意大利佛罗伦萨养老院接种疫苗后新冠病毒疫情的病程及致死率
Course and Lethality of SARS-CoV-2 Epidemic in Nursing Homes after Vaccination in Florence, Italy.
作者信息
Rivasi Giulia, Bulgaresi Matteo, Mossello Enrico, Buscemi Primo, Lorini Chiara, Balzi Daniela, Barucci Riccardo, Del Lungo Ilaria, Gangemi Salvatore, Giardini Sante, Piga Cecilia, Barghini Eleonora, Boni Serena, Bulli Giulia, Carrai Paolo, Crociani Andrea, Faraone Antonio, Lo Forte Aldo, Martella Letizia, Pupo Simone, Fortini Giacomo, Marozzi Irene, Bandini Giulia, Cosma Claudia, Stacchini Lorenzo, Vaccaro Gabriele, Baggiani Lorenzo, Landini Giancarlo, Bonaccorsi Guglielmo, Ungar Andrea, Benvenuti Enrico
机构信息
Division of Geriatric and Intensive Care Medicine, Careggi Hospital and University of Florence, 50134 Florence, Tuscany, Italy.
Geriatric Unit, Santa Maria Annunziata Hospital, Local Health Unit "Toscana Centro", 50134 Florence, Tuscany, Italy.
出版信息
Vaccines (Basel). 2021 Oct 13;9(10):1174. doi: 10.3390/vaccines9101174.
Evidence on the effectiveness of SARS-CoV-2 vaccines in nursing home (NHs) residents is limited. We examined the impact of the BNT162b2 mRNA SARS-CoV-2 vaccine on the course of the epidemic in NHs in the Florence Health District, Italy, before and after vaccination. Moreover, we assessed survival and hospitalization by vaccination status in SARS-CoV-2-positive cases occurring during the post-vaccination period. We calculated the weekly infection rates during the pre-vaccination (1 October-26 December 2020) and post-vaccination period (27 December 2020-31 March 2021). Cox analysis was used to analyze survival by vaccination status. The study involved 3730 residents (mean age 84, 69% female). Weekly infection rates fluctuated during the pre-vaccination period (1.8%-6.5%) and dropped to zero during the post-vaccination period. Nine unvaccinated (UN), 56 partially vaccinated (PV) and 35 fully vaccinated (FV) residents tested SARS-CoV-2+ during the post-vaccination period. FV showed significantly lower hospitalization and mortality rates than PV and UV (hospitalization: FV 3%, PV 14%, UV 33%; mortality: FV 6%, PV 18%, UV 56%). The death risk was 84% and 96% lower in PV (HR 0.157, 95%CI 0.049-0.491) and FV (HR 0.037, 95%CI 0.006-0.223) versus UV. SARS-CoV-2 vaccination was followed by a marked decline in infection rates and was associated with lower morbidity and mortality among infected NH residents.
关于严重急性呼吸综合征冠状病毒2（SARS-CoV-2）疫苗对养老院居民有效性的证据有限。我们研究了BNT162b2 mRNA SARS-CoV-2疫苗在意大利佛罗伦萨卫生区养老院接种前后对疫情发展的影响。此外，我们评估了接种疫苗后期间出现的SARS-CoV-2阳性病例中按疫苗接种状况划分的生存率和住院率。我们计算了接种前（2020年10月1日至12月26日）和接种后期间（2020年12月27日至2021年3月31日）的每周感染率。采用Cox分析按疫苗接种状况分析生存率。该研究涉及3730名居民（平均年龄84岁，69%为女性）。接种前期间每周感染率波动（1.8%-6.5%），接种后期间降至零。接种后期间，9名未接种疫苗（UN）、56名部分接种疫苗（PV）和35名完全接种疫苗（FV）的居民检测出SARS-CoV-2呈阳性。FV组的住院率和死亡率显著低于PV组和UV组（住院率：FV组3%，PV组14%，UV组33%；死亡率：FV组6%，PV组18%，UV组56%）。与UV组相比，PV组（风险比[HR]0.157，95%置信区间[CI]0.049-0.491）和FV组（HR 0.037，95%CI 0.006-0.223）的死亡风险分别降低了84%和96%。SARS-CoV-2疫苗接种后感染率显著下降，并与感染的养老院居民中较低的发病率和死亡率相关。
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