COVID-19 疫苗在降低 COVID-19 的发病率、住院率和死亡率方面的有效性：系统评价和荟萃分析。

The effectiveness of COVID-19 vaccines in reducing the incidence, hospitalization, and mortality from COVID-19: A systematic review and meta-analysis.

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.

Department of Pharmacy, Shahid Behest University of Medical Sciences, Tehran, Iran.

出版信息

Front Public Health. 2022 Aug 26;10:873596. doi: 10.3389/fpubh.2022.873596. eCollection 2022.

BACKGROUND

Vaccination, one of the most important and effective ways of preventing infectious diseases, has recently been used to control the COVID-19 pandemic. The present meta-analysis study aimed to evaluate the effectiveness of COVID-19 vaccines in reducing the incidence, hospitalization, and mortality from COVID-19.

METHODS

A systematic search was performed independently in Scopus, PubMed Medline, ProQuest, and Google Scholar electronic databases as well as preprint servers using the keywords under study. We used random-effect models and the heterogeneity of the studies was assessed using and χ statistics. In addition, the Pooled Vaccine Effectiveness (PVE) obtained from the studies was calculated by converting based on the type of outcome.

RESULTS

A total of 54 studies were included in this meta-analysis. The PVE against SARS-COV 2 infection were 71% [odds ratio (OR) = 0.29, 95% confidence intervals (CI): 0.23-0.36] in the first dose and 87% (OR = 0.13, 95% CI: 0.08-0.21) in the second dose. The PVE for preventing hospitalization due to COVID-19 infection was 73% (OR = 0.27, 95% CI: 0.18-0.41) in the first dose and 89% (OR = 0.11, 95% CI: 0.07-0.17) in the second dose. With regard to the type of vaccine, mRNA-1273 and combined studies in the first dose and ChAdOx1 and mRNA-1273 in the second dose had the highest effectiveness in preventing infection. Regarding the COVID-19-related mortality, PVE was 68% (HR = 0.32, 95% CI: 0.23-0.45) in the first dose and 92% (HR = 0.08, 95% CI: 0.02-0.29) in the second dose.

CONCLUSION

The results of this meta-analysis indicated that vaccination against COVID-19 with BNT162b2 mRNA, mRNA-1273, and ChAdOx1, and also their combination, was associated with a favorable effectiveness against SARS-CoV2 incidence rate, hospitalization, and mortality rate in the first and second doses in different populations. We suggest that to prevent the severe form of the disease in the future, and, in particular, in the coming epidemic picks, vaccination could be the best strategy to prevent the severe form of the disease.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO International Prospective Register of Systematic Reviews: http://www.crd.york.ac.uk/PROSPERO/, identifier [CRD42021289937].

背景

疫苗接种是预防传染病的最重要和最有效的方法之一，最近已被用于控制 COVID-19 大流行。本荟萃分析旨在评估 COVID-19 疫苗在降低 COVID-19 发病率、住院率和死亡率方面的有效性。

方法

使用研究关键词，在 Scopus、PubMed Medline、ProQuest 和 Google Scholar 电子数据库以及预印本服务器中独立进行了系统搜索。我们使用随机效应模型，并使用和 χ 统计量评估研究的异质性。此外，通过基于结局类型转换，计算研究中得到的汇总疫苗有效性（PVE）。

结果

本荟萃分析共纳入 54 项研究。第一剂疫苗对 SARS-COV 2 感染的 PVE 为 71%（OR = 0.29，95%CI：0.23-0.36），第二剂疫苗为 87%（OR = 0.13，95%CI：0.08-0.21）。第一剂疫苗预防 COVID-19 感染住院的 PVE 为 73%（OR = 0.27，95%CI：0.18-0.41），第二剂疫苗为 89%（OR = 0.11，95%CI：0.07-0.17）。关于疫苗类型，mRNA-1273 和联合研究在第一剂疫苗中以及 ChAdOx1 和 mRNA-1273 在第二剂疫苗中具有最高的预防感染效果。关于与 COVID-19 相关的死亡率，第一剂疫苗的 PVE 为 68%（HR = 0.32，95%CI：0.23-0.45），第二剂疫苗为 92%（HR = 0.08，95%CI：0.02-0.29）。

结论

这项荟萃分析的结果表明，在不同人群中，使用 BNT162b2 mRNA、mRNA-1273 和 ChAdOx1 进行 COVID-19 疫苗接种，以及它们的组合，与 SARS-CoV2 发病率、住院率和死亡率的良好有效性相关。我们建议，为了预防未来疾病的严重形式，特别是在未来的疫情高峰期，疫苗接种可能是预防疾病严重形式的最佳策略。