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新冠病毒疫苗接种能否预防肺栓塞?

Does COVID-19 vaccination protect against pulmonary embolism?

作者信息

Tantillo Simona, Cilloni Nicola, Guarnera Martina, Talarico Francesco, Citino Mario, Silingardi Mauro, Catalano Leonardo, Imbriani Michele

机构信息

Bologna, Italy Department of Anaesthesia, Intensive Care and EMS, Ospedale Maggiore "Carlo Alberto Pizzardi".

Bologna, Italy Department of Internal Medicine, Ospedale Maggiore "Carlo Alberto Pizzardi".

出版信息

J Anesth Analg Crit Care. 2023 May 30;3:14. doi: 10.1186/s44158-023-00097-4. eCollection 2023.

Abstract

The prevalence of venous thromboembolism (VTE) in COVID-19 patients is highly variable, depending on methodological and clinical factors, among which vaccination (1). The hypothesis of a possible protective role of vaccination in preventing pulmonary embolism (PE) in hospitalized COVID-19 patients has not been explored. The aim of the study was to evaluate PE prevalence in vaccinated versus unvaccinated hospitalized COVID-19 patients. We conducted a retrospective case-control study from 2021/11/01 to 2022/01/15; we reviewed all the chest computed topographies (chest-CT) performed because of a clinical suspicion for PE at our Institution. Sixty-two patients were included in the study: 27/62 (43.5%) were vaccinated and 35/62 (56.4%) were not. Vaccinated patients were older and with more comorbidities than unvaccinated people. Overall, PE was diagnosed in 19/62 patients (30.1% prevalence). CT Severity Score (CT-SS) differs between the two groups; not vaccinated patients had a more severe CT imaging than the vaccinated (< 0.00005). PE prevalence in ICU was 43.2% (16/37 patients), while in the Internal Medicine ward, it was 12% (3/25 cases). PE was significantly higher among unvaccinated people: 16/35 (45.7%) vs 3/27 (11.1%), OR  = 0.04. We observed a strong association between vaccination and protection from PE in hospitalized COVID-19 patients: morbidity was significantly lower in vaccinated versus not vaccinated patients. The issue of the protective role of vaccination in COVID-19-associated VTE should be addressed in adequately designed and powered future prospective studies.

摘要

新冠病毒病(COVID-19)患者静脉血栓栓塞症(VTE)的患病率差异很大,这取决于方法学和临床因素,其中包括疫苗接种情况(1)。疫苗接种在预防住院COVID-19患者肺栓塞(PE)方面可能具有保护作用这一假设尚未得到探讨。本研究的目的是评估接种疫苗与未接种疫苗的住院COVID-19患者的PE患病率。我们于2021年11月1日至2022年1月15日进行了一项回顾性病例对照研究;我们查阅了因临床怀疑PE而在本机构进行的所有胸部计算机断层扫描(胸部CT)。62例患者纳入研究:62例中有27例(43.5%)接种了疫苗,35例(56.4%)未接种。接种疫苗的患者比未接种疫苗的患者年龄更大,合并症更多。总体而言,62例患者中有19例(患病率30.1%)被诊断为PE。两组的CT严重程度评分(CT-SS)不同;未接种疫苗的患者CT成像比接种疫苗的患者更严重(<0.00005)。重症监护病房(ICU)的PE患病率为43.2%(37例患者中的16例),而在内科病房为12%(25例中的3例)。未接种疫苗者的PE患病率显著更高:16/35(45.7%)对比3/27(11.1%),比值比(OR)=0.04。我们观察到住院COVID-19患者接种疫苗与预防PE之间存在密切关联:接种疫苗的患者发病率明显低于未接种疫苗的患者。疫苗接种在COVID-19相关VTE中的保护作用问题应在未来设计充分且有足够样本量的前瞻性研究中加以探讨。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/101c/10245434/6e0504dc408d/44158_2023_97_Fig1_HTML.jpg

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