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持续的 COVID-19 疫苗接种风险和对 SARS-CoV-2 感染后长期健康后果的影响。

Persistence in risk and effect of COVID-19 vaccination on long-term health consequences after SARS-CoV-2 infection.

机构信息

Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.

Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.

出版信息

Nat Commun. 2024 Feb 26;15(1):1716. doi: 10.1038/s41467-024-45953-1.

Abstract

The persisting risk of long-term health consequences of SARS-CoV-2 infection and the protection against such risk conferred by COVID-19 vaccination remains unclear. Here we conducted a retrospective territory-wide cohort study on 1,175,277 patients with SARS-CoV-2 infection stratified by their vaccination status and non-infected controls to evaluate the risk of clinical sequelae, cardiovascular and all-cause mortality using a territory-wide public healthcare database with population-based vaccination records in Hong Kong. A progressive reduction in risk of all-cause mortality was observed over one year between patients with SARS-CoV-2 infection and controls. Patients with complete vaccination or have received booster dose incurred a lower risk of health consequences including major cardiovascular diseases, and all-cause mortality than unvaccinated or patients with incomplete vaccination 30-90 days after infection. Completely vaccinated and patients with booster dose of vaccines did not incur significant higher risk of health consequences from 271 and 91 days of infection onwards, respectively, whilst un-vaccinated and incompletely vaccinated patients continued to incur a greater risk of clinical sequelae for up to a year following SARS-CoV-2 infection. This study provided real-world evidence supporting the effectiveness of COVID-19 vaccines in reducing the risk of long-term health consequences of SARS-CoV-2 infection and its persistence following infection.

摘要

SARS-CoV-2 感染长期健康后果的持续风险以及 COVID-19 疫苗接种对这种风险的保护作用仍不清楚。在这里,我们通过香港全人群公共卫生保健数据库,利用基于人群的疫苗接种记录,对 1175277 名 SARS-CoV-2 感染患者(按其接种状况分层)和未感染对照进行了回顾性全港范围队列研究,以评估临床后遗症、心血管和全因死亡率的风险。在 SARS-CoV-2 感染患者和对照组中,在一年的时间里,全因死亡率的风险呈逐渐下降趋势。完全接种疫苗或已接种加强针的患者,发生重大心血管疾病和全因死亡等健康后果的风险低于未接种疫苗或感染后 30-90 天内未完成接种的患者。完全接种疫苗和接种加强针的患者,分别从感染后 271 天和 91 天起,不会因健康后果而面临显著更高的风险,而未接种疫苗和未完全接种疫苗的患者,在 SARS-CoV-2 感染后长达一年的时间里,仍持续面临更大的临床后遗症风险。本研究提供了真实世界的证据,支持 COVID-19 疫苗在降低 SARS-CoV-2 感染长期健康后果风险及其在感染后的持续存在方面的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a210/10894867/baee36e061ac/41467_2024_45953_Fig1_HTML.jpg

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