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术后局灶性癫痫患者 COVID-19 疫苗接种的预测因素和流行率。

Predictors and prevalence of COVID-19 vaccination in patients with focal epilepsy following resection surgery.

机构信息

Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Department of Radiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

出版信息

Epilepsy Behav. 2023 Aug;145:109344. doi: 10.1016/j.yebeh.2023.109344. Epub 2023 Jul 3.

Abstract

BACKGROUND AND PURPOSE

In light of the ongoing COVID-19 pandemic, vaccination has emerged as the primary and most effective solution. The aim of this study was to examine compliance rates of vaccination and explore the factors that predict vaccine uptake among patients with epilepsy (PWE) who have undergone resection surgery.

METHOD

To examine the variations in vaccination coverage, safety concerns, and factors influencing vaccination hesitancy among PWE who have undergone resection surgery, this study recruited patients with at least one-year follow-up. We utilized questionnaires to gather clinical characteristics and obtain information regarding COVID-19 vaccines.

RESULTS

Among the 303 patients included in the study, a majority of 229 (75.58%) achieved a seizure-free outcome (Engel Ia). Of these patients, 178 (58.75%) received at least one dose of COVID-19 vaccine, and the vaccination rate has remained relatively consistent over the past six months. Nearly 94.95% of those who received the vaccine completed the full vaccination regimen, with the majority (n = 174, 97.75%) opting for an inactivated vaccine. Only three patients reported side effects unrelated to epilepsy, and one patient experienced a worsening of typical aura seizures within one month after vaccination. Notably, significant positive associations were observed between COVID-19 vaccine acceptance and adulthood (age 18 years or older) (OR = 1.820, 95% CI = 1.018-3.252, p = 0.043) as well as achieving a seizure-free outcome (OR = 2.823, 95% CI = 1.619-4.921, p < 0.001). Regarding the unvaccinated patients, approximately one-fifth expressed willingness to receive a future COVID-19 vaccine, while the remainder were hesitant (41.60%) or unsure (39.20%) about vaccination. These reservations mainly stemmed from concerns about the potential worsening of seizures and vaccine safety.

CONCLUSIONS

Inactivated vaccines can be considered safe for individuals with epilepsy who have undergone resection surgery. The likelihood of being vaccinated was found to be comparatively higher among the cohort with seizure-free status or adults. To promote COVID-19 vaccination among children, it is crucial to implement comprehensive education and public awareness campaigns that emphasize the safety of vaccines. These efforts will help encourage widespread acceptance of vaccination and ensure the well-being of individuals with epilepsy.

摘要

背景与目的

鉴于当前的 COVID-19 大流行,接种疫苗已成为主要且最有效的解决方案。本研究旨在评估接受过切除术的癫痫患者(PWE)的疫苗接种率,并探讨预测疫苗接种率的因素。

方法

为了研究接受过切除术的 PWE 中疫苗接种覆盖率、安全性问题以及疫苗接种犹豫的影响因素的变化,本研究招募了至少随访一年的患者。我们使用问卷收集临床特征并获取有关 COVID-19 疫苗的信息。

结果

在纳入的 303 例患者中,229 例(75.58%)达到无癫痫发作的结果(Engel Ia)。其中,178 例(58.75%)患者接种了至少一剂 COVID-19 疫苗,且在过去六个月中疫苗接种率保持相对稳定。近 94.95%的已接种疫苗者完成了完整的疫苗接种方案,其中大多数(n=174,97.75%)选择了灭活疫苗。仅 3 例患者报告了与癫痫无关的副作用,1 例患者在接种疫苗后一个月内癫痫典型先兆发作恶化。值得注意的是,COVID-19 疫苗接种率与成年(18 岁及以上)(OR=1.820,95%CI=1.018-3.252,p=0.043)和达到无癫痫发作的结果(OR=2.823,95%CI=1.619-4.921,p<0.001)之间存在显著正相关。对于未接种疫苗的患者,约五分之一表示愿意接受未来的 COVID-19 疫苗,而其余的人则对疫苗接种犹豫不决(41.60%)或不确定(39.20%)。这些保留意见主要源于对癫痫发作恶化和疫苗安全性的担忧。

结论

灭活疫苗可被认为对接受过切除术的癫痫患者是安全的。无癫痫发作或成年患者的疫苗接种率相对较高。为了在儿童中推广 COVID-19 疫苗接种,必须实施全面的教育和公众意识运动,强调疫苗的安全性。这些努力将有助于鼓励广泛接受疫苗接种,并确保癫痫患者的健康。

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