除了预防之外:揭示了三次接种疫苗对COVID-19严重性和固体器官移植接受者资源利用的好处
Jared R Zhang1, John C Johnson1, Richard G Preble1
1Department of Surgery, Division of Multiorgan Transplant and Hepatobiliary Surgery, University of Texas Medical Branch, Galveston, TX 77550, USA.
Transplant immunology
|April 19, 2024
概括
接种COVID-19疫苗,特别是在第三剂 (三剂) 时,可显著降低固体器官移植接受者 (SOTR) 的死亡率和住院病例. 双重疫苗接种 (双剂量) 显示死亡率降低,但没有医院住院,这突显了在这个易受伤害的群体中增强剂的好处.
科学领域:
- 免疫学 免疫学 免疫学
- 移植医学 移植医学 移植医学
- 传染性疾病 传染性疾病
背景情况:
- 疫苗在固体器官移植接受者 (SOTR) 中的疗效至关重要,因为他们的免疫能力受损.
- COVID-19对SOTR构成重大风险,需要了解疫苗在这个人群中的有效性.
研究的目的:
- 评估双 (双剂量) 和三 (三剂量) 接种疫苗的临床结果与被诊断患有COVID-19的未接种疫苗的SOTR.
- 评估COVID-19疫苗接种对SOTR中死亡率,住院和输管率的影响.
主要方法:
- 使用美国协作网络数据库 (TriNetX) 进行回顾性倾向得分匹配的队列研究.
- 包括超过1.17亿个人,与COVID-19疫苗接种和未接种疫苗的SOTR队伍相匹配.
- 控制了42个影响COVID-19严重性的因素,并监测了30天的结果,包括急性呼吸衰竭,输管治疗和死亡.
主要成果:
- 与未接种疫苗的SOTR.相比,三次疫苗接种 (三剂量) 与30天死亡率 (2.0%与7.5%) 和住院率 (29.4%与36.6%) 的显著降低有关.
- 双重疫苗接种 (双剂量) 也显示30天死亡率明显降低 (3.7%与8.2%相比),但住院率相似.
- 三次疫苗接种显著降低了输管率 (2.3%对5.2%),而双重疫苗接种没有显著降低.
结论:
- 三重COVID-19疫苗接种,但不是双重疫苗接种,与医院资源利用率的减少以及SOTR中短期并发症的减少有关.
- 现实世界的数据支持COVID-19疫苗接种助推剂对固体器官移植接受者的保护性益处.
- 这些发现强调了增强剂量对于提高免疫受损人群中疫苗有效性的重要性.
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