Department of Internal Medicine, Kangnam Sacred Heart Hospital, Seoul, Republic of Korea.
Hallym Kidney Research Institute, Hallym University College of Medicine, Seoul, Republic of Korea.
Front Public Health. 2024 May 9;12:1372525. doi: 10.3389/fpubh.2024.1372525. eCollection 2024.
Patients undergoing hemodialysis (HD) have a high risk of novel coronavirus disease 2019 (COVID-19) and poor clinical outcomes. This study aimed to investigate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine effectiveness against infection and deaths in the South Korean population undergoing HD.
We conducted a retrospective cohort study to compare the incidence of COVID-19 and post-diagnosis mortality between patients who were either never vaccinated or fully or partially vaccinated. The Korean nationwide COVID-19 registry and the Korean National Health Insurance Service databases were used. Adult patients without a history of COVID-19 were included between October 8, 2020, and December 31, 2021. The study outcomes were COVID-19 diagnosis, severe clinical COVID-19-related events, and post-diagnosis death.
Eighty-five thousand eighteen patients undergoing HD were included, of whom 69,601 were fully vaccinated, 2,213 were partially vaccinated and 13,204 were unvaccinated. Compared with the unvaccinated group, the risk of being diagnosed with COVID-19 in patients who were fully vaccinated decreased during the study period (adjusted odds ratio [aOR] = 0.147; 95% confidence interval [CI] = 0.135-0.159). There were 1,140 (1.3%) patients diagnosed with COVID-19. After diagnosis, fully vaccinated patients were significantly less likely to die than unvaccinated patients (aOR = 0.940; 95% CI = 0.901-0.980) and to experience severe clinical events (aOR = 0.952; 95% CI = 0.916-0.988).
Full vaccination against COVID-19 was associated with a reduced risk of both infection and severe clinical outcomes in the South Korean population undergoing HD. These findings support the use of vaccination against SARS-CoV-2 among patients undergoing HD.
接受血液透析（HD）的患者感染 2019 年新型冠状病毒病（COVID-19）的风险较高，临床结局较差。本研究旨在调查 SARS-CoV-2 疫苗对韩国 HD 患者的感染和死亡的有效性。
我们进行了一项回顾性队列研究，比较了从未接种疫苗或完全或部分接种疫苗的患者 COVID-19 的发病率和诊断后死亡率。使用了韩国全国 COVID-19 登记处和韩国国家健康保险服务数据库。纳入了 2020 年 10 月 8 日至 2021 年 12 月 31 日期间无 COVID-19 病史的成年患者。研究结果是 COVID-19 诊断、严重临床 COVID-19 相关事件和诊断后死亡。
共纳入 85018 名 HD 患者，其中 69601 名患者完全接种了疫苗，2213 名患者部分接种了疫苗，13204 名患者未接种疫苗。与未接种疫苗组相比，研究期间完全接种疫苗的患者 COVID-19 诊断风险降低（调整后的优势比[aOR] = 0.147；95%置信区间[CI] = 0.135-0.159）。有 1140 名（1.3%）患者被诊断患有 COVID-19。诊断后，完全接种疫苗的患者死亡风险明显低于未接种疫苗的患者（aOR = 0.940；95% CI = 0.901-0.980），且发生严重临床事件的风险也较低（aOR = 0.952；95% CI = 0.916-0.988）。
在韩国 HD 患者中，COVID-19 疫苗的完全接种与感染和严重临床结局的风险降低有关。这些发现支持在 HD 患者中使用 SARS-CoV-2 疫苗。
