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新型冠状病毒肺炎(COVID-19)疫苗接种与心血管和其他疾病住院风险的关联:来自英国生物库(UK Biobank)数据的研究。

Association of COVID-19 vaccination with risks of hospitalization due to cardiovascular and other diseases: A study using data from the UK Biobank.

机构信息

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.

出版信息

Int J Infect Dis. 2024 Aug;145:107080. doi: 10.1016/j.ijid.2024.107080. Epub 2024 May 2.

Abstract

OBJECTIVES

To explore whether COVID-19 vaccination protects against hospital admission by preventing infections and severe disease.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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