110例儿童奥密克戎变异株感染恢复期血清IgG抗体变化

Change in serum IgG antibody during the recovery stage of Omicron variant infection in children: an analysis of 110 cases

摘要:

目的 探讨儿童严重急性呼吸综合征冠状病毒2（severe acute respiratory syndrome coronavirus 2，SARS-CoV-2）奥密克戎（Omicron）变异株感染后恢复期血清抗SARS-CoV-2受体结构域特异性IgG抗体（简称SARS-CoV-2 IgG抗体）水平，了解SARS-CoV-2疫苗（简称新冠疫苗）接种对奥密克戎感染的保护作用。 方法 回顾性收集2022年1月8日至2月7日天津市确诊奥密克戎变异株感染的新型冠状病毒肺炎（coronavirus disease 2019，COVID-19）患儿110例，根据患儿确诊前新冠疫苗接种情况分为4组，加强针接种组（3剂）2例，完全接种组（2剂）90例，不完全接种组（1剂）5例，未接种组13例。比较4组患儿的临床资料和SARS-CoV-2 IgG抗体水平。 结果 完全接种组确诊年龄大于未接种组（P<0.05），完全接种组的传播途径与未接种组比较差异有统计学意义（P<0.05）。4组患儿性别、临床分型、SARS-CoV-2核酸检测再阳性率比较差异无统计学意义（P>0.05）。97例患儿均接种灭活病毒疫苗，以国药集团中国生物北京生物制品研究所疫苗接种人数最多（85/97，88%）。确诊后1个月加强针接种组、完全接种组SARS-CoV-2 IgG抗体水平高于未接种组（P<0.05）；确诊后2个月，完全接种组SARS-CoV-2 IgG抗体水平高于未接种组（P<0.05）。完全接种组患儿确诊后2个月的SARS-CoV-2 IgG抗体水平低于确诊后1个月水平（P<0.05）。 结论 接种灭活新冠疫苗在奥密克戎流行期对儿童有保护作用，完全接种新冠疫苗的患儿发生奥密克戎感染后保护性抗体SARS-CoV-2 IgG抗体水平在确诊后2个月时有轻度下降。

Abstract:

Objective To investigate the serum level of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific RBD IgG antibody (SARS-CoV-2 IgG antibody for short) in children with SARS-CoV-2 Omicron variant infection during the recovery stage, as well as the protective effect of SARS-CoV-2 vaccination against Omicron infection. Methods A retrospective analysis was performed on 110 children who were diagnosed with coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 Omicron variant infection in Tianjin of China from January 8 to February 7, 2022. According to the status of vaccination before diagnosis, they were divided into a booster vaccination (3 doses) group with 2 children, a complete vaccination (2 doses) group with 90 children, an incomplete vaccination (1 dose) group with 5 children, and a non-vaccination group with 13 children. The clinical data and IgG level were compared among the 4 groups. Results The complete vaccination group had a significantly higher age than the non-vaccination group at diagnosis (P<0.05), and there was a significant difference in the route of transmission between the two groups (P<0.05). There were no significant differences among the four groups in sex, clinical classification, and re-positive rate of SARS-CoV-2 nucleic acid detection (P>0.05). All 97 children were vaccinated with inactivated vaccine, among whom 85 children (88%) were vaccinated with BBIBP-CorV Sinopharm vaccine (Beijing Institute of Biological Products, Beijing, China). At 1 month after diagnosis, the booster vaccination group and the complete vaccination group had a significantly higher level of SARS-CoV-2 IgG antibody than the non-vaccination group (P<0.05), and at 2 months after diagnosis, the complete vaccination group had a significantly higher level of SARS-CoV-2 IgG antibody than the non-vaccination group (P<0.05). For the complete vaccination group, the level of SARS-CoV-2 IgG antibody at 2 months after diagnosis was significantly lower than that at 1 month after diagnosis (P<0.05). Conclusions Vaccination with inactivated SARS-CoV-2 vaccine has a protective effect against Omicron infection in children. For children vaccinated with 2 doses of the vaccine who experience Omicron infection, there may be a slight reduction in the level of SARS-CoV-2 IgG antibody at 2 months after diagnosis. Citation:Chinese Journal of Contemporary Pediatrics, 2022, 24(7): 736-741