Population Immunity Against COVID-19 hauv Tebchaws Meskas Part 2
Feb 05, 2024
Sensitivity Analyzes
Muab qhov sib txawv ntawm IFRs vim yog cov pej xeem heterogeneity thiab seroprevalence kev tshawb fawb, peb kuj tau txiav txim siab IFR kwv yees los ntawm 2 lwm cov kev tshawb fawb los qhia peb cov kev suav ntawm tag nrho cov pej xeem kev tiv thaiv (Table 1).
Kev sib txawv ntawm pawg neeg yog hais txog tib neeg cov yam ntxwv sib txawv thiab qhov sib txawv ntawm ntau yam, suav nrog poj niam txiv neej, hnub nyoog, keeb kwm kev coj noj coj ua, tus cwj pwm, keeb kwm kev kawm, thiab lwm yam. Kev nco yog ib qho tsim nyog rau tib neeg los ua cov haujlwm neural siab heev xws li kev kawm, nco, thiab xav. Muaj kev sib raug zoo ntawm pej xeem heterogeneity thiab nco.
Ua ntej, pejxeem heterogeneity tuaj yeem txhawb kev txhim kho kev nco. Txhua tus neeg muaj cov yam ntxwv tshwj xeeb xws li lawv tus kheej cov kev paub dhau los, kev xav, thiab kev ua neej, uas ua rau muaj ntau txoj kev paub thiab kev kawm. Yog li ntawd, kev sib txuas lus thiab kev cuam tshuam nrog ntau pawg neeg tuaj yeem ua rau peb nthuav dav ntau txoj kev xav thiab kev daws teeb meem, yog li nthuav peb lub qab ntug thiab cov tswv yim. Qhov no pab txhim kho peb lub cim xeeb thiab kev txawj ntse.
Qhov thib ob, cov pejxeem heterogeneity tuaj yeem pab peb nco qab zoo dua thiab nkag siab txog kev paub tshiab. Kev sib txuas lus nrog cov neeg los ntawm ntau haiv neeg tuaj yeem pab peb nkag siab zoo dua thiab lees txais cov kab lis kev cai sib txawv, qhov muaj txiaj ntsig, thiab cov qauv kev xav. Qhov no yuav pab peb nkag siab txog kev paub tshiab zoo dua kom peb nco tau zoo dua thiab siv tau.
Thaum kawg, pejxeem heterogeneity tuaj yeem txhim kho peb txoj kev xav thiab kev tsim kho tshiab. Kev sib txuas lus nrog ntau pawg neeg tuaj yeem txhawb nqa peb txoj kev xav thiab kev tsim kho tshiab kom peb tuaj yeem hloov mus rau qhov chaw sib txawv thiab cov teeb meem sai dua. Qhov no yuav pab peb daws cov teeb meem zoo dua thiab teb cov teeb meem, ua kom peb cov khoom tsim tau thiab muaj tswv yim.
Hauv cov ntsiab lus, muaj kev sib txuas zoo ntawm cov pej xeem heterogeneity thiab kev nco. Peb yuav tsum nquag sib txuas lus thiab sib cuam tshuam nrog ntau pawg neeg, txuas ntxiv nthuav peb lub qab ntug thiab cov tswv yim, thiab txhim kho peb lub cim xeeb thiab kev muaj tswv yim nyob rau hauv ib puag ncig ntawm kev sib nrig sib kev kawm, kev ua siab ntev, thiab kev sib haum xeeb. Nws tuaj yeem pom tau tias peb yuav tsum txhim kho kev nco, thiab Cistanche deserticola tuaj yeem txhim kho kev nco, vim Cistanche deserticola tseem tuaj yeem tswj hwm qhov sib npaug ntawm cov neurotransmitters, xws li nce qib ntawm acetylcholine thiab kev loj hlob. Cov khoom no tseem ceeb heev rau kev nco thiab kev kawm. Tsis tas li ntawd, Cistanche deserticola tseem tuaj yeem txhim kho cov ntshav khiav thiab txhawb nqa cov pa oxygen, uas tuaj yeem ua kom lub hlwb tau txais cov as-ham txaus thiab lub zog, yog li txhim kho lub hlwb tseem ceeb thiab kev ua siab ntev.
Nyem Paub Short-term Nco yuav ua li cas txhim kho
Ua ntej, peb siv IFR kev kwv yees los ntawm ib tus neeg-qib cov ntaub ntawv rau cov neeg mob uas tuag ntawm COVID-19 hauv Hubei, Tuam Tshoj, thaum ntxov ntawm kev kis tus kabmob (8). Tom qab ntawd peb tau siv cov txiaj ntsig IFR tsis ntev los no uas tso siab rau cov ntaub ntawv muaj hnub nyoog tshwj xeeb ntawm COVID-19-tsim kev tuag los ntawm kev tshawb fawb hauv tebchaws qib seroprevalence (9).
Txhawm rau suav rau qhov tsis paub tseeb hauv kev txhaj tshuaj tiv thaiv kab mob thiab tau txais kev tiv thaiv ib puag ncig, peb tau ua 500 Monte Carlo simulations uas suav nrog kev ntseeg siab nyob ib puag ncig cov kev kwv yees no.
Lub sijhawm muaj kev ntseeg siab (CrIs) nyob ib ncig ntawm cov pej xeem kev tiv thaiv kab mob tau txais los ntawm kev ua 500 MonteCarlo simulations los suav rau qhov tsis paub meej nyob ib puag ncig inputparameters.
Lub luag haujlwm ntawm Cov Nyiaj Tau Los
Cov peev nyiaj tsis muaj lub luag haujlwm hauv kev tsim cov kev tshawb fawb, sau, thiab tshuaj xyuas cov ntaub ntawv, txhais cov txiaj ntsig, lossis kev txiav txim siab luam tawm cov ntawv sau.
TSEEM CEEB
Kev Ntsuam Xyuas Thawj
Siv cov kev kwv yees IFR tau tshaj tawm los ntawm CDC (Table 1), peb suav tias txij li 15 Lub Xya Hli 2021, 114.9 (95% CrI, 103.2 txog 127.4) lab tus tib neeg tau kis tus kabmob SARS-CoV-2 hauv Tebchaws Meskas (Daim duab 1), uas yog 3.38 npaug ntau dua li cov xov xwm tshaj tawm (18).
Kev suav nyiaj rau qhov nruab nrab ntawm 80.5% kev tiv thaiv tiv thaiv kab mob rov ua dua tshiab (6, 10) thiab cov tshuaj tiv thaiv tshwj xeeb tiv thaiv kab mob hauv cov neeg tau txhaj tshuaj ib nrab (8, 9), peb kwv yees qhov kev tiv thaiv tag nrho ntawm cov pej xeem ntawm 62.0% (CrI , 58.4% rau 66.4%) (Figure2).
Cov neeg laus hnub nyoog 65 xyoo lossis tshaj saud tau kwv yees tias muaj kev tiv thaiv kab mob siab tshaj plaws (77.2% [CrI, 76.2% mus rau 78.6%), tom qab ntawd cov neeg laus hnub nyoog 18 txog 49 xyoo (72.7% [CrI, 67.6% to79.{14} }%]) thiab cov hnub nyoog 50 txog 64 xyoo (70.6% [CrI, 67.7% rau 74.3%)).
Kev tiv thaiv kab mob qis dua ntawm cov tub ntxhais hluas hnub nyoog 12 txog 17 xyoo (37.9% [CrI, 34.8% rau 41.9%)]) thiab cov menyuam yaus hnub nyoog qis dua 12 xyoos (17.9% [CrI, 14.4% rau 21.9%)] (Daim duab 2).
Sensitivity Analyzes
Thaum xav txog IFR cov txiaj ntsig tau los ntawm cov theem pib ntawm kev sib kis hauv tus qauv (8), peb tau txais 91.48 (CrI, 82.94 txog 100.77) lab tus kab mob, uas yog 26% qis dua tus lej suav los ntawm kev siv CDC IFR kev kwv yees hauv tus qauv (Appendix Daim duab 1, muaj nyob rau ntawm Annals.org).
Qhov kev tiv thaiv kab mob siab tshaj plaws thiab qis tshaj yog txuam nrog cov neeg muaj hnub nyoog 65 xyoo lossis laus dua thiab cov menyuam yaus hnub nyoog qis dua 12 xyoos, raws li. Kev tiv thaiv tag nrho cov pej xeem tau kwv yees li 58.3% (CrI, 55.3% rau 62.1%).
Txawm li cas los xij, thaum IFR qhov txiaj ntsig kwv yees los ntawm ntau qhov kev tshawb fawb seroprevalence tau siv (9), tag nrho cov kab mob hauv Tebchaws Meskas yog 163.68 (CrI, 147.47 txog 180.78) lab, thiab tag nrho cov pejxeem tiv thaiv tau nce mus rau 66.7% (CrI, 62.3% mus rau 71.7%). )(Cov Ntawv Ntxiv 2, muaj nyob rau ntawm Annals.org).
Cov qauv ntawm kev tiv thaiv hnub nyoog tshwj xeeb tseem zoo ib yam li cov kev siv IFR kwv yees los ntawm CDC, nrog kev tiv thaiv siab tshaj plaws rau cov neeg muaj hnub nyoog 65 xyoo lossis laus dua (82.5% [CrI, 79.9% rau 85.7%]) thiab kev tiv thaiv qis tshaj ntawm cov menyuam yaus hnub nyoog qis dua 12 xyoos. xyoo (17.9% [CrI, 14.5% rau 21.8%)).
Cov kev kwv yees no tau suav nrog siv qhov kev tshaj tawm cov tshuaj tiv thaiv kev ua tau zoo thiab qib ntawm kev tiv thaiv ib puag ncig tiv thaiv rov ua dua tshiab. Thaum peb suav txog qhov kev ntseeg siab ntawm cov qib kev tiv thaiv no thiab txiav txim siab 3 qhov chaw ntawm IFR qhov tseem ceeb, qhov nruab nrab ntawm kev tiv thaiv pej xeem muaj txij li 52.1% mus rau 71.0% (Daim duab 3).
Kev sib tham
Siv cov hnub nyoog-stratified IFR kwv yees qhia los ntawm CDC, peb suav tias txij li 15 Lub Xya Hli 2021, 114.9 (CrI, 103.2 txog 127.4) lab tus kab mob SARS-CoV-2 tau tshwm sim hauv Tebchaws Meskas. Qhov ntau ntawm peb qhov kev kwv yees sib tshooj ntawm CDC tam sim no kwv yees ntawm 120.2 lab tus kab mob, uas tau muab los ntawm tus qauv txheeb cais siv rau kev lees paub COVID-19 kis (19).
Thaum peb suav tag nrho cov peev txheej ntawm IFR qhov tseem ceeb hauv peb qhov kev tshuaj xyuas thiab siv qhov kev kwv yees kwv yees ntawm cov tshuaj tiv thaiv thiab kev tiv thaiv ib txwm muaj, qhov nruab nrab ntawm kev tiv thaiv pej xeem muaj li ntawm 58.3% mus rau 66.7%. Qhov txawv ntawm SARS-CoV-2 nrog kev sib kis ntau dua, xws li Delta variant (20), yuav ua rau muaj kev tiv thaiv ib txwm muaj, tab sis ntawm tus nqi ntawm cov txiaj ntsig kev noj qab haus huv ntau ntxiv.
Kev txhim kho cov tshuaj tiv thaiv txhua hnub yuav ua rau kom muaj kev tiv thaiv kab mob tiv thaiv kab mob thiab txo qis kev mus pw hauv tsev kho mob thiab kev tuag, txawm tias muaj kab mob tshwm sim nrog cov tshuaj tiv thaiv qis dua tiv thaiv kab mob tiv thaiv kab mob (21, 22).
Muab qhov sib txawv ntawm thaj chaw loj thiab kev sib koom ua ke hauv kev tiv thaiv, cov cheeb tsam uas muaj kev txhaj tshuaj tiv thaiv qis yuav txuas ntxiv muaj kev sib kis hauv zos thiab txuas ntxiv kis tus kab mob mus rau lwm thaj chaw, ua rau lub sijhawm COVID-19 kis thoob plaws hauv Tebchaws Meskas.Peb txoj kev tshawb fawb muaj kev txwv. Ua ntej, peb qhov kev kwv yees ntawm kev tiv thaiv pej xeem yog raws li kev tshaj tawm cov txiaj ntsig ntawm cov tshuaj tiv thaiv Pfizer-BioNTech thiab Moderna, uas yog 96% ntawm tag nrho cov koob tshuaj hauv Tebchaws Meskas (17).
Txawm li cas los xij, peb nco ntsoov tias ib koob tshuaj Johnson & Johnson tau tso cai rau kev siv thaum muaj xwm txheej ceev hauv Tebchaws Meskas tau ua haujlwm qis dua li cov tshuaj tiv thaiv Pfizer-BioNTech thiab Moderna (23, 24).
Qhov thib ob, peb xav tias txhua tus neeg uas muaj tus kab mob ua ntej muaj kev tiv thaiv qib ntawm 80.5% tiv thaiv kab mob rov ua dua tshiab (6, 10) thiab ua qhov kev ntsuam xyuas rhiab heev ntawm qhov kwv yees (Daim duab 3). Txawm li cas los xij, qhov kev tiv thaiv no tuaj yeem ua rau muaj hnub nyoog, txo qis rau kwv yees li 47% rau cov neeg muaj hnub nyoog 65 xyoo lossis laus dua (6).
Thib peb, txhawm rau txiav txim siab txog qhov piv txwv ntawm cov neeg mob yav dhau los uas tau txhaj tshuaj tiv thaiv, peb xav tias qhov kev txiav txim siab txhaj tshuaj tiv thaiv tsis muaj tus kab mob ua ntej.
Plaub, kev tiv thaiv kev txhaj tshuaj tiv thaiv tuaj yeem qis dua rau kev tiv thaiv kab mob tiv thaiv kab mob, xws li Delta variant, dua li qub SARS-CoV-2 strain (22). Thaum kawg, peb siv cov neeg tuag txhua hnub uas tau tshaj tawm los ntawm CDC los suav tag nrho cov kab mob. Kev kwv yees tsis ntev los no qhia tias 24% ntawm tag nrho cov neeg tuag vim yog COVID-19 hauv Tebchaws Meskas tsis tau tshaj tawm (25, 26), uas ntau tshaj li ib feem peb tau tshwm sim ntawm cov neeg muaj hnub nyoog 80 xyoo lossis laus dua.
Txawm hais tias cov neeg tuag uas tsis tau tshaj tawm tuaj yeem ua rau peb qhov kev kwv yees qis dua kev tiv thaiv cov pej xeem, IFR kev kwv yees kuj raug cuam tshuam los ntawm kev txwv zoo sib xws, txo qis qhov kev tsis ncaj ncees hauv peb qhov kev kwv yees. Tsis tas li ntawd, ib qho kev kwv yees tsis txaus ntseeg ntawm cov pej xeem kev tiv thaiv yuav ua rau pom qhov sib txawv ntawm cov pej xeem kev tiv thaiv kab mob thiab cov tsiaj tiv thaiv kab mob uas yuav tsum tau ua kom tiav kom thim rov qab txoj kev sib kis.
Tsis tas li ntawd, kev txhaj tshuaj thiab kis kab mob sib txawv raws qhov chaw. Piv txwv li, ntau lub xeev nyob rau sab qaum teb sab hnub tuaj tau ua tiav qhov kev txhaj tshuaj tiv thaiv siab thiab muaj tus kab mob tsawg, tab sis qee thaj chaw ntawm South thiab Midwest muaj cov tshuaj tiv thaiv qis thiab muaj tus kab mob siab heev.Peb txoj kev tshawb fawb qhia txog qhov xav tau txhawm rau txhawm rau txhaj tshuaj tiv thaiv kom tsis txhob muaj cov nthwv dej ntxiv ntawm COVID-19 thiab kev hloov pauv ntawm cov kev hloov tshiab tshiab thiab kom txo lub sijhawm rau kev tswj hwm kev sib kis thoob plaws hauv Tebchaws Meskas.
Kev ua raws li cov kev cuam tshuam tsis yog tshuaj, xws li lub ntsej muag lub ntsej muag thiab kev soj ntsuam xyuas, yuav tsum tau txhawb kom tsawg kawg kom txog thaum cov pej xeem kev tiv thaiv tsis txaus kom muaj tus kab mob kis thoob qhov txhia chaw.Los ntawm York University, Toronto, Ontario, Canada (SMM); YaleSchool of Public Health, New Haven, Connecticut (PS, AS, APG); thiab University of Texas ntawm Austin, Austin, Texas, thiab Santa Fe Institute, Santa Fe, New Mexico (LAM).
Grant Support: Dr. Galvani tau txais nyiaj los ntawm NSFExpeditions nyiaj pab 1918784, National Institutes of Healthgrant 1R01AI151176-01, National Science Foundation grantRAPID-2027755, thiab Notsew Orm Sands Foundation. Dr.Moghadas tau txais kev txhawb nqa los ntawm Canadian Institutes of Health Research (OV4 – 170643, COVID-19 Kev tshawb fawb nrawm) thiab Natural Sciences thiab Engineering Research Councilof Canada, Emerging Infectious Disease Modelling, Mathematicsfor Public Health nyiaj pab.
Kev Tshaj Tawm: Cov kws sau ntawv tau tshaj tawm tsis muaj kev tshaj tawm txog kev txaus siab.
Cov ntawv tuaj yeem pom ntawmwww.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M21-2721.
Reproducible Research Statement: Study protocol and dataset: Muaj los ntawm Dr. Galvani (e-mail, Alison.galvani@yale.edu). Statistical code: Muaj nyob ntawmhttps://github.com/affans/c19popimmunity.
Cov ntaub ntawv
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