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卡塔尔开展的一项关于流感疫苗接种对 COVID-19 严重程度影响的横断面研究。

A cross-sectional study from Qatar on the effect of influenza vaccination on the severity of COVID-19.

机构信息

Department of Pulmonary Medicine, Hamad General Hospital, Doha, Qatar.

Department of Medicine, Weil Cornell Medical College, Doha, Qatar.

出版信息

Medicine (Baltimore). 2023 Sep 15;102(37):e35107. doi: 10.1097/MD.0000000000035107.

Abstract

To assess and compare the severity of corona virus disease 2019 (COVID-19) infection in patients with and without a history of influenza vaccination. In this cross-sectional study descriptive statistics were used to analyze COVID-19-related parameters, including demographics, comorbidities, and severity. Normally distributed data with mean, standard deviation, and 95% confidence interval (CI) were reported, while non-normally distributed data was presented with median and inter-quartile range. Categorical data was summarized using frequencies and percentages. Associations were assessed using Pearson Chi-square, Fisher Exact, t test, or Mann-Whitney U test. Univariate and multivariate logistic regression methods were used to evaluate the relationship between disease severity, clinical outcomes, influenza vaccination status, and other predictors. Significance was considered for p values < 0.05. Statistical analyses were done using SPSS V.27.0 (IBM Corp) and Epi Info (CDC) software. Between March 2020 and December 2020 before the availability of COVID-19 vaccination, 148,215 severe acute respiratory syndrome corona virus 2 positive patients were studied, with 3519 vaccinated against influenza, and 144,696 unvaccinated. After random sampling at 1:2 ratio, the final analysis included 3234 vaccinated and 5640 unvaccinated patients. The majority (95.4%) had mild or asymptomatic COVID-19, while 4.6% had severe or critical cases as defined by World Health Organization severity grading. Multivariate logistic regression analysis revealed that the vaccinated group had significantly less severe (adjusted odds ratio [OR] 0.683; 95% CI 0.513-0.911, P = .009) and critical (adjusted OR 0.345; 95% CI 0.145-0.822, P = .016) COVID-19 and were less likely to require oxygen therapy (adjusted OR 0.696; 95% CI 0.531-0.912, P = .009) after adjusting for confounders like age, gender and comorbidities. No significant differences in Intensive care unit admissions (adjusted OR 0.686; 95% CI 0.425-1.11, P = .122), mechanical ventilation (adjusted OR 0.631; 95% CI 0.308-1.295, P = .209) and mortality (adjusted OR 1.105; 95% CI 0.348-3.503, P = .866) were noted between the 2 groups. Influenza vaccination may significantly reduce the severity of COVID-19 but has no significant effect on intensive care unit admissions, mechanical ventilation and all- cause mortality.

摘要

目的

评估和比较有流感疫苗接种史和无流感疫苗接种史的 2019 年冠状病毒病(COVID-19)感染患者的严重程度。方法:本回顾性研究采用描述性统计方法分析 COVID-19 相关参数,包括人口统计学、合并症和严重程度。正态分布数据采用均值、标准差和 95%置信区间(CI)表示,非正态分布数据采用中位数和四分位距表示。分类数据采用频率和百分比表示。采用 Pearson χ2 检验、Fisher 确切检验、t 检验或 Mann-Whitney U 检验评估关联。采用单变量和多变量逻辑回归方法评估疾病严重程度、临床结局、流感疫苗接种状况和其他预测因素之间的关系。p 值<0.05 认为有统计学意义。采用 SPSS V.27.0(IBM 公司)和 Epi Info(CDC)软件进行统计分析。结果:在 2020 年 3 月至 2020 年 12 月 COVID-19 疫苗接种可用之前,研究了 148215 例严重急性呼吸综合征冠状病毒 2 阳性患者,其中 3519 例接种了流感疫苗,144696 例未接种。按照 1:2 的比例随机抽样后,最终分析纳入了 3234 例接种疫苗和 5640 例未接种疫苗的患者。大多数(95.4%)患者 COVID-19 为轻度或无症状,4.6%的患者按世界卫生组织严重程度分级为严重或危重症。多变量逻辑回归分析显示,接种组 COVID-19 严重程度(调整优势比[OR]0.683;95%CI 0.513-0.911,P=0.009)和危重症(调整 OR 0.345;95%CI 0.145-0.822,P=0.016)发生率显著降低,且更不可能需要氧疗(调整 OR 0.696;95%CI 0.531-0.912,P=0.009)。两组间重症监护病房入住率(调整 OR 0.686;95%CI 0.425-1.11,P=0.122)、机械通气(调整 OR 0.631;95%CI 0.308-1.295,P=0.209)和死亡率(调整 OR 1.105;95%CI 0.348-3.503,P=0.866)无显著差异。结论:流感疫苗接种可能显著降低 COVID-19 的严重程度,但对重症监护病房入住率、机械通气和全因死亡率无显著影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16c1/10508454/4d29ece120de/medi-102-e35107-g001.jpg

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