34.88 ± 19.22 years; the majority (61.82%) of the respondents were mild cases and 31.64% were asymptomatic cases; 55.86% and 29.56% of the respondents reported having been vaccinated with 3 and 2 doses of COVID-19 vaccine. Based on genome sequencing on virus strains isolated from the cases of the 5 local epidemics, the most (98.89%) of the sufferers of the 5 epidemics were infected with Omicron subvariant BA.2. Among all the eligible respondents, 197 (8.71%) reported COVID-19 reinfection appearing during November – December, 2022 – an epidemic period with Omicron subvariant BA.5.2 being the most prevalent strain in local region and there was no reinfection case being reported before the period, and the self-reported median interval from previous infection to the reinfection was 98 (25th percentile: 93, 75th percentile: 104) days. For the 197 reinfections, 193 (97.97%) reported clinic symptoms including fever, throat ache and headache; 113 (57.36%) reported only having self-medication; more reinfections were reported by the respondents without COVID-19 vaccination compared to the respondents with 3 or 2 doses of COVID-19 vaccine. Conclusion The survey results suggest that Omicron variant-related SARS-CoV-2 reinfection is relatively low but the most of the reinfections are symptomatic. More researches and control measures on are needed for the control of SARS-CoV-2 reinfection.
- COVID-19 virus /
- Omicron variant /
- reinfection

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表 1 2022年2 — 9月成都市5轮新冠病毒感染者完成电话随访情况

疫情	流行毒株	感染例数	完成随访例数	应答率（%）
第一轮	BA.2进化分支	38	26	68.42
第二轮	BA.2.2和BA.1.1	51	30	58.82
第三轮	BA.2.12.1	76	63	82.89
第四轮	BA.2.38	207	163	78.74
第五轮	BA.2.76	2195	1981	90.25

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表 2 2263例既往新冠病毒感染者基本情况

项目		人数	构成比（%）
性别	男	1011	44.68
	女	1252	55.32
年龄（岁）	0～5	108	4.77
	6～7	381	16.84
	18～59	1550	68.49
	60～79	197	8.71
	≥ 80	27	1.19
职业	医务人员	48	2.12
	学生及幼托儿童	516	22.80
	其他 ^a	1699	75.08
初次感染时间（月份）	2 — 4	56	2.47
	7	215	9.50
	8	786	34.73
	9	1206	53.29
初次感染临床分型	无症状	716	31.64
	轻型	1399	61.82
	普通型	143	6.32
	重型	5	0.22
初次感染毒株测序	BA.2进化分支	26	1.15
	BA.2.2	5	0.22
	BA.1.1	25	1.11
	BA.2.12.1	63	2.78
	BA.2.38	163	7.20
	BA.2.76	1 981	87.54
新冠病毒疫苗接种剂次	从未接种	261	11.53
	1剂	69	3.05
	2剂	669	29.56
	3剂	1264	55.86
最近6个月接种新冠病毒疫苗	无	2225	98.32
	有	38	1.68
注：a 包括机关、企事业单位人员、家务及待业、农民、商业服务等多类人群。

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表 3 不同人口学特征、不同初次感染情况既往感染者重复感染率比较

项目		重复感染		重复感染率（%）	χ² 值	P 值
项目		否	是	重复感染率（%）	χ² 值	P 值
性别	男	921	90	8.90	0.09	0.765
	女	1145	107	8.54
年龄（岁）	0～5	100	8	7.41		0.827 ^a
	6～7	345	36	9.45
	18～59	1412	138	8.9
	60～79	183	14	7.11
	≥ 80	26	1	3.7
职业	医务人员	42	6	12.5	0.96	0.619
	学生及幼托儿童	473	43	8.33
	其他 ^b	1551	148	8.71
初次感染时间（月份）	2 — 4	54	2	3.57		< 0.001 ^a
	7	196	19	8.84
	8	683	103	13.1
	9	1133	73	6.05
初次感染临床分型	无症状	657	59	8.24		0.858 ^a
	轻型	1275	124	8.86
	普通型	129	14	9.79
	重型	5	0	0.00
初次感染毒株测序	BA.2其他分支 ^c	93	1	1.08		0.006 ^a
	BA.2.38	143	20	12.27
	BA.2.76	1 806	175	8.83
	BA.1.1	24	1	4.00
注：a 为Fisher精确检验；b包括机关、企事业单位人员、家务及待业、农民、商业服务等人群；c包括BA.2进化分支、BA.2.12.1、BA.2.2。

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表 4 不同新冠病毒疫苗接种情况重复感染率比较

疫苗接种情况		重复感染		重复感染率（%）	χ² 值	P 值
疫苗接种情况		否	是	重复感染率（%）	χ² 值	P 值
新冠病毒疫苗接种剂次	未接种	225	36	13.80	12.11	0.007
	1剂	67	2	2.89
	2剂	616	53	7.92
	3剂	1158	106	8.39
最近6个月接种新冠病毒疫苗	无	2 031	194	8.72		1.000 ^a
	有	35	3	7.90
初次感染后接种新冠病毒疫苗	无	1 820	159	8.03		0.707 ^a
	有	21	2	8.70
注：a为fisher精确检验。

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