全国范围内对免疫功能低下患者的COVID-19住院负担进行纵向分析
Henrique Andrade R Fonseca1, Lucas Ferreira Theotonio Dos Santos2, Antonio José Cordeiro Mattos2
1Academic Research Organization, Instituto Israelita de Ensino e Pesquisa, Hospital Israelita Albert Einstein, Rua Comendador Elias Jafet, 755, 4º andar. 409N Office, São Paulo, SP, 05652-900, Brazil. henrique.fonseca@einstein.br.
Scientific reports
|September 30, 2025
概括
在COVID-19大流行期间,免疫力受损 (IC) 个体与非免疫力受损个体相比,在重症监护室的入院率和死亡率显著更高,突出了严重结果的差异.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 免疫学 免疫学 免疫学
背景情况:
- COVID-19在全球造成了数百万人的死亡,严重的结果不成比例地影响了患有潜在疾病和免疫抑制的个人.
- 免疫功能低下 (IC) 个体的疫苗有效性降低,增加了突破性感染和严重COVID-19的风险.
- 了解IC和非IC人群之间COVID-19结果的差异对于公共卫生干预至关重要.
研究的目的:
- 评估和比较免疫功能低下 (IC) 与非免疫功能低下 (non-IC) 住院治疗COVID-19的患者在重症监护室 (ICU) 入院率和死亡率.
- 在整个大流行期间,根据COVID-19的严重程度和免疫状况对结果进行分层.
主要方法:
- 一项纵向队列研究分析了来自巴西DATASUS系统 (2020年3月 - 2023年12月) 的非识别COVID-19数据.
- 包括361,898名受试者,其中7,484名 (2.07%) 被确定为IC个体.
- 在IC和非IC队列之间比较住院和结局数据,考虑人口统计学和并发症因素.
主要成果:
- 与非IC个体相比,IC个体的慢性肝脏,神经和肺部疾病的发病率更高,而非IC个体的肥胖率更高.
- 与非IC患者相比,IC患者的ICU入院率 (42.6%与38.5%) 和死亡率 (51.1%与35.9%) 较高.
- 由于SARS-CoV-2变种的影响,急症监护室入院和死亡率的差异在疫情期间扩大 (OR从2020年的1.68增加到2023年的2.39),受到SARS-CoV-2变种的影响.
结论:
- 在整个大流行期间,免疫受损的个体面临着显著更高的COVID-19发病率和死亡率.
- 这些发现强调,迫切需要针对IC人群制定有针对性的战略,包括早期干预和优先护理.
- 持续的监测和优化的疫苗接种策略对于减轻易受免疫损害群体中严重的COVID-19结果至关重要.
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