新型冠状病毒疫苗加强针接种对德尔塔感染者临床指标及血清特异性抗体影响的分析

Analysis on impacts of vaccination of COVID-19 vaccine booster on clinical indicators and serum specific antibodies of patients infected with novel coronavirus Delta variants

目的探讨新型冠状病毒疫苗(新冠疫苗)接种剂次对新型冠状病毒德尔塔变异株感染者临床指标及血清特异性抗体的影响。方法本研究为病例对照研究。采用非随机抽样的方法,纳入2021年12月至2022年2月于西安市胸科医院诊疗的317例新型冠状病毒感染患者(病例组)和同期进行健康体检的248名健康人群(健康对照组)。根据新型冠状病毒疫苗接种情况将病例组患者分为已接种加强针组(36例)、1针或2针组(249例)、未接种组(32例),比较3组患者临床分型、C反应蛋白(CRP)、降钙素原(PCT)、淋巴细胞情况。比较病例组与健康对照组是否接种加强针的新型冠状病毒特异性抗体SARS-CoV-2-IgG、SARS-CoV-2-IgM水平。结果加强针组的普通型患者比例低于1或2针剂组及未接种组的普通型患者比例(19.4%比29.7%比37.5%),但差异无统计学意义(χ^(2)=2.75,P>0.05)。在发病第1、2周,加强针组、1针或2针组及未接种组的SARS-CoV-2-IgG水平差异均有统计学意义(P值均<0.001);发病第3周,3组SARS-CoV-2-IgG抗体水平比较差异无统计学意义;加强针组的CRP和PCT水平低于1针或2针组及未接种组(χ^(2)值分别为43.89、77.83,P值均<0.001),1针或2针组的淋巴细胞水平低于未接种组(χ^(2)=55.73,P<0.001);加强针组和未加强针组的新冠患者的SARS-CoV-2-IgG和SARS-CoV-2-IgM抗体水平均高于相同疫苗接种情况的健康对照者(P值均<0.001)。结论接种新冠疫苗加强针能够一定程度缓解SARS-CoV-2感染患者的临床症状,降低炎症指标水平,且在发病初期升高血清IgG抗体水平。

Objective To investigate impacts of inoculation times of COVID-2019 vaccine(CoronaVac)on clinical biomarkers and serum specific antibodies of patients infected with novel coronavirus Delta variants.Methods The present study is a case-control study,and the non-random sampling method was applied to enroll 317 patients infected with novel coronaviruses(case group)diagnosed and treated in Xi′an Chest Hospital and 248 cases of health population receiving health examination(healthy control group)from December 2021 to February 2022.The patients were divided into the vaccinated booster group(36 cases),1-injection or 2-injection group(249 cases)and unvaccinated group(32 cases)based on the vaccination of COVID-19 vaccine booster.The details of clinical typing,C-reactive protein(CRP),procalcitonin(PCT)and lymphocytes were compared among the three groups.In term of the availability of boosters vaccinated,the level of SARS-CoV-2-IgG and SARS-CoV-2-IgM of two specific antibodies for CoronaVac was compared between the case group and the healthy control group.Results The proportion of ordinary patients in the booster group was lower than that in the 1-injection or 2-injection group and the unvaccinated group(19.4% versus 29.7% versus 37.5%),and the difference was not statistically significant(χ^(2)=2.75,P>0.05).The difference in the level of SARS-CoV-2-IgG between the booster group,the 1-injection or 2-injection group and the unvaccinated group was statistically significant in the 1st or 2nd week of onset(all P<0.001),the difference in the level of SARS-CoV-2-IgG antibodies between three groups at the third week of onset was not statistically significant(all P<0.001);the level of CRP and PCT in the booster group were lower than that in the 1-injection or 2-injection group and the unvaccinated group(the value of χ^(2) was 43.89 and 77.83,respectively,all P<0.001),and the level of lymphocytes in the 1-injection or 2-injection needle group were lower than that in the un-vaccinated group(χ^(2)=55.73,P<0.001);the antibody level of SARS-CoV-2-IgG and SARS-CoV-2-IgM of COVID-19 patients in the booster group and the non-booster group were higher than that of healthy control group in identical vaccination situation(P value<0.001).Conclusions Vaccination of COVID-19 Vaccine supports offering remission for clinical symptoms of SARS-CoV-2 infected patients,reducing the level of inflammatory indicators,and rising the level of serum IgG antibodies in the early stage of illness to a certain extent.