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严重急性呼吸综合征冠状病毒2(SARS-CoV-2)疫苗接种的有效性及免疫功能低下个体采用替代预防方法的必要性:系统评价的叙述性综述

Effectiveness of vaccination against SARS-CoV-2 and the need for alternative preventative approaches in immunocompromised individuals: a narrative review of systematic reviews.

作者信息

Tan Thuan Tong, Ng Heng Joo, Young Barnaby, Khan Behram Ali, Shetty Vikram, Azmi Nura, Clissold Steve

机构信息

Department of Infectious Diseases, Singapore General Hospital, Singapore, Singapore.

Department of Haematology, Singapore General Hospital, Singapore, Singapore.

出版信息

Expert Rev Vaccines. 2023 Jan-Dec;22(1):341-365. doi: 10.1080/14760584.2023.2191716.

Abstract

INTRODUCTION

Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including administration of booster doses, continues to be the most effective method for controlling COVID-19-related complications including progression to severe illness and death. However, there is mounting evidence that more needs to be done to protect individuals with compromised immune function.

AREAS COVERED

Here, we review the effectiveness of COVID-19 vaccination in immunocompromised patients, including those with primary immunodeficiencies, HIV, cancer (including hematological malignancies), solid organ transplant recipients, and chronic kidney disease, as reported in systematic reviews/meta-analyses published over a 12-month period in PubMed. Given the varied responses to vaccination in patients with compromised immune function, a major goal of this analysis was to try to identify specific risk-factors related to vaccine failure.

EXPERT OPINION

COVID-19 remains a global problem, with new variants of concern emerging at regular intervals. There is an ongoing need for optimal vaccine strategies to combat the pandemic. In addition, alternative treatment approaches are needed for immunocompromised patients who may not mount an adequate immune response to current COVID-19 vaccines. Identification of high-risk patients and the introduction of newer antiviral approaches such as monoclonal antibodies will offer physicians therapeutic options for such vulnerable individuals.

摘要

引言

接种针对严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的疫苗,包括接种加强针,仍然是控制与COVID-19相关并发症(包括进展为重症和死亡)的最有效方法。然而,越来越多的证据表明,需要采取更多措施来保护免疫功能受损的个体。

涵盖领域

在此,我们回顾了免疫功能低下患者中COVID-19疫苗接种的有效性,包括原发性免疫缺陷患者、HIV患者、癌症患者(包括血液系统恶性肿瘤患者)、实体器官移植受者和慢性肾病患者,这些内容来自于在PubMed上发表的为期12个月的系统评价/荟萃分析。鉴于免疫功能受损患者对疫苗接种的反应各不相同,本分析的一个主要目标是试图确定与疫苗接种失败相关的具体风险因素。

专家意见

COVID-19仍然是一个全球性问题,新的关注变种定期出现。持续需要最佳的疫苗策略来抗击这一疫情。此外,对于可能对当前COVID-19疫苗没有产生足够免疫反应的免疫功能低下患者,需要有替代治疗方法。识别高危患者并引入更新的抗病毒方法,如单克隆抗体,将为医生为这些弱势群体提供治疗选择。

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