Division of Plastic & Reconstructive Surgery, University of Miami Miller School of Medicine, Miami, Florida, United States of America.
Department of Surgery, Luminis Health-Anne Arundel Medical Center, Annapolis, Maryland, United States of America.
PLoS One. 2023 Mar 10;18(3):e0281990. doi: 10.1371/journal.pone.0281990. eCollection 2023.
Multiple recent studies suggest a possible protective effect of the influenza vaccine against severe acute respiratory coronavirus 2 (SARS-CoV-2). This effect has yet to be evaluated in surgical patients. This study utilizes a continuously updated federated electronic medical record (EMR) network (TriNetX, Cambridge, MA) to analyze the influence of the influenza vaccine against post-operative complications in SARS-CoV-2-positive patients.
The de-identified records of 73,341,020 patients globally were retrospectively screened. Two balanced cohorts totaling 43,580 surgical patients were assessed from January 2020-January 2021. Cohort One received the influenza vaccine six months-two weeks prior to SARS-CoV-2-positive diagnosis, while Cohort Two did not. Post-operative complications within 30, 60, 90, and 120 days of undergoing surgery were analyzed using common procedural terminology(CPT) codes. Outcomes were propensity score matched for characteristics including age, race, gender, diabetes, obesity, and smoking.
SARS-CoV-2-positive patients receiving the influenza vaccine experienced significantly decreased risks of sepsis, deep vein thrombosis, dehiscence, acute myocardial infarction, surgical site infections, and death across multiple time points(p<0.05, Bonferroni Correction p = 0.0011). Number needed to vaccinate (NNV) was calculated for all significant and nominally significant findings.
Our analysis examines the potential protective effect of influenza vaccination in SARS-CoV-2-positive surgical patients. Limitations include this study's retrospective nature and reliance on accuracy of medical coding. Future prospective studies are warranted to confirm our findings.
最近多项研究表明，流感疫苗可能对严重急性呼吸冠状病毒 2（SARS-CoV-2）有保护作用。这一效果尚未在外科患者中进行评估。本研究利用一个不断更新的联邦电子病历（EMR）网络（TriNetX，马萨诸塞州剑桥），分析流感疫苗对 SARS-CoV-2 阳性患者术后并发症的影响。
全球范围内的 73341020 份患者记录被回顾性筛选。从 2020 年 1 月至 2021 年 1 月，评估了两个共包含 43580 名外科患者的平衡队列。队列一在 SARS-CoV-2 阳性诊断前六个月至两周内接种了流感疫苗，而队列二则没有。术后 30、60、90 和 120 天内使用常见手术程序术语（CPT）代码分析术后并发症。结果根据年龄、种族、性别、糖尿病、肥胖和吸烟等特征进行倾向评分匹配。
接受流感疫苗的 SARS-CoV-2 阳性患者在多个时间点上经历了败血症、深静脉血栓形成、裂开、急性心肌梗死、手术部位感染和死亡的风险显著降低（p<0.05，Bonferroni 校正 p = 0.0011）。所有有统计学意义和名义上有统计学意义的发现都计算了需要接种疫苗的人数（NNV）。
我们的分析检查了流感疫苗在 SARS-CoV-2 阳性外科患者中的潜在保护作用。局限性包括本研究的回顾性性质和对医疗编码准确性的依赖。需要进行未来的前瞻性研究来证实我们的发现。
