英国约翰·雷德克利夫医院David W. Eyre团队研究了医务人员SARS-CoV-2抗体状况及感染率。2020年12月23日，该研究发表在《新英格兰医学杂志》上。

SARS-CoV-2抗体的存在与后续再感染风险之间的关系尚不清楚。

研究组调查了在英国牛津大学医院接受无症状和有症状人员检测的血清阳性和血清阴性医护人员中，通过聚合酶链反应（PCR）确诊SARS-CoV-2感染的发生率。通过抗刺突（初步分析）和抗核衣壳IgG检测来确定基线抗体状态，并对工作人员进行长达31周的随访，来估算PCR阳性检测结果和新症状性感染的相对发生率。

共有12541名医护人员参加，并进行了抗刺突IgG的检测。11364名在抗体结果阴性后接受随访，1265名在抗体阳性结果后接受随访，其中88例在随访期间发生了血清转化。共有223名抗刺突血清阴性健康护理人员的PCR检测为阳性，其中筛选时无症状者为100例，有症状者为123例；而两名抗刺突血清阳性的医护人员PCR检测结果呈阳性，在接受检测时均无症状。带有抗刺突抗体的工作者未发生症状性感染。单独使用抗核衣壳IgG分析或与抗刺突IgG分析结合使用以确定基线状态时，结果相差不大。

研究结果表明，在接下来的6个月中，抗刺突或抗核衣壳IgG抗体的存在与SARS-CoV-2再次感染的风险大大降低有关。

附：英文原文

Title: Antibody Status and Incidence of SARS-CoV-2 Infection in Health Care Workers

Author: Sheila F. Lumley, B.M., B.Ch.,, Denise O’Donnell, B.Sc.,, Nicole E. Stoesser, M.B., B.S., D.Phil.,, Philippa C. Matthews, F.R.C.P., D.Phil.,, Alison Howarth, Ph.D.,, Stephanie B. Hatch, Ph.D.,, Brian D. Marsden, D.Phil.,, Stuart Cox,, Tim James, Ph.D.,, Fiona Warren, B.Sc.,, Liam J. Peck, D.Phil.,, Thomas G. Ritter, B.A.,, Zoe de Toledo, M.Sc.,, Laura Warren,, David Axten, B.A.,, Richard J. Cornall, M.D., D.Phil.,, E. Yvonne Jones, D.Phil.,, David I. Stuart, Ph.D.,, Gavin Screaton, B.M., B.Ch., D.Phil.,, Daniel Ebner, B.Sc.,, Sarah Hoosdally, Ph.D.,, Meera Chand, M.B., B.S.,, Derrick W. Crook, F.R.C.Path.,, Anne-Marie O’Donnell, M.B., B.S.,, Christopher P. Conlon, M.D.,, Koen B. Pouwels, Ph.D.,, A. Sarah Walker, Ph.D.,, Tim E.A. Peto, F.R.C.P.,, Susan Hopkins, F.R.C.P.,, Timothy M. Walker, M.B., B.S., D.Phil.,, Katie Jeffery, F.R.C.Path., Ph.D.,, and David W. Eyre, B.M., B.Ch., D.Phil.

Issue&Volume: 2020-12-23

Abstract:

BACKGROUND

The relationship between the presence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the risk of subsequent reinfection remains unclear.

METHODS

We investigated the incidence of SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR) in seropositive and seronegative health care workers attending testing of asymptomatic and symptomatic staff at Oxford University Hospitals in the United Kingdom. Baseline antibody status was determined by anti-spike (primary analysis) and anti-nucleocapsid IgG assays, and staff members were followed for up to 31 weeks. We estimated the relative incidence of PCR-positive test results and new symptomatic infection according to antibody status, adjusting for age, participant-reported gender, and changes in incidence over time.

RESULTS

A total of 12,541 health care workers participated and had anti-spike IgG measured; 11,364 were followed up after negative antibody results and 1265 after positive results, including 88 in whom seroconversion occurred during follow-up. A total of 223 anti-spike–seronegative health care workers had a positive PCR test (1.09 per 10,000 days at risk), 100 during screening while they were asymptomatic and 123 while symptomatic, whereas 2 anti-spike–seropositive health care workers had a positive PCR test (0.13 per 10,000 days at risk), and both workers were asymptomatic when tested (adjusted incidence rate ratio, 0.11; 95% confidence interval, 0.03 to 0.44; P=0.002). There were no symptomatic infections in workers with anti-spike antibodies. Rate ratios were similar when the anti-nucleocapsid IgG assay was used alone or in combination with the anti-spike IgG assay to determine baseline status.

CONCLUSIONS

The presence of anti-spike or anti-nucleocapsid IgG antibodies was associated with a substantially reduced risk of SARS-CoV-2 reinfection in the ensuing 6 months.

DOI: 10.1056/NEJMoa2034545

Source: https://www.nejm.org/doi/full/10.1056/NEJMoa2034545