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垂体疾病患者的新型冠状病毒感染与疫苗接种:巴西一家参考中心的经验

SARS-CoV-2 infection and vaccination in patients with pituitary diseases: the experience of a Brazilian reference center.

作者信息

da Silva Marcela Cunha, Fidalski Solena Ziemer Kusma, Boguszewski Cesar Luiz

机构信息

SEMPR (Endocrine Division), Department of Internal Medicine, Federal University of Parana, Agostinho Leão Junior 285, Curitiba, 80030-110, PR, Brazil.

Department of Community Health, Federal University of Parana, Curitiba, Brazil.

出版信息

Pituitary. 2024 Dec;27(6):992-999. doi: 10.1007/s11102-024-01456-2. Epub 2024 Sep 9.

Abstract

PURPOSE

To evaluate the prevalence and characteristics of SARS-CoV-2 infection, and the prevalence, efficacy, and safety of anti-SARS-CoV-2 vaccination in patients with pituitary diseases.

METHODS

Observational, cross-sectional study of adult patients with pituitary diseases followed in a reference center. Clinical data were collected and a questionnaire about SARS-CoV-2 infection, vaccination and its possible adverse effects was applied. COVID-19 disease severity was defined as mild, moderate, and severe according to the WHO classification.

RESULTS

145 patients were studied (79 women; age 50 ± 15.8 years; duration of pituitary disease 16.8 ± 11.5 years), the cause of pituitary disease was tumoral in 74.5%, and 45.9% were on glucocorticoid replacement due to ACTH deficiency. SARS-CoV-2 infection was confirmed in 51 patients (35.2%; 32 women; age 53.8 ± 14.8 years, 22 before vaccination), with 28 (54.9%), 17 (33.3%) and 6 (11.8%) cases of mild, moderate, and severe disease, respectively, and hospitalization was indicated in 7 (14%) cases. One mild case presented pituitary apoplexy after SARS-CoV-2 infection. Advanced age was a risk factor for COVID-19. Patients with moderate and severe forms of COVID-19 had higher prevalence of dyslipidemia and duration of pituitary disease. All but one of the participants were vaccinated against COVID-19, and 60.4% had adverse events, the most common local pain (54.0%), fever (33.3%), and headache (18.4%), with one case of alopecia and two of persistent fatigue.

CONCLUSION

The prevalence of SARS-CoV-2 infection in our cohort was 35.2%, including 14% of moderate and severe cases requiring hospitalization. The vaccination was universal and safe.

摘要

目的

评估垂体疾病患者中新型冠状病毒2(SARS-CoV-2)感染的患病率及特征,以及抗SARS-CoV-2疫苗接种的患病率、疗效和安全性。

方法

在一家参考中心对成年垂体疾病患者进行观察性横断面研究。收集临床数据,并应用一份关于SARS-CoV-2感染、疫苗接种及其可能不良反应的问卷。根据世界卫生组织分类,将新型冠状病毒肺炎(COVID-19)疾病严重程度定义为轻度、中度和重度。

结果

共研究了145例患者(79例女性;年龄50±15.8岁;垂体疾病病程16.8±11.5年),垂体疾病的病因在74.5%为肿瘤性,45.9%因促肾上腺皮质激素(ACTH)缺乏接受糖皮质激素替代治疗。51例患者(35.2%;32例女性;年龄53.8±14.8岁,22例在接种疫苗前)确诊感染SARS-CoV-2,其中轻度、中度和重度病例分别为28例(54.9%)、17例(33.3%)和6例(11.8%),7例(14%)需要住院治疗。1例轻度病例在感染SARS-CoV-2后出现垂体卒中。高龄是COVID-19的危险因素。中度和重度COVID-19患者血脂异常患病率更高,垂体疾病病程更长。除1名参与者外,其他所有参与者均接种了COVID-19疫苗,60.4%出现不良事件,最常见的是局部疼痛(54.0%)、发热(33.3%)和头痛(18.4%),1例脱发和2例持续性疲劳。

结论

我们队列中SARS-CoV-2感染的患病率为35.2%,包括14%需要住院治疗的中度和重度病例。疫苗接种率高且安全。

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