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流感疫苗对 COVID-19 死亡率的影响:一项回顾性研究。

Effect of influenza vaccine on COVID-19 mortality: a retrospective study.

机构信息

Emergency Medicine Department, Fondazione Universitaria Policlinico Gemelli-IRCCS-Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00135, Rome, Italy.

Anestesiology and Resuscitation Department, Fondazione Universitaria Policlinico Gemelli-IRCCS-Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00135, Rome, Italy.

出版信息

Intern Emerg Med. 2021 Oct;16(7):1849-1855. doi: 10.1007/s11739-021-02702-2. Epub 2021 Mar 20.

Abstract

It has been proposed that vaccines may exert an unspecific protective effect against infectious agents, different than expected. Coronavirus disease 2019 (COVID-19) is a pandemic infection with high mortality in older patients due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The high number of vaccinations may be one of the reasons why children show a lower susceptibility to SARS-CoV-2 infection and milder severity when compared to adults. We have designed a study aimed at investigating whether the influenza vaccine may reduce the susceptibility and severity of SARS-CoV-2 infection. We retrospectively enrolled 635 patients who accessed our Emergency Department from March 1st to June 30th, 2020, and were diagnosed with COVID-19 infection confirmed by an RT-PCR on an oropharyngeal swab. Clinical data, outcomes, and influenza vaccination status were collected from the electronic medical records of our Hospital. We also used data from the Italian Health Ministry to compare the prevalence of flu vaccination among the general population of the Lazio Region and our enrolled patients. We then compared clinical outcomes between vaccinated and non-vaccinated patients, by univariate and multivariate analysis. COVID-19-positive patients older than 65 years reported a lower prevalence of flu vaccination when compared to the general population residing in the Lazio (p = 0.004). After correction for gender, age, and comorbidities, we found a lower risk of death at 60 days in patients with flu vaccination than in not vaccinated patients (p = 0.001). Our study shows that flu vaccination could reduce the mortality of COVID-19. Prospective studies are needed to confirm this result.

摘要

有人提出,疫苗可能对传染性病原体产生非特异性的保护作用,这与预期的不同。2019 年冠状病毒病(COVID-19)是一种大流行感染,由于严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2),老年患者的死亡率很高。大量接种疫苗可能是儿童感染 SARS-CoV-2 的易感性较低且严重程度较轻的原因之一。我们设计了一项研究,旨在调查流感疫苗是否可以降低 SARS-CoV-2 感染的易感性和严重程度。我们回顾性地招募了 635 名于 2020 年 3 月 1 日至 6 月 30 日期间因呼吸道鼻咽拭子 RT-PCR 检测到 COVID-19 感染而到我们急诊科就诊的患者。从我们医院的电子病历中收集了临床数据、结局和流感疫苗接种情况。我们还使用了意大利卫生部的数据来比较拉齐奥地区普通人群和我们招募的患者中流感疫苗接种的流行率。然后,我们通过单变量和多变量分析比较了接种疫苗和未接种疫苗患者的临床结局。与居住在拉齐奥的普通人群相比,年龄大于 65 岁的 COVID-19 阳性患者流感疫苗接种率较低(p=0.004)。在性别、年龄和合并症校正后,我们发现接种流感疫苗的患者在 60 天的死亡率低于未接种疫苗的患者(p=0.001)。我们的研究表明,流感疫苗接种可以降低 COVID-19 的死亡率。需要前瞻性研究来证实这一结果。

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