Protective effectiveness of previous infection against subsequent SARS-Cov-2 infection: systematic review and meta-analysis

作者：Weihua Hu, Huanle Cai, Huan-Chang Yan, Han Wang, Huimin Sun, Yongyue Wei, Yuantao Hao · 发表于：Frontiers in Public Health · 年份：2024 · DOI：10.3389/fpubh.2024.1353415 · 被引用次数：11 · 研究领域：SARS-CoV-2 and COVID-19 Research、Immune responses and vaccinations、COVID-19 Clinical Research Studies

Background The protective effectiveness provided by naturally acquired immunity against SARS-CoV-2 reinfection remain controversial. Objective To systematically evaluate the protective effect of natural immunity against subsequent SARS-CoV-2 infection with different variants. Methods We searched for related studies published in seven databases before March 5, 2023. Eligible studies included in the analysis reported the risk of subsequent infection for groups with or without a prior SARS-CoV-2 infection. The primary outcome was the overall pooled incidence rate ratio ( IRR ) of SARS-CoV-2 reinfection/infection between the two groups. We also focused on the protective effectiveness of natural immunity against reinfection/infection with different SARS-CoV-2 variants. We used a random-effects model to pool the data, and obtained the bias-adjusted results using the trim-and-fill method. Meta-regression and subgroup analyses were conducted to explore the sources of heterogeneity. Sensitivity analysis was performed by excluding included studies one by one to evaluate the stability of the results. Results We identified 40 eligible articles including more than 20 million individuals without the history of SARS-CoV-2 vaccination. The bias-adjusted efficacy of naturally acquired antibodies against reinfection was estimated at 65% (pooled IRR = 0.35, 95% CI = 0.26–0.47), with higher efficacy against symptomatic COVID-19 cases (pooled IRR = 0.15, 95% CI = 0.08–0.26) than asymptomatic infe...