与 COVID-19 住院免疫功能低下成年人严重结局相关的因素 - COVID-NET，10 个州，2020 年 3 月-2022 年 2 月。
Factors Associated with Severe Outcomes Among Immunocompromised Adults Hospitalized for COVID-19 - COVID-NET, 10 States, March 2020-February 2022.
出版信息
MMWR Morb Mortal Wkly Rep. 2022 Jul 8;71(27):878-884. doi: 10.15585/mmwr.mm7127a3.
Immunocompromised persons are at increased risk for severe COVID-19-related outcomes, including intensive care unit (ICU) admission and death (1). Data on adults aged ≥18 years hospitalized with laboratory-confirmed COVID-19 from 10 U.S. states in the COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) were analyzed to assess associations between immunocompromise and ICU admission and in-hospital death during March 1, 2020-February 28, 2022. Associations of COVID-19 vaccination status with ICU admission and in-hospital death were also examined during March 1, 2021-February 28, 2022. During March 1, 2020-February 28, 2022, among a sample of 22,345 adults hospitalized for COVID-19, 12.2% were immunocompromised. Among unvaccinated patients, those with immunocompromise had higher odds of ICU admission (adjusted odds ratio [aOR] = 1.26; 95% CI = 1.08-1.49) and in-hospital death (aOR = 1.34; 95% CI = 1.05-1.70) than did nonimmunocompromised patients. Among vaccinated patients,* those with immunocompromise had higher odds of ICU admission (aOR = 1.40; 95% CI = 1.01-1.92) and in-hospital death (aOR = 1.87; 95% CI = 1.28-2.75) than did nonimmunocompromised patients. During March 1, 2021-February 28, 2022, among nonimmunocompromised patients, patients who were vaccinated had lower odds of death (aOR = 0.58; 95% CI = 0.39-0.86) than did unvaccinated patients; among immunocompromised patients, odds of death between vaccinated and unvaccinated patients did not differ. Immunocompromised persons need additional protection from COVID-19 and using multiple known COVID-19 prevention strategies, including nonpharmaceutical interventions, up-to-date vaccination of immunocompromised persons and their close contacts, early testing, and COVID-19 prophylactic (Evusheld) and early antiviral treatment, can help prevent hospitalization and subsequent severe COVID-19 outcomes among immunocompromised persons.
免疫功能低下者患 COVID-19 相关严重后果（包括入住重症监护病房（ICU）和死亡）的风险增加（1）。对来自美国 COVID-19 相关住院监测网络（COVID-NET）的 10 个州 2020 年 3 月 1 日至 2022 年 2 月 28 日期间因实验室确诊的 COVID-19 住院的 18 岁及以上成年人的数据进行分析，以评估免疫抑制与入住 ICU 和院内死亡之间的关系。还分析了 COVID-19 疫苗接种状态与 2021 年 3 月 1 日至 2022 年 2 月 28 日期间入住 ICU 和院内死亡的关联。在 2020 年 3 月 1 日至 2022 年 2 月 28 日期间，在因 COVID-19 住院的 22345 名成年人中，有 12.2%的人免疫功能低下。在未接种疫苗的患者中，免疫抑制患者入住 ICU 的几率（调整后的优势比[aOR] 1.26；95%CI 1.08-1.49）和院内死亡的几率（aOR 1.34；95%CI 1.05-1.70）均高于非免疫抑制患者。在接种疫苗的患者中，免疫抑制患者入住 ICU 的几率（aOR 1.40；95%CI 1.01-1.92）和院内死亡的几率（aOR = 1.87；95%CI 1.28-2.75）均高于非免疫抑制患者。在 2021 年 3 月 1 日至 2022 年 2 月 28 日期间，在非免疫抑制患者中，与未接种疫苗的患者相比，接种疫苗的患者死亡几率（aOR 0.58；95%CI 0.39-0.86）较低；在免疫抑制患者中，接种疫苗和未接种疫苗的患者之间的死亡几率没有差异。免疫功能低下者需要额外的 COVID-19 保护，可采用多种已知的 COVID-19 预防策略，包括非药物干预措施、及时为免疫功能低下者及其密切接触者接种疫苗、早期检测以及 COVID-19 预防性药物（Evusheld）和早期抗病毒治疗，有助于预防免疫功能低下者住院和随后发生严重的 COVID-19 结局。
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