Song Jihun, Choi Seulggie, Jeong Seogsong, Chang Joo Young, Park Sun Jae, Oh Yun Hwan, Kim Ji Soo, Cho Yoosun, Byeon Kyeonghyang, Choi Jun Yong, Lee Seju, Park Sang Min
Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea.
Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Clin Res Cardiol. 2024 Feb;113(2):235-245. doi: 10.1007/s00392-023-02271-8. Epub 2023 Jul 31.
This study investigated the incidence of CVDs after COVID-19.
Data for 2,146,130 infected people were collected, including the vaccination status. COVID-19 patients were classified according to the number of the received vaccine doses: no, first, second, and ≥ third. To evaluate the short-term risk of CVDs after infection, adjusted odds ratios (aOR) and 95% confidence intervals (CIs) were calculated by multivariable logistic regression analysis after adjustments for covariates.
Compared to non-infected people, aORs [95% CIs; p value] for CVDs within a month after infection were 2.80 [2.64-2.97; < 0.001] in overall infected people and 4.62 [4.23-5.05; < 0.001], 4.20 [3.45-5.11; < 0.001], 2.79 [2.55-3.05; < 0.001], and 2.07 [1.91-2.24; < 0.001] in those who were infected after receiving no, first, second, and ≥ third vaccine doses, respectively. Among participants who received second doses of vaccine prior to contracting COVID-19, the aOR in those vaccinated with only the mRNA-based vaccine (BNT162b2 and mRNA-1273; Reference) was lower than those vaccinated with the virus-derived vaccine (ChAdOx1 nCov-19 and AD26.COV2-S; aOR 1.25 [1.06-1.48; < 0.01]).
Although COVID-19 increased the CVD risk, the inverse association in the risk of CVDs according to vaccine doses was significant in a dose-response manner. Our findings suggest that ≥ second doses of the COVID-19 vaccine prevent the risk of CVDs after SARS-CoV-2 infection.
本研究调查了新型冠状病毒肺炎(COVID-19)后心血管疾病(CVDs)的发病率。
收集了2146130名感染者的数据,包括疫苗接种状况。COVID-19患者根据接种疫苗剂量的数量进行分类:未接种、第一剂、第二剂和≥第三剂。为了评估感染后CVDs的短期风险,在对协变量进行调整后,通过多变量逻辑回归分析计算调整后的优势比(aOR)和95%置信区间(CIs)。
与未感染者相比,总体感染者感染后一个月内CVDs的aORs [95% CIs;p值]为2.80 [2.64 - 2.97;<0.001],未接种、接种第一剂、接种第二剂和≥接种第三剂疫苗后感染的人群中分别为4.62 [4.23 - 5.05;<0.001]、4.20 [3.45 - 5.11;<0.001]、2.79 [2.55 - 3.05;<0.001]和2.07 [1.91 - 2.24;<0.001]。在感染COVID-19之前接种第二剂疫苗的参与者中,仅接种基于mRNA的疫苗(BNT162b2和mRNA-1273;参照)的人群的aOR低于接种病毒衍生疫苗(ChAdOx1 nCov-19和AD26.COV2-S;aOR 1.25 [1.06 - 1.48;<0.01])的人群。
尽管COVID-19增加了CVD风险,但根据疫苗剂量,CVDs风险的负相关呈显著的剂量反应关系。我们的研究结果表明,≥两剂COVID-19疫苗可预防严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染后的CVDs风险。