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接种 COVID-19 疫苗和感染后普通人群中的视网膜静脉阻塞。

Retinal vein occlusion in the general population after COVID-19 vaccination and infection.

机构信息

Depto. de Medicina y Psiquiatría. Universidad de Cantabria, Santander, Spain.

Department of Internal Medicine, Spain.

出版信息

Med Clin (Barc). 2023 Sep 29;161(6):231-237. doi: 10.1016/j.medcli.2023.04.027. Epub 2023 May 9.

Abstract

INTRODUCTION

Retinal vein occlusion (RVO) is mostly a consequence of vascular risk factors (VRF). COVID-19 vaccines have been related to vascular and thrombotic events (VTE).

OBJECTIVE

To assess the RVO incidence in the general population in our health area and the possible relation with COVID-19 infection and vaccination.

METHODS

Demographic features, classic VRF, thrombophilia data, COVID-19 status, and Framingham risk score were collected prospectively.

RESULTS

472 consecutive patients studied over 13 years with RVO were included (Valdecilla Cohort). Classic VRFs were present in 90%, antiphospholipid syndrome in 12.3%, and genetic thrombophilia in 13.5%. Ninety-one percent of RVO patients were vaccinated and 6.8% suffered COVID-19 infection. In the cohort, no patient had a new RVO after vaccination or infection. In the general population, 20 subjects had RVO after receiving the vaccine (0.006%). Overall, 8 cases occurred in the first-month post-vaccination and 12 after 30 days. In the early and late groups, there are 3 and 4 patients respectively, with a low-intermediate risk Framingham score. Twenty-nine patients in the cohort suffered SARS-CoV-2 infection, twenty-seven of them had RVO before infection. Two patients with low-risk Framingham scores had RVO after infection, one of them early (<1 month).

CONCLUSIONS

Vaccination and COVID-19 might be involved in the development of RVO in some cases, mainly in patients without VRF, thrombophilia, or chronic inflammatory conditions and with a lower Framingham score, especially in the first month after vaccination or infection.

摘要

介绍

视网膜静脉阻塞(RVO)主要是血管危险因素(VRF)的后果。COVID-19 疫苗与血管和血栓事件(VTE)有关。

目的

评估我们卫生区域内一般人群中 RVO 的发病率,以及与 COVID-19 感染和疫苗接种的可能关系。

方法

前瞻性收集人口统计学特征、经典 VRF、血栓形成倾向数据、COVID-19 状态和 Framingham 风险评分。

结果

共纳入 13 年来连续研究的 472 例 RVO 患者(瓦尔迪塞利亚队列)。90%存在经典 VRF,12.3%存在抗磷脂综合征,13.5%存在遗传性血栓形成倾向。91%的 RVO 患者接受了疫苗接种,6.8%的患者感染了 COVID-19。在该队列中,接种疫苗或感染后没有患者发生新的 RVO。在普通人群中,有 20 例在接种疫苗后发生 RVO(0.006%)。总体而言,8 例发生在接种后 1 个月内,12 例发生在 30 天后。在早期和晚期组中,分别有 3 例和 4 例患者,Framingham 评分处于低-中危。该队列中有 29 例患者感染了 SARS-CoV-2,其中 27 例在感染前患有 RVO。2 例Framingham 评分低危的患者在感染后发生了 RVO,其中 1 例发生在早期(<1 个月)。

结论

在某些情况下,疫苗接种和 COVID-19 可能与 RVO 的发展有关,主要发生在没有 VRF、血栓形成倾向或慢性炎症性疾病且 Framingham 评分较低的患者中,尤其是在接种疫苗或感染后的第一个月。

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