年齢と性別によるCOVID-19ワクチンの連続投与とSARS-CoV-2感染後の心筋炎のリスク
Martina Patone1, Xue W Mei1, Lahiru Handunnetthi2
1Nuffield Department of Primary Health Care Sciences (M.P., X.W.M., S.D., A.H., C.A.C.C., J.H.-C.), University of Oxford.
Circulation
|August 22, 2022
まとめ
COVID-19感染後の心筋炎のリスクはワクチン接種よりも高い. 一般的にCOVID-19ワクチン接種後に控えめですが,若い男性は特にmRNA-1273ワクチンの2回目の投与後にリスクが高まります.
科学分野:
- 免疫学
- 感染症
- 心臓病科
背景:
- 心筋炎は,重症急性呼吸器症候群コロナウイルス2 (SARS-CoV-2) 感染症の既知の合併症である.
- COVID-19 ワクチン接種と SARS-CoV-2 感染症の比較リスクは,特に若年層および複数のワクチン接種後に,さらなる調査が必要です.
研究 の 目的:
- COVID-19ワクチン (アデノウイルスおよびmRNAベースのワクチン) と心筋炎の関連性を評価する.
- ワクチン接種後の心筋梗塞のリスクと,SARS-CoV-2感染後のリスクを比較する.
- 特に若い個体および連続接種後の年齢および性別特有のリスクを評価する.
主な方法:
- 2020年12月から2021年12月の間にワクチン接種を受けた13歳以上の個人のデータを分析した自己制御症例シリーズ研究がイングランドで実施されました.
- この研究では,ワクチン接種 (ChAdOx1,BNT162b2,mRNA-1273) またはSARS-CoV-2感染後の28日以内に発症した心筋炎を評価した.
- 年齢,性別,ワクチンの種類/用量によって層分かれ,発生率の比率と100万人あたりの過剰発生を計算した.
主要な成果:
- ワクチン接種後28日以内に617件の発症で,0. 007%の患者で発症した.
- ChAdOx1の最初の投与と,BNT162b2の第1回,第2回およびブースター投与で,心筋炎のリスクが増加した.
- ワクチン接種と比較して,SARS-CoV-2感染後の心筋炎のリスクは著しく高かった. 第2回mRNA-1273投与後,特に40歳未満の男性ではリスクが顕著に増加した.
結論:
- COVID-19 感染症は,COVID-19 ワクチン接種よりも心筋炎のリスクが大きい.
- 連続投与とブースター投与を含むワクチン接種後の心筋炎のリスクは,一般的に控えめです.
- 若い男性は,特に第二回のmRNA-1273投与後に心筋梗塞のリスクが高く,特に注意が必要です.
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