新冠多次感染的危害研究

來源: 欲千北於 2022-11-13 12:18:31 [檔案] [博客] [舊帖] [給我悄悄話] 本文已被閱讀：次 (3469 bytes)

link: https://www.nature.com/articles/s41591-022-02051-3 ，摘要，機器翻譯：

與 SARS-CoV-2 再感染相關的急性和急性後遺症
抽象的
首次感染嚴重急性呼吸係統綜合症冠狀病毒 2 (SARS-CoV-2) 與各種器官係統中急性和急性後死亡和後遺症的風險增加有關。再感染是否會增加首次感染後發生的風險尚不清楚。在這裏，我們使用美國退伍軍人事務部的國家醫療保健數據庫建立了一組感染 SARS-CoV-2 （n = 443,588）、再感染（兩次或更多感染，n = 40,947）和未感染對照（n = 5,334,729）。我們使用逆概率加權生存模型來估計死亡、住院和事故後遺症的風險和 6 個月負擔。與沒有再感染相比，再感染增加了死亡風險（風險比 (HR) = 2.17, 95% 置信區間 (CI) 1.93–2.45）、住院（HR = 3.32, 95% CI 3.13–3.51）和包括肺部在內的後遺症，心血管、血液、糖尿病、胃腸道、腎髒、心理健康、肌肉骨骼和神經係統疾病。無論疫苗接種狀態如何，風險都是顯而易見的。風險在急性期最為明顯，但在急性期後 6 個月持續存在。與未感染的對照組相比，重複感染的累積風險和負擔隨著感染次數的增加而增加。限製包括一組主要是白人男性。證據表明，再感染進一步增加了急性期和急性期多器官係統死亡、住院和後遺症的風險。減少因 SARS-CoV-2 導致的總體死亡和疾病負擔將需要采取預防再感染的策略。

Acute and postacute sequelae associated with SARS-CoV-2 reinfection
Abstract
First infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with increased risk of acute and postacute death and sequelae in various organ systems. Whether reinfection adds to risks incurred after first infection is unclear. Here we used the US Department of Veterans Affairs’ national healthcare database to build a cohort of individuals with one SARS-CoV-2 infection (n = 443,588), reinfection (two or more infections, n = 40,947) and a noninfected control (n = 5,334,729). We used inverse probability-weighted survival models to estimate risks and 6-month burdens of death, hospitalization and incident sequelae. Compared to no reinfection, reinfection contributed additional risks of death (hazard ratio (HR) = 2.17, 95% confidence intervals (CI) 1.93–2.45), hospitalization (HR = 3.32, 95% CI 3.13–3.51) and sequelae including pulmonary, cardiovascular, hematological, diabetes, gastrointestinal, kidney, mental health, musculoskeletal and neurological disorders. The risks were evident regardless of vaccination status. The risks were most pronounced in the acute phase but persisted in the postacute phase at 6 months. Compared to noninfected controls, cumulative risks and burdens of repeat infection increased according to the number of infections. Limitations included a cohort of mostly white males. The evidence shows that reinfection further increases risks of death, hospitalization and sequelae in multiple organ systems in the acute and postacute phase. Reducing overall burden of death and disease due to SARS-CoV-2 will require strategies for reinfection prevention.