Abstract
Coronavirus disease 2019 (COVID-19) continues to constitute an international public health emergency. Vaccination is a prospective approach to control this pandemic. However, apprehension about the safety of vaccines is a major obstacle to vaccination. Amongst health professionals, one evident concern is the risk of antibody-dependent enhancement (ADE), which may increase the severity of COVID-19. To explore whether ADE occurs in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and increase confidence in the safety of vaccination, we conducted a meta-analysis to investigate the relationship between post-immune infection and disease severity from a population perspective. Databases, including PubMed, EMBASE, Chinese National Knowledge Infrastructure, SinoMed, Scopus, Science Direct, and Cochrane Library, were searched for articles on SARS-CoV-2 reinfection published until 25 October 2021. The papers were reviewed for methodological quality, and a random effects model was used to analyse the results. Heterogeneity was assessed using the I 2 statistic. Publication bias was evaluated using a funnel plot and Egger’s test. Eleven studies were included in the final meta-analysis. The pooled results indicated that initial infection and vaccination were protective factors against severe COVID-19 during post-immune infection (OR = 0.55, 95%CI = 0.31-0.98). A subgroup (post-immune infection after natural infection or vaccination) analysis showed similar results. Primary SARS-CoV-2 infection and vaccination provide adequate protection against severe clinical symptoms after post-immune infection. This finding demonstrates that SARS-CoV-2 may not trigger ADE at the population level.
Keywords: ADE; COVID-19; Reinfection; SARS-CoV-2 vaccine; Vaccination.
【저자키워드】 COVID-19, SARS-CoV-2 vaccine, vaccination., Reinfection, ADE, 【초록키워드】 Meta-analysis, SARS-CoV-2, Coronavirus disease 2019, Vaccine, coronavirus, vaccination, pandemic, severe COVID-19, Antibody-dependent enhancement, SARS-COV-2 infection, disease severity, Infection, risk, databases, Health, severity of COVID-19, natural infection, Methodological quality, Analysis, Science, Infrastructure, acute respiratory syndrome, 95%CI, clinical symptom, Perspective, Chinese, protective factor, population level, Cochrane Library, professionals, Final, international public health, article, SinoMed, random effect, Direct, approach, initial, was used, indicated, evaluated, conducted, searched, occur, Egger, Publication bia, 【제목키워드】 Meta-analysis, Antibody-dependent enhancement, SARS-COV-2 infection, natural infection, occur,