关注的COVID-19变种的临床严重性:基于人口的回顾性分析
Sean P Harrigan1,2, Héctor A Velásquez García2, Younathan Abdia2
1BC Centre for Disease Control, Vancouver, BC, Canada.
JMIR public health and surveillance
|August 27, 2024
概括
与其他令人担忧的变种相比,SARS-CoV-2的Delta变种造成了最严重的COVID-19结果,包括住院治疗和死亡. 健康和疫苗接种状况的社会决定因素在不同变异中显著影响了疾病严重程度.
科学领域:
- 流行病学 流行病学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 引起关注的SARS-CoV-2变种 (VOCs) 在全球迅速传播,增加了感染和死亡率.
- 有限的回顾性研究存在于考虑公共卫生措施和健康的社会决定因素 (SDOHs) 的VOC严重性.
研究的目的:
- 以回顾评估COVID-19 VOCs的临床严重程度.
- 分析与各种SDOH和疫苗接种推广有关的严重程度.
主要方法:
- 基于人口的回顾性队列设计,使用不列颠哥伦比亚省COVID-19队列数据.
- 反向概率治疗加权考克斯比例危险建模,以比较VOC严重程度 (阿尔法,马,三角形,欧米克朗).
- 对未接种疫苗的个体进行次分析,以评估变异严重程度和SDOH影响.
主要成果:
- 与阿尔法相比,Delta感染的严重程度 (住院,ICU入院,死亡) 是最高的 (aHR分别为2.00,2.05,3.70).
- 严重程度的顺序通常遵循Delta>Gamma>Omicron/Alpha.
- 与接种疫苗相比,未接种Delta/Omicron疫苗的个人住院率是接种疫苗的两倍.
- 低收入地区在所有VOC中显示出更高的住院率;种族化群体显示出对Alpha/Gamma的差异性住院率.
结论:
- 与Alpha相比,Delta是最严重的VOC,其次是Gamma,Omicron和Alpha,相对于Alpha.
- 强调需要针对新出现的变种及其严重程度进行有针对性的监测.
- 强调疫苗接种和解决SDOHs的关键作用,以确保疫情防控和公平的资源分配.
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