Rizzo Pier Andrea, Bellavia Simone, Scala Irene, Colò Francesca, Broccolini Aldobrando, Antonica Riccardo, Vitali Francesca, Angeloni Benedetta Maria, Brunetti Valerio, Di Iorio Riccardo, Monforte Mauro, Della Marca Giacomo, Calabresi Paolo, Luigetti Marco, Frisullo Giovanni
UOC Neurology, Catholic University of Sacred Heart, 00168 Rome, Italy.
UOC Neurology, Fondazione Policlinico Universitario Agostino Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), 00168 Rome, Italy.
J Clin Med. 2022 Nov 22;11(23):6878. doi: 10.3390/jcm11236878.
Background: It is unclear whether and how COVID-19 vaccination may affect the outcome of patients with acute ischemic stroke (AIS). We investigated this potential association in a retrospective study by comparing previously vaccinated (VAX) versus unvaccinated (NoVAX) stroke patients. Methods: We collected clinical reports for all consecutive AIS patients admitted to our hospital and evaluated the outcome predictors in VAX and NoVAX groups. Adjustments were made for possible confounders in multivariable logistic regression analysis, and adjusted hazard ratios were calculated. Results: A total of 466 AIS patients (287 VAX and 179 NoVAX) were included in this study. The NIHSS score at discharge and mRS score at a 3-month follow-up visit were significantly lower in VAX patients compared to NoVAX patients (p < 0.001). Good outcomes (mRS 0−2) were significantly associated with COVID-19 vaccination before AIS (adjusted hazard ratio, 0.400 [95% CI = 0.216−0.741]). Conclusions: The observation that COVID-19 vaccination can influence the outcome of AIS provides support for further studies investigating the role of immunity in ischemic brain damage.
目前尚不清楚2019冠状病毒病（COVID-19）疫苗接种是否以及如何影响急性缺血性卒中（AIS）患者的预后。我们通过比较既往接种过疫苗（VAX）和未接种过疫苗（NoVAX）的卒中患者，在一项回顾性研究中调查了这种潜在关联。方法：我们收集了我院收治的所有连续性AIS患者的临床报告，并评估了VAX组和NoVAX组的预后预测因素。在多变量逻辑回归分析中对可能的混杂因素进行了调整，并计算了调整后的风险比。结果：本研究共纳入466例AIS患者（287例VAX和179例NoVAX）。与NoVAX患者相比，VAX患者出院时的美国国立卫生研究院卒中量表（NIHSS）评分和3个月随访时的改良Rankin量表（mRS）评分显著更低（p<0.001）。良好预后（mRS 0−2）与AIS前接种COVID-19疫苗显著相关（调整后的风险比，0.400[95%置信区间=0.216−0.741]）。结论：COVID-19疫苗接种可影响AIS预后这一观察结果为进一步研究免疫在缺血性脑损伤中的作用提供了支持。
