澳大利亚维多利亚州按年龄和疫苗接种状况划分的 COVID-19 病例确定率差异:血清监测和记录关联研究。

Q3 Medicine
Joshua Szanyi, David J Price, Kylie S Carville, Mitch Batty, Sarah Yallop, Suellen Nicholson, Theo Karapanagiotidis, Stacey Rowe, Sheena Sullivan, Vinay Menon, Daniel West, Lakshmi Manoharan, Eliza Copsey, Suman S Majumdar, Brett Sutton, Deborah A Williamson, Jodie McVernon
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引用次数: 0

摘要

目的比较澳大利亚维多利亚州严重急性呼吸系统综合征冠状病毒2(SARS-CoV-2)既往感染的血清学证据与2019年冠状病毒疾病(COVID-19)病例通报数据,并根据既往感染和疫苗接种史确定体外SARS-CoV-2中和活性:在 2022 年 6 月 30 日至 10 月 31 日期间(Omicron BA.4/BA.5 优势期),利用从维多利亚传染病参考实验室获得的 1,974 份残留血清样本进行了四次横断面血清学调查。血清学结果与 COVID-19 病例通报和疫苗接种数据相关联。进行替代病毒中和试验,以获得抗核头壳血清状态和 COVID-19 疫苗接种史的体外抑制估算值:按性别、年龄和居住地区调整的抗 SARS-CoV-2 穗状病毒和核头状病毒血清阳性率;按抗核头状病毒血清状态、年龄和接种 COVID-19 疫苗的剂量调整的病例通报比例;按抗核头状病毒血清状态和 COVID-19 疫苗接种史调整的对野生型和 Omicron BA.4/BA.5 SARS-CoV-2 变体的体外抑制百分比:结果:抗SARS-CoV-2核头抗体的流行率与年龄成反比。2022 年 10 月,18-29 岁人群的感染率为 84%(95% 置信区间 [95%CI]:75-93%),而≥80 岁人群的感染率为 39%(95% CI:27-52%)。在大多数年龄组中,约 40% 的 COVID-19 病例似乎是通过现有监测机制通报的。病例通报率最高的人群是 80 岁以上的老人和接种过 COVID-19 疫苗加强剂的人。体外中和 Omicron BA.4/BA.5 亚变异体的比例在有证据表明曾感染和接种过加强疫苗的人群中最高:结论:维多利亚州人口中 SARS-CoV-2 感染的通知不足现象在不同年龄和接种疫苗的阶层中并不一致。血清流行率数据有助于深入了解病例通报行为,为解读现有的 COVID-19 监测信息提供了更多的背景资料。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Differential COVID-19 case ascertainment by age and vaccination status in Victoria, Australia: a serosurveillance and record linkage study.

Objectives: To compare serological evidence of prior severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with linked coronavirus disease 2019 (COVID-19) case notification data in Victoria, Australia, and to determine in vitro SARS-CoV-2 neutralisation activity based on prior infection and vaccination history.

Design, setting, participants: Four cross-sectional serological surveys were conducted between 30 June and 31 October 2022 (a period of Omicron BA.4/BA.5 dominance) using 1,974 residual serum samples obtained from the Victorian Infectious Diseases Reference Laboratory. Serological results were linked to COVID-19 case notification and vaccination data. Surrogate virus neutralisation testing was performed to obtain in vitro inhibition estimates by anti-nucleocapsid serostatus and COVID-19 vaccination history.

Main outcome measures: Adjusted anti-SARS-CoV-2 spike and nucleocapsid seropositivity by sex, age and region of residence; adjusted proportion of cases notified by anti-nucleocapsid serostatus, age and number of COVID-19 vaccination doses received; adjusted percentage in vitro inhibition against wildtype and Omicron BA.4/BA.5 SARS-CoV-2 variants by anti-nucleocapsid serostatus and COVID-19 vaccination history.

Results: The prevalence of anti-SARS-CoV-2 nucleocapsid antibodies was inversely proportional to age. In October 2022, prevalence was 84% (95% confidence interval [95% CI]: 75-93%) among 18-29-year-olds, compared to 39% (95% CI: 27-52%) among ≥ 80-year-olds. In most age groups, approximately 40% of COVID-19 cases appear to have been notified via existing surveillance mechanisms. Case notification was highest among individuals older than 80 years and people who had received COVID-19 vaccine booster doses. In vitro neutralisation of Omicron BA.4/BA.5 sub-variants was highest for individuals with evidence of both prior infection and booster vaccination.

Conclusions: Under-notification of SARS-CoV-2 infections in the Victorian population is not uniform across age and vaccination strata. Seroprevalence data that give insights into case notification behaviour provide additional context for the interpretation of existing COVID-19 surveillance information.

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