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COVID-19 疫苗对儿童多系统炎症综合征 (MIS-C) 发病的保护作用:系统文献回顾和荟萃分析。

The protective effect of COVID-19 vaccines on developing multisystem inflammatory syndrome in children (MIS-C): a systematic literature review and meta-analysis.

机构信息

Department of Paediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, P.O. box 85090, Utrecht, 3508 AB, The Netherlands.

Department of Pediatrics, Carmel Medical Center, Technion Faculty of Medicine, Haifa, Israel.

出版信息

Pediatr Rheumatol Online J. 2023 Aug 7;21(1):80. doi: 10.1186/s12969-023-00848-1.

Abstract

OBJECTIVE

To review whether the current COVID-19 vaccines can prevent the occurrence of multisystem inflammatory syndrome in children (MIS-C) and adolescents.

METHODS

A systematic literature review and meta-analysis were performed. The data were abstracted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Primary outcome was the efficacy of COVID-19 vaccination in preventing MIS-C development. The search was performed in PubMed and Embase.

RESULTS

The review yielded 13 studies, which were included for critical appraisal and data extraction. The available studies showed a reduced incidence of MIS-C after mRNA COVID-19 vaccination in children aged 12-18 years. Four studies were eligible for meta-analysis and the pooled odds ratio for MIS-C in vaccinated children compared to unvaccinated children was 0.04 (95% confidence interval: 0.03-0.06). Additionally, the risk of MIS-C as an adverse effect of vaccination was much lower compared to the risk of MIS-C post-infection.

CONCLUSIONS

Our systematic review highlights the current available evidence on the efficacy of COVID-19 vaccination in preventing MIS-C. The published studies so far - mainly conducted during the Delta wave - indicate that (original strain) COVID-19 mRNA vaccines in children are safe and associated with significantly less development of MIS-C. These findings further reinforce the recommendation for COVID-19 vaccination in children, which should be promoted and largely supported.

摘要

目的

综述当前的 COVID-19 疫苗是否能预防儿童多系统炎症综合征(MIS-C)和青少年 MIS-C。

方法

进行了系统的文献综述和荟萃分析。数据是按照系统评价和荟萃分析的首选报告项目(PRISMA)指南提取的。主要结果是 COVID-19 疫苗预防 MIS-C 发生的效果。在 PubMed 和 Embase 进行了检索。

结果

综述共纳入 13 项研究,进行了关键性评估和数据提取。现有研究表明,12-18 岁儿童接种 mRNA COVID-19 疫苗后,MIS-C 的发病率降低。四项研究适合进行荟萃分析,与未接种疫苗的儿童相比,接种疫苗的儿童 MIS-C 的汇总优势比为 0.04(95%置信区间:0.03-0.06)。此外,与感染后 MIS-C 的风险相比,疫苗接种的 MIS-C 风险要低得多。

结论

本系统综述强调了 COVID-19 疫苗预防 MIS-C 的当前可用证据。迄今为止发表的研究主要是在 Delta 波期间进行的,表明儿童接种(原始株)COVID-19 mRNA 疫苗是安全的,与 MIS-C 的发生显著减少相关。这些发现进一步强化了儿童 COVID-19 疫苗接种的建议,应促进并大力支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/40d9/10405572/88f97a4c55cd/12969_2023_848_Fig1_HTML.jpg

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