COVID-19 疫苗接种对脾切除术后免疫性血小板减少症患者的保护作用。

Protective effects of COVID-19 vaccination in splenectomized patients with immune thrombocytopenia.

机构信息

Department of Hematology, West China Hospital, Sichuan University, Chengdu, China.

West China School of Medicine, Sichuan University, Chengdu, China.

出版信息

Br J Haematol. 2024 Jun;204(6):2217-2221. doi: 10.1111/bjh.19405. Epub 2024 Apr 17.

DOI:10.1111/bjh.19405

PMID:38632670

Abstract

Splenectomy is an effective treatment for immune thrombocytopenia (ITP). The effect of COVID-19 vaccination on splenectomized patients with ITP during the COVID-19 pandemic has not been reported. Therefore, this study aimed to investigate the effect of COVID-19 vaccination on clinical outcomes in these patients. This was a longitudinal study of splenectomized patients with ITP. A total of 191 splenectomized patients were included in this study. After a median follow-up of 114 months, 146 (76.4%) patients had a sustained response to splenectomy. During COVID-19 infection, vaccinated patients showed a lower risk of severe infections (odds ratio [OR], 0.13; 95% confidence interval [CI]: 0.05-0.36; p < 0.001), hospitalization (OR, 0.13; 95% CI, 0.04-0.48; p = 0.002), and ITP exacerbation (OR, 0.16; 95% CI, 0.04-0.67; p = 0.012). These findings indicate that COVID-19 vaccination plays a protective role in splenectomized patients with ITP.

摘要

脾切除术是治疗免疫性血小板减少症 (ITP) 的有效方法。在 COVID-19 大流行期间，COVID-19 疫苗接种对接受脾切除术的 ITP 患者的影响尚未报道。因此，本研究旨在探讨 COVID-19 疫苗接种对这些患者临床结局的影响。这是一项对接受脾切除术的 ITP 患者进行的纵向研究。共有 191 例接受脾切除术的患者纳入本研究。在中位数为 114 个月的随访后，146 例（76.4%）患者对脾切除术有持续反应。在 COVID-19 感染期间，接种疫苗的患者发生严重感染的风险较低（比值比 [OR]，0.13；95%置信区间 [CI]：0.05-0.36；p<0.001）、住院（OR，0.13；95% CI，0.04-0.48；p=0.002）和 ITP 加重（OR，0.16；95% CI，0.04-0.67；p=0.012）的风险较低。这些发现表明 COVID-19 疫苗接种在接受脾切除术的 ITP 患者中发挥保护作用。