Salmen Anke, Marti Stefanie, Hoepner Andreas G F, Chan Andrew, Hoepner Robert
Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
Department of Banking and Finance, Michael Smurfit Graduate Business School, University College Dublin, Dublin, Ireland.
Front Pharmacol. 2023 Jun 15;14:1186404. doi: 10.3389/fphar.2023.1186404. eCollection 2023.
Patients under immunotherapies were excluded from the pivotal trials of vaccinations against the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), and no population-level data on disease outcomes such as case fatality rates in relation to vaccination coverage exist. Our study aims to fill this gap by investigating whether CFRs in patients with immunotherapies decrease with increasing vaccination coverage in the total population. We combined aggregated open source data on COVID-19 vaccination coverage from "Our World in Data" with publicly available anonymized COVID-19 case reports from the FDA Adverse Event Reporting System to compute COVID-19 CFRs for patients under immunotherapy at different vaccination coverage levels in the total population. CFRs at different vaccination coverage levels were then compared to CFRs before vaccination campaign start. While we found an overall decrease in CFRs on population level with increasing vaccination coverage, we found no decrease in people using anti-CD20 or glucocorticoids. Risk-mitigation strategies on an individual- and population-level are thus still needed to lower the probability of fatal SARS-CoV2 infection for these vulnerable populations.
接受免疫疗法的患者被排除在针对严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)的疫苗接种关键试验之外,并且不存在关于疾病结局(如与疫苗接种覆盖率相关的病死率)的人群水平数据。我们的研究旨在通过调查在总人口中,接受免疫疗法的患者的病死率是否随着疫苗接种覆盖率的增加而降低来填补这一空白。我们将来自“Our World in Data”的关于COVID-19疫苗接种覆盖率的汇总开源数据与美国食品药品监督管理局不良事件报告系统中公开可用的匿名COVID-19病例报告相结合,以计算在总人口中不同疫苗接种覆盖率水平下接受免疫疗法的患者的COVID-19病死率。然后将不同疫苗接种覆盖率水平下的病死率与疫苗接种运动开始前的病死率进行比较。虽然我们发现随着疫苗接种覆盖率的增加,总体人群水平的病死率有所下降,但我们发现使用抗CD20或糖皮质激素的人群病死率没有下降。因此,仍需要在个体和人群层面采取风险缓解策略,以降低这些脆弱人群感染致命SARS-CoV-2的概率。