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疫苗接种可预防住院 COVID-19 患者的呼吸恶化和死亡:载体疫苗和 mRNA 疫苗之间的差异。

Vaccination provides protection from respiratory deterioration and death among hospitalized COVID-19 patients: Differences between vector and mRNA vaccines.

机构信息

Primary Respiratory and Intensive Care Center, University Hospital Dubrava, Zagreb, Croatia.

Endocrinology and Clinical Pharmacology Department, University Hospital Dubrava, Zagreb, Croatia.

出版信息

J Med Virol. 2022 Jun;94(6):2849-2854. doi: 10.1002/jmv.27666. Epub 2022 Feb 26.

Abstract

Outcomes of 109 hospitalized COVID-19 patients who received at least one vaccine dose 14 or more days prior the disease onset were retrospectively compared to control cohort of 109 age, sex, and Charlson comorbidity index-matched patients chosen among 2990 total hospitalized patients in our tertiary-level institution in a period from January to June 2021. Among 109 vaccinated patients, 84 patients were partially and 25 fully vaccinated. Vaccinated patients experienced significantly lower 30 days mortality (30% vs. 49%; hazard ratio [HR]: 0.56 [0.37-0.85]; p = 0.008), less frequently required high flow oxygen therapy (17% vs. 34%; HR: 0.45 [0.26-0.76]; p = 0.005), and mechanical ventilation (8% vs. 18%; HR: 0.41 [0.20-0.88]; p = 0.027) in comparison to the matched cohort of unvaccinated patients. More favorable survival was observed in patients receiving vector in comparison to messenger RNA (mRNA) vaccine types in unadjusted analysis (30 days mortality 18% vs. 40%; HR: 0.45 [0.25-0.79]; p = 0.034). In the multivariable Cox regression analysis model both mRNA (HR: 0.59 [0.36-0.98]; p = 0.041) and vector vaccine types (HR: 0.30 [0.15-0.60]; p < 0.001) were associated with improved survival in comparison to unvaccinated patients, independently of age (HR: 1.03 [1.01-1.06]; p = 0.011), male sex (HR: 1.78 [1.14-2.76]; p = 0.010), severity of illness (HR: 2.06 [1.36-3.10]; p < 0.001) and functional status on admission (HR: 1.42 [1.07-1.85]; p = 0.013).

摘要

我们回顾性地比较了 109 名在发病前 14 天或以上接受至少一剂疫苗的住院 COVID-19 患者的结果,与我们三级机构 2021 年 1 月至 6 月期间 2990 名住院患者中选择的 109 名年龄、性别和 Charlson 合并症指数匹配的对照组患者进行比较。在 109 名接种疫苗的患者中,84 名部分接种,25 名完全接种。接种疫苗的患者 30 天死亡率明显较低(30%比 49%;风险比[HR]:0.56[0.37-0.85];p=0.008),较少需要高流量氧疗(17%比 34%;HR:0.45[0.26-0.76];p=0.005)和机械通气(8%比 18%;HR:0.41[0.20-0.88];p=0.027)与未接种疫苗的匹配组患者相比。与未调整分析中的信使 RNA(mRNA)疫苗类型相比,接受载体疫苗的患者观察到更有利的生存(30 天死亡率 18%比 40%;HR:0.45[0.25-0.79];p=0.034)。在多变量 Cox 回归分析模型中,mRNA(HR:0.59[0.36-0.98];p=0.041)和载体疫苗类型(HR:0.30[0.15-0.60];p<0.001)与未接种疫苗的患者相比,与年龄(HR:1.03[1.01-1.06];p=0.011)、男性(HR:1.78[1.14-2.76];p=0.010)、疾病严重程度(HR:2.06[1.36-3.10];p<0.001)和入院时的功能状态(HR:1.42[1.07-1.85];p=0.013)无关,生存状况得到改善。

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