Department of Medicine, Bærum Hospital, Vestre Viken Hospital Trust, Norway (Håkon Ihle-Hansen).
Department of Infection Control and Vaccines (H.B., J.D.B.), Norwegian Institute of Public Health, Oslo, Norway.
Stroke. 2023 May;54(5):e190-e193. doi: 10.1161/STROKEAHA.122.040430. Epub 2023 Mar 30.
Whether the SARS-CoV-2 mRNA vaccines may cause a transient increased stroke risk is uncertain.
In a registry-based cohort of all adult residents at December 27, 2020, in Norway, we linked individual-level data on COVID-19 vaccination, positive SARS-CoV-2 test, hospital admissions, cause of death, health care worker status, and nursing home resident status extracted from the Emergency Preparedness Register for COVID-19 in Norway. The cohort was followed for incident intracerebral bleeding, ischemic stroke, and subarachnoid hemorrhage within the first 28 days after the first/second or third dose of mRNA vaccination until January 24, 2022. Stroke risk after vaccination relative to time not exposed to vaccination was assessed by Cox proportional hazard ratio, adjusted for age, sex, risk groups, health care personnel, and nursing home resident.
The cohort included 4 139 888 people, 49.8% women, and 6.7% were ≥80 years of age. During the first 28 days after an mRNA vaccine, 2104 people experienced a stroke (82% ischemic stroke, 13% intracerebral hemorrhage, and 5% subarachnoid hemorrhage). Adjusted hazard ratios (95% CI) after the first/second and after the third mRNA vaccine doses were 0.92 (0.85-1.00) and 0.89 (0.73-1.08) for ischemic stroke, 0.81 (0.67-0.98) and 1.05 (0.64-1.71) for intracerebral hemorrhage, and 0.64 (0.46-0.87) and 1.12 (0.57-2.19) for subarachnoid hemorrhage, respectively.
We did not find increased risk of stroke during the first 28 days after an mRNA SARS-CoV-2 vaccine.
SARS-CoV-2 mRNA 疫苗是否会导致短暂的中风风险增加尚不确定。
在挪威 2020 年 12 月 27 日所有成年居民的基于登记的队列中，我们将个体层面的 COVID-19 疫苗接种、SARS-CoV-2 检测阳性、住院、死亡原因、卫生保健工作者状态和疗养院居民状态的数据与挪威 COVID-19 应急准备登记处提取的数据进行了关联。该队列在接种 mRNA 疫苗后的第 1/2 剂或第 3 剂后的 28 天内，随访了脑内出血、缺血性中风和蛛网膜下腔出血的发病情况，直至 2022 年 1 月 24 日。通过 Cox 比例风险比评估了接种疫苗后相对于未暴露于疫苗时的风险，调整了年龄、性别、风险组、卫生保健人员和疗养院居民等因素。
该队列包括 4139888 人，49.8%为女性，6.7%年龄≥80 岁。在接种 mRNA 疫苗后的 28 天内，2104 人发生了中风（82%为缺血性中风，13%为脑内出血，5%为蛛网膜下腔出血）。接种第 1/2 剂和第 3 剂 mRNA 疫苗后，缺血性中风的调整后风险比（95%CI）分别为 0.92（0.85-1.00）和 0.89（0.73-1.08），脑内出血分别为 0.81（0.67-0.98）和 1.05（0.64-1.71），蛛网膜下腔出血分别为 0.64（0.46-0.87）和 1.12（0.57-2.19）。
我们没有发现接种 mRNA SARS-CoV-2 疫苗后 28 天内中风风险增加。
