新冠病毒 19 型疫苗加强针在奥密克戎变异株流行期间显著降低了心力衰竭患者入住重症监护病房的风险：一项基于人群的研究。
COVID-19 vaccine booster significantly decreases the risk of intensive care unit hospitalization in heart failure patients during the Omicron variant wave: A population-based study.
作者信息
Parenica Jiri, Benesova Klara, Radvan Martin, Sanca Ondrej, Hlasensky Jiri, Lokaj Petr, Ondrus Tomas, Helanova Katerina, Kala Petr, Dusek Ladislav, Jarkovsky Jiri
机构信息
Internal and Cardiology Department, University Hospital Brno, Brno, Czechia.
Faculty of Medicine, Masaryk University, Brno, Czechia.
出版信息
Front Cardiovasc Med. 2022 Oct 20;9:998842. doi: 10.3389/fcvm.2022.998842. eCollection 2022.
BACKGROUND
Heart failure (HF) patients are at higher risk of severe coronavirus disease 2019 (COVID-19). The Omicron variant has many novel mutations including those in the spike protein, leading to questions about vaccine effectiveness. The aim of this analysis was to evaluate the effectiveness of the COVID-19 vaccine with or without a booster (i.e., after the third dose) during the Omicron variant wave.
METHODS
Chronic heart failure patients in the Czech Republic were included in the analysis. COVID-19 infection was monitored from January 1st 2022 to March 31st 2022. The analysis was conducted on data collected in the National Health Information System. Vaccine effectiveness of vaccinated (with or without booster) vs. unvaccinated patients was analyzed for incidence of COVID-19, COVID-19-related hospitalizations, COVID-19 related intensive care unit admissions, and COVID-19 related mechanical ventilation/extracorporeal membrane oxygenation treatment.
FINDINGS
From a total 165,453 HF patients in the Czech Republic, 9,728 contracted COVID-19 (22.9% of them not vaccinated, 23.2% vaccinated and 53.8% vaccinated and boosted). Risk of intensive care unit (ICU) hospitalization was 7.6% in the unvaccinated group, 4.8% in the vaccinated group and 2.9% in the boosted group. The calculated effectiveness of the COVID-19 vaccine in prevention of ICU hospitalization in the vaccinated group was 41.9 and 76.6% in the boosted group.
INTERPRETATION
The results demonstrated moderate vaccine effectiveness in the prevention of severe COVID-19 in vaccinated but not boosted HF patients. Much stronger effectiveness was found in those who were vaccinated and boosted.
背景
心力衰竭（HF）患者感染新型冠状病毒肺炎2019（COVID-19）的风险更高。奥密克戎变异株有许多新的突变，包括刺突蛋白中的突变，这引发了关于疫苗有效性的问题。本分析的目的是评估在奥密克戎变异株流行期间，接种或未接种加强针（即第三剂之后）的COVID-19疫苗的有效性。
方法
纳入捷克共和国的慢性心力衰竭患者进行分析。监测2022年1月1日至2022年3月31日期间的COVID-19感染情况。分析基于国家卫生信息系统收集的数据。对接种（有或无加强针）与未接种患者的COVID-19发病率、与COVID-19相关的住院治疗、与COVID-19相关的重症监护病房入院情况以及与COVID-19相关的机械通气/体外膜肺氧合治疗进行疫苗有效性分析。
结果
在捷克共和国总共165453例HF患者中，9728例感染了COVID-19（其中22.9%未接种疫苗，23.2%接种了疫苗，53.8%接种了疫苗并接种了加强针）。未接种疫苗组的重症监护病房（ICU）住院风险为7.6%，接种疫苗组为4.8%，接种加强针组为2.9%。计算得出COVID-19疫苗在预防接种疫苗组ICU住院方面的有效性为41.9%，在接种加强针组为76.6%。
解读
结果表明，在未接种加强针的接种疫苗的HF患者中，疫苗在预防重症COVID-19方面具有中等有效性。在接种疫苗并接种加强针的患者中发现有效性更强。
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