Clinical Spectrum of Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Protection From Symptomatic Reinfection.

Autor:	Maier HE; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA., Kuan G; Sustainable Sciences Institute, Managua, Nicaragua.; Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua., Saborio S; Sustainable Sciences Institute, Managua, Nicaragua.; Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua., Carrillo FAB; Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, California, USA., Plazaola M; Sustainable Sciences Institute, Managua, Nicaragua., Barilla C; Sustainable Sciences Institute, Managua, Nicaragua., Sanchez N; Sustainable Sciences Institute, Managua, Nicaragua., Lopez R; Sustainable Sciences Institute, Managua, Nicaragua.; Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua., Smith M; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA., Kubale J; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA., Ojeda S; Sustainable Sciences Institute, Managua, Nicaragua.; Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua., Zuniga-Moya JC; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA., Carlson B; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA., Lopez B; Sustainable Sciences Institute, Managua, Nicaragua., Gajewski AM; Sustainable Sciences Institute, Managua, Nicaragua., Chowdhury M; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA., Harris E; Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, California, USA., Balmaseda A; Sustainable Sciences Institute, Managua, Nicaragua.; Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua., Gordon A; Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
Jazyk:	angličtina
Zdroj:	Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2022 Aug 24; Vol. 75 (1), pp. e257-e266.
DOI:	10.1093/cid/ciab717
Abstrakt:	Background: There are few data on the full spectrum of disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection across the lifespan from community-based or nonclinical settings. Methods: We followed 2338 people in Managua, Nicaragua, aged <94 years from March 2020 through March 2021. SARS-CoV-2 infection was identified through real-time reverse transcription polymerase chain reaction (RT-PCR) or through enzyme-linked immunosorbent assay. Disease presentation was assessed at the time of infection or retrospectively by survey at the time of blood collection. Results: There was a large epidemic that peaked between March and August 2020. In total, 129 RT-PCR-positive infections were detected, for an overall incidence rate of 5.3 infections per 100 person-years (95% confidence interval [CI], 4.4-6.3). Seroprevalence was 56.7% (95% CI, 53.5%-60.1%) and was consistent from age 11 through adulthood but was lower in children aged ≤10 years. Overall, 31.0% of the infections were symptomatic, with 54.7% mild, 41.6% moderate, and 3.7% severe. There were 2 deaths that were likely due to SARS-CoV-2 infection, yielding an infection fatality rate of 0.2%. Antibody titers exhibited a J-shaped curve with respect to age, with the lowest titers observed among older children and young adults and the highest among older adults. When compared to SARS-CoV-2-seronegative individuals, SARS-CoV-2 seropositivity at the midyear sample was associated with 93.6% protection from symptomatic reinfection (95% CI, 51.1%-99.2%). Conclusions: This population exhibited a very high SARS-CoV-2 seropositivity with lower-than-expected severity, and immunity from natural infection was protective against symptomatic reinfection. (© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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