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SARS-CoV-2 感染和 mRNA COVID-19 疫苗接种后的心脏并发症 - PCORnet,美国,2021 年 1 月至 2022 年 1 月。

Cardiac Complications After SARS-CoV-2 Infection and mRNA COVID-19 Vaccination - PCORnet, United States, January 2021-January 2022.

出版信息

MMWR Morb Mortal Wkly Rep. 2022 Apr 8;71(14):517-523. doi: 10.15585/mmwr.mm7114e1.

Abstract

Cardiac complications, particularly myocarditis and pericarditis, have been associated with SARS-CoV-2 (the virus that causes COVID-19) infection (1-3) and mRNA COVID-19 vaccination (2-5). Multisystem inflammatory syndrome (MIS) is a rare but serious complication of SARS-CoV-2 infection with frequent cardiac involvement (6). Using electronic health record (EHR) data from 40 U.S. health care systems during January 1, 2021-January 31, 2022, investigators calculated incidences of cardiac outcomes (myocarditis; myocarditis or pericarditis; and myocarditis, pericarditis, or MIS) among persons aged ≥5 years who had SARS-CoV-2 infection, stratified by sex (male or female) and age group (5-11, 12-17, 18-29, and ≥30 years). Incidences of myocarditis and myocarditis or pericarditis were calculated after first, second, unspecified, or any (first, second, or unspecified) dose of mRNA COVID-19 (BNT162b2 [Pfizer-BioNTech] or mRNA-1273 [Moderna]) vaccines, stratified by sex and age group. Risk ratios (RR) were calculated to compare risk for cardiac outcomes after SARS-CoV-2 infection to that after mRNA COVID-19 vaccination. The incidence of cardiac outcomes after mRNA COVID-19 vaccination was highest for males aged 12-17 years after the second vaccine dose; however, within this demographic group, the risk for cardiac outcomes was 1.8-5.6 times as high after SARS-CoV-2 infection than after the second vaccine dose. The risk for cardiac outcomes was likewise significantly higher after SARS-CoV-2 infection than after first, second, or unspecified dose of mRNA COVID-19 vaccination for all other groups by sex and age (RR 2.2-115.2). These findings support continued use of mRNA COVID-19 vaccines among all eligible persons aged ≥5 years.

摘要

心脏并发症,特别是心肌炎和心包炎,与 SARS-CoV-2(引起 COVID-19 的病毒)感染(1-3)和 mRNA COVID-19 疫苗接种(2-5)有关。多系统炎症综合征(MIS)是 SARS-CoV-2 感染的一种罕见但严重的并发症,常伴有心脏受累(6)。研究人员使用 2021 年 1 月 1 日至 2022 年 1 月 31 日期间来自 40 个美国医疗保健系统的电子健康记录(EHR)数据,计算了≥5 岁人群中 SARS-CoV-2 感染后心脏结局(心肌炎;心肌炎或心包炎;心肌炎、心包炎或 MIS)的发生率,按性别(男性或女性)和年龄组(5-11、12-17、18-29 和≥30 岁)分层。心肌炎和心肌炎或心包炎的发生率在首次、第二次、未指明或任何(首次、第二次或未指明)剂量的 mRNA COVID-19(BNT162b2[辉瑞-BioNTech]或 mRNA-1273[Moderna])疫苗接种后进行计算,按性别和年龄组分层。风险比(RR)用于比较 SARS-CoV-2 感染后发生心脏结局的风险与 mRNA COVID-19 疫苗接种后发生心脏结局的风险。在接受第二次疫苗接种的 12-17 岁男性中,mRNA COVID-19 疫苗接种后心脏结局的发生率最高;然而,在该年龄组中,SARS-CoV-2 感染后的心脏结局风险是第二次疫苗接种后的 1.8-5.6 倍。对于所有其他性别和年龄组,SARS-CoV-2 感染后发生心脏结局的风险同样明显高于 mRNA COVID-19 疫苗接种的首次、第二次或未指定剂量(RR 2.2-115.2)。这些发现支持在所有符合条件的≥5 岁人群中继续使用 mRNA COVID-19 疫苗。

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