Hanafy Amr Shaaban, Seleem Waseem M, Elkattawy Hany A
Internal Medicine Department, College of Medicine, Zagazig University, Zagazig-40-Mostafa Fouad Street, Zagazig, Al-Sharkia, 44519, Egypt.
Department of Basic Medical Sciences, College of Medicine, Almaarefa University, Ad Diriyah, Saudi Arabia.
Clin Exp Med. 2023 Feb;23(1):141-150. doi: 10.1007/s10238-022-00795-3. Epub 2022 Jan 22.
To retrospectively assess the impact of regular yearly administration of recombinant influenza and single administration of pneumococcal conjugate vaccines on the occurrence of serious respiratory infection including COVID-19 in patients with type 2 diabetes mellitus. Hundred patients with type 2 diabetes mellitus were given Vaxigrip and Prevnar13 vaccines and were evaluated by comprehensive clinical review, airflow screening questionnaire, and routine laboratory investigations with follow-up during the COVID-19 pandemic and compared to a control group of diabetic patients with the same inclusion criteria (n = 100). After Vaxigrip and Prevnar13, there is a significant improvement in respiratory symptoms and a decrease in the airflow screening questionnaire (p = 0.0001) with a significant improvement in inflammatory parameters as neutrophil-lymphocyte ratio, ESR, CRP, and platelet count. Four patients had mild COVID-19 (4%), mainly gastrointestinal with no complications. Twenty-one out of 32 (65.6%) patients in the control group had severe COVID-19. The hazard ratios of significant respiratory tract infection and death due to COVID-19 were 2.29 and 10.24 in the non-vaccinated control (p = 0.001).The severity of COVID-19 in diabetes correlated with HBA1C (p = 0.007), combined Vaxigrip and Prevnar13 vaccination (p = 0.0001), serum creatinine (p = 0.001), neutrophil-lymphocyte ratio (p = 0.001), and thrombocytopenia (p = 0.003). The present study suggested that the combination of Prevnar13 and Vaxigrip may be related to decreased occurrence of serious respiratory infections including COVID-19. Further randomized control trials may be needed to establish a direct causation between the two and clarify these associations.
回顾性评估每年定期接种重组流感疫苗和单次接种肺炎球菌结合疫苗对2型糖尿病患者严重呼吸道感染(包括新型冠状病毒肺炎)发生率的影响。100例2型糖尿病患者接种了流感疫苗(Vaxigrip)和13价肺炎球菌结合疫苗(Prevnar13),并在新型冠状病毒肺炎大流行期间通过全面临床检查、气流筛查问卷和常规实验室检查进行评估,同时与具有相同纳入标准的糖尿病对照组(n = 100)进行比较。接种流感疫苗和13价肺炎球菌结合疫苗后,呼吸道症状有显著改善,气流筛查问卷结果有所下降(p = 0.0001),炎症参数如中性粒细胞与淋巴细胞比值、红细胞沉降率、C反应蛋白和血小板计数也有显著改善。4例患者发生轻度新型冠状病毒肺炎(4%),主要为胃肠道症状,无并发症。对照组32例患者中有21例(65.6%)发生严重新型冠状病毒肺炎。未接种疫苗的对照组中,严重呼吸道感染和新型冠状病毒肺炎死亡的风险比分别为2.29和10.24(p = 0.001)。糖尿病患者新型冠状病毒肺炎的严重程度与糖化血红蛋白(p = 0.007)、联合接种流感疫苗和13价肺炎球菌结合疫苗(p = 0.0001)、血清肌酐(p = 0.001)、中性粒细胞与淋巴细胞比值(p = 0.001)和血小板减少(p = 0.003)相关。本研究表明,13价肺炎球菌结合疫苗和流感疫苗联合使用可能与包括新型冠状病毒肺炎在内的严重呼吸道感染发生率降低有关。可能需要进一步的随机对照试验来确定两者之间的直接因果关系并阐明这些关联。
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