School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong.
School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, China.
Int J Infect Dis. 2024 Aug;145:107080. doi: 10.1016/j.ijid.2024.107080. Epub 2024 May 2.
To explore whether COVID-19 vaccination protects against hospital admission by preventing infections and severe disease.
We leveraged the UK Biobank and studied associations of COVID-19 vaccination (BioNTech-BNT162b2 or Oxford-AstraZeneca-ChAdOx1) with hospitalizations from cardiovascular and other selected diseases (N = 393,544; median follow-up = 54 days among vaccinated individuals). Multivariable Cox, Poisson regression, propensity score matching, and inverse probability treatment weighting analyses were performed. We also performed adjustment using prescription-time distribution matching, and prior event rate ratio.
We observed that COVID-19 vaccination (at least one dose), compared with no vaccination, was associated with reduced short-term risks of hospitalizations from stroke (hazard ratio [HR] = 0.178, 95% confidence interval [CI]: 0.127-0.250, P = 1.50e-23), venous thromboembolism (HR = 0.426, CI: 0.270-0.673, P = 2.51e-4), dementia (HR = 0.114, CI: 0.060-0.216; P = 2.24e-11), non-COVID-19 pneumonia (HR = 0.108, CI: 0.080-0.145; P = 2.20e-49), coronary artery disease (HR = 0.563, CI: 0.416-0.762; P = 2.05e-4), chronic obstructive pulmonary disease (HR = 0.212, CI: 0.126-0.357; P = 4.92e-9), type 2 diabetes (HR = 0.216, CI: 0.096-0.486, P = 2.12e-4), heart failure (HR = 0.174, CI: 0.118-0.256, P = 1.34e-18), and renal failure (HR = 0.415, CI: 0.255-0.677, P = 4.19e-4), based on standard Cox regression models. Among the previously mentioned results, reduced hospitalizations for stroke, heart failure, non-COVID-19 pneumonia, and dementia were consistently observed across regression, propensity score matching/inverse probability treatment weighting, prescription-time distribution matching, and prior event rate ratio. The results for two-dose vaccination were similar.
Taken together, this study provides further support to the safety and benefits of COVID-19 vaccination, and such benefits may extend beyond reduction of infection risk or severity per se. However, causal relationship cannot be concluded and further studies are required.
探讨 COVID-19 疫苗接种是否通过预防感染和重症来保护患者免于住院。
我们利用英国生物银行(UK Biobank)的数据,研究了 COVID-19 疫苗(辉瑞- BioNTech-BNT162b2 或阿斯利康-牛津-ChAdOx1)接种与心血管疾病和其他选定疾病(N=393544;接种人群的中位随访时间=54 天)住院之间的关联。采用多变量 Cox 回归、泊松回归、倾向评分匹配和逆概率治疗加权分析。我们还通过处方时间分布匹配和先前事件率比进行了调整。
与未接种疫苗相比,我们观察到 COVID-19 疫苗(至少一剂)接种与中风(风险比[HR] = 0.178,95%置信区间[CI]:0.127-0.250,P = 1.50e-23)、静脉血栓栓塞(HR = 0.426,CI:0.270-0.673,P = 2.51e-4)、痴呆(HR = 0.114,CI:0.060-0.216;P = 2.24e-11)、非 COVID-19 肺炎(HR = 0.108,CI:0.080-0.145;P = 2.20e-49)、冠状动脉疾病(HR = 0.563,CI:0.416-0.762;P = 2.05e-4)、慢性阻塞性肺疾病(HR = 0.212,CI:0.126-0.357;P = 4.92e-9)、2 型糖尿病(HR = 0.216,CI:0.096-0.486,P = 2.12e-4)、心力衰竭(HR = 0.174,CI:0.118-0.256,P = 1.34e-18)和肾衰竭(HR = 0.415,CI:0.255-0.677,P = 4.19e-4)风险降低相关,这基于标准的 Cox 回归模型。在上述结果中,中风、心力衰竭、非 COVID-19 肺炎和痴呆住院风险降低在回归、倾向评分匹配/逆概率治疗加权、处方时间分布匹配和先前事件率比中均一致观察到。两剂疫苗接种的结果相似。
综上所述,本研究进一步支持 COVID-19 疫苗接种的安全性和益处,并且这些益处可能超出感染风险或严重程度本身的降低。然而,尚不能得出因果关系的结论,还需要进一步的研究。