METHODS: We conducted a retrospective cohort study among all patients screened for MERS-CoV at a tertiary care hospital in Saudi Arabia between 2012 and early 2020. Both MERS-CoV positive and negative patients were followed up from early 2020 to September 2021 for developing COVID-19 infection confirmed by RT-PCR testing.
RESULTS: A total of 397 participants followed for an average 15 months during COVID-19 pandemic (4.9 years from MERS-CoV infection). Of the 397 participants, 93 (23.4%) were positive for MERS-CoV at baseline; 61 (65.6%) of the positive cases were symptomatic. Out of 397, 48 (12.1%) participants developed COVID-19 by the end of the follow-up period. Cox regression analysis adjusted for age, gender, and major comorbidity showed a marginally significant lower risk of COVID-19 disease (hazard ratio = 0.533, p = 0.085) and hospital admission (hazard ratio = 0.411, p = 0.061) in patients with positive MERS-CoV. Additionally, the risk of COVID-19 disease was further reduced and became significant in patients with symptomatic MERS-CoV infection (hazard ratio = 0.324, p = 0.034) and hospital admission (hazard ratio = 0.317, p = 0.042).
CONCLUSIONS: The current findings may indicate a partial cross-immunity, where patients with symptomatic MERS-CoV have a lower risk of future COVID-19 infection and related hospitalization. The present results may need further examination nationally using immunity markers.
方法:我们对2012年至2020年初在沙特阿拉伯一家三级医院筛查MERS-CoV的所有患者进行了回顾性队列研究。从2020年初至2021年9月,MERS-CoV阳性和阴性患者均接受了RT-PCR检测证实的COVID-19感染的随访。
结果:共有397名参与者在COVID-19大流行期间平均随访15个月(距MERS-CoV感染4.9年)。在397名参与者中,基线时,93例(23.4%)的MERS-CoV阳性;61例(65.6%)的阳性病例是有症状的。在397名参与者中,48名(12.1%)参与者在随访期结束时发展为COVID-19。Cox回归分析调整了年龄,性别,和主要合并症显示,在MERS-CoV阳性的患者中,COVID-19疾病(风险比=0.533,p=0.085)和住院(风险比=0.411,p=0.061)的风险略显着降低。此外,在有症状的MERS-CoV感染(风险比=0.324,p=0.034)和住院(风险比=0.317,p=0.042)的患者中,COVID-19疾病的风险进一步降低,并且变得显著.
结论:当前的发现可能表明部分交叉免疫,有症状的MERS-CoV患者未来发生COVID-19感染和相关住院的风险较低。目前的结果可能需要使用免疫标记在全国范围内进行进一步检查。