Department of Nephrology, The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Chongqing Clinical Research Center of Kidney and Urology Diseases, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, P.R. China.
Hum Vaccin Immunother. 2023 Aug 1;19(2):2252257. doi: 10.1080/21645515.2023.2252257.
The impact of vaccination on the outcomes of dialysis patients with Omicron infections in China remains unknown. This study aimed to examine the relationship between vaccination and hospitalization as well as all-cause mortality. We included patients who had undergone maintenance hemodialysis (HD) for at least three months at our center. The follow-up period spanned from December 2022 to February 2023. We assessed the connections between vaccination and hospitalization as well as all-cause mortality using univariable and multivariable logistic regression models. Receiver operating characteristic (ROC) curves were used to assess the diagnostic accuracy for hospitalization and all-cause mortality. Ultimately, a total of 427 HD patients with confirmed SARS-CoV-2 infections were included. The patients had a mean age of 54 years, and 59.4% of them were male. Prior to the investigation, 108 patients had received vaccinations, with 81 of them having completed or received booster vaccinations. Throughout the follow-up period, 81 patients were admitted to the hospital, and 39 patients died. Multivariable logistic regression revealed that vaccination significantly decreased all-cause mortality (OR 0.25, 95% CI 0.07-1.94, = .04). Moreover, completed or booster vaccinations were effective in reducing the hospitalization rate (OR 0.41, 95%CI 0.17-0.99, = .047). It is noteworthy that both unvaccinated and vaccinated individuals experienced mild symptoms, and the hospitalization rates were relatively low in both groups. Despite the reduced pathogenicity of Omicron compared to previous strains in dialysis patients, both vaccinated and unvaccinated, vaccination still provides benefits for improving the prognosis.
在中国,接种疫苗对奥密克戎感染透析患者结局的影响尚不清楚。本研究旨在探讨疫苗接种与住院及全因死亡率之间的关系。我们纳入了在本中心至少接受了三个月维持性血液透析(HD)的患者。随访时间从 2022 年 12 月到 2023 年 2 月。我们使用单变量和多变量逻辑回归模型评估了疫苗接种与住院和全因死亡率之间的关系。采用受试者工作特征(ROC)曲线评估住院和全因死亡率的诊断准确性。最终,共纳入 427 例确诊为 SARS-CoV-2 感染的 HD 患者。患者的平均年龄为 54 岁,其中 59.4%为男性。在调查之前,有 108 例患者接受了疫苗接种,其中 81 例完成了全程或加强免疫接种。在整个随访期间,有 81 例患者住院,39 例患者死亡。多变量逻辑回归显示,疫苗接种显著降低了全因死亡率(OR 0.25,95%CI 0.07-1.94, = .04)。此外,完成或加强免疫接种可有效降低住院率(OR 0.41,95%CI 0.17-0.99, = .047)。值得注意的是,未接种疫苗和接种疫苗的患者均出现了轻症,且两组的住院率均较低。尽管与透析患者既往毒株相比,奥密克戎的致病性降低,但接种疫苗仍能改善预后。