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减重手术对 COVID-19 疫苗接种后血清学应答有效性的影响。

Impact of bariatric surgery on the effectiveness of serological response after COVID-19 vaccination.

机构信息

Department of Surgery, Medical Research Institute, Alexandria University, Alexandria, Egypt.

Clinical Epidemiologist, Leiden University Medical Center (LUMC), Leiden, The Netherlands.

出版信息

Langenbecks Arch Surg. 2022 Sep;407(6):2337-2346. doi: 10.1007/s00423-022-02516-6. Epub 2022 Apr 29.

Abstract

PURPOSE

The primary objective of the current study is to determine whether bariatric surgery reversed the negative impact of obesity on the serological response after the COVID-19 vaccination. This objective is achieved in two steps: (a) quantifying the negative impact of obesity on the serological response after COVID-19 vaccination if it is present, and (b) testing whether bariatric surgery reversed this impact. The secondary objective was to monitor the occurrence of adverse events.

METHODS

This is a prospective cohort study between May 2021 and August 2021 on the strength of serological response after COVID-19 vaccination. Patients were classified into three groups. Group A (controls with normal or overweight), Group B (bariatric patients pre-operative), and Group C (bariatric patients post-operative). Quantitative antibodies against SARS‑CoV‑2 RBD with a strong neutralizing capacity were quantified from sera after at least 2 weeks post-vaccination.

RESULTS

Of the 276 participants, Group A had n = 73, Group B had n = 126, and Group C had n = 77 patients. Overall, a strongly positive vaccine serological response was observed among 86% in group A, 63% in Group B, and 88% in Group C. Group C showed 5.33 times [95% CI 2.15 to 13.18] higher immune response than group B. Mild to moderate adverse events occurred in 30.1% [95% CI 24.7 to 35.9] of the study samples. Adverse events with the whole virus, mRNA, and vector vaccines occurred in 25%, 28%, and 37%, respectively.

CONCLUSION

Vaccinating and bariatric surgery are safe and effective treatments in the serological response in patients who suffer from obesity.

摘要

目的

本研究的主要目的是确定减重手术是否能逆转肥胖对 COVID-19 疫苗接种后血清学反应的负面影响。这一目标通过两步来实现:(a) 量化肥胖对 COVID-19 疫苗接种后血清学反应的负面影响,如果存在的话;(b) 检验减重手术是否逆转了这种影响。次要目标是监测不良事件的发生。

方法

这是一项 2021 年 5 月至 8 月期间关于 COVID-19 疫苗接种后血清学反应的前瞻性队列研究。患者被分为三组。A 组(对照组,体重正常或超重)、B 组(术前肥胖患者)和 C 组(术后肥胖患者)。从至少接种疫苗后 2 周的血清中定量检测针对 SARS-CoV-2 RBD 的具有强中和能力的抗体。

结果

在 276 名参与者中,A 组有 n=73 例,B 组有 n=126 例,C 组有 n=77 例。总体而言,A 组 86%、B 组 63%和 C 组 88%的患者表现出强烈的疫苗血清学反应。C 组的免疫反应比 B 组高 5.33 倍[95%CI 2.15 至 13.18]。30.1%[95%CI 24.7 至 35.9]的研究样本出现了轻微至中度的不良事件。全病毒、mRNA 和载体疫苗的不良事件发生率分别为 25%、28%和 37%。

结论

对于肥胖患者,接种疫苗和减重手术是安全有效的血清学反应治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/009b/9467938/1c5e58d8b13a/423_2022_2516_Fig1_HTML.jpg

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