接种疫苗和未接种疫苗的固体器官移植接受者的COVID-19临床表型:一个多中心验证研究
Carmen Infante-Domínguez1,2, Sonsoles Salto-Alejandre1,2, Rocío Álvarez-Marín1,2
1Clinical Unit of Infectious Diseases, Microbiology and Parasitology, Instituto de Biomedicina de Sevilla (IBiS), Virgen del Rocío University Hospital /CSIC/University of Seville, Seville, Spain.
Scientific reports
|December 2, 2024
概括
COVID-19的临床表型适用于固体器官移植接受者 (SOTR). 疫苗接种显著降低了所有表型的死亡风险,特别是在高风险群体中.
科学领域:
- 移植医学 移植医学
- 传染性疾病 传染性疾病
- 关键的护理关键的护理
背景情况:
- 已经建立了COVID-19 (2019年冠状病毒疾病) 的临床表型,以预测一般人群的死亡风险.
- 这些表型在固体器官移植接受者 (SOTR) 中的适用性,这是一个脆弱的人群,需要进行具体的研究.
- SOTR经常表现出改变的免疫反应,并且面临更高的风险,从COVID-19等感染的严重结果.
研究的目的:
- 评估已确定的COVID-19临床表型 (A,B和C) 在预测住院SOTR.中死亡率方面的有用性.
- 为了比较不同表型的死亡率,并评估SARS-CoV-2 (严重急性呼吸系统综合征冠状病毒2) 疫苗接种状态在这些表型中的影响.
- 为了确定COVID-19表型是否是SOTR人群中风险的可靠指标.
主要方法:
- 对488名COVID-19患者住院的SOTR进行了队列研究.
- 患者被分为未接种疫苗 (n=394) 和接种疫苗 (n=94) 组.
- 用16个人口,临床,分析和放射学变量将患者分为A,B和C类表型,并记录了全因死亡率.
主要成果:
- 总体所有原因的死亡率为21.5% (105/488),在未接种疫苗 (23.4%) 和接种疫苗 (13.8%) SOTR (P=0.04) 之间更高.
- 现型C的死亡率最高 (40.1%),其次是B (16.6%) 和A (8.7%).
- 与未接种疫苗的SOTR相比,接种疫苗的SOTR在各类表型中死亡率明显较低,特别是在表型C (17.3%与52.0%相比,P<0.001).
结论:
- 已确定的COVID-19临床表型适用于并对固体器官移植受体的风险分层有用.
- 针对SARS-CoV-2的疫苗接种显著降低了在所有已识别的表型中与COVID-19住院的SOTR患者的全因死亡率.
- 这些发现强调了疫苗接种在缓解免疫功能低下的SOTR.中COVID-19严重后果方面的重要性.
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