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探索新冠病毒疫苗接种后雷诺现象的风险因素。

Exploring risk factors for Raynaud's phenomenon post COVID-19 vaccination.

作者信息

Ho Tzu-Chuan, Chuang Shih-Chang, Hung Kuo-Chen, Chang Chin-Chuan, Chuang Kuo-Pin, Yuan Cheng-Hui, Yang Ming-Hui, Tyan Yu-Chang

机构信息

Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung 807, Taiwan.

Division of General and Digestive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan; School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.

出版信息

Vaccine. 2024 Dec 2;42(26):126470. doi: 10.1016/j.vaccine.2024.126470. Epub 2024 Oct 29.

Abstract

BACKGROUND

Raynaud's phenomenon (RP) has recently been observed in recipients of the COVID-19 vaccine. It is unclear whether RP is directly caused by the COVID-19 vaccine. This study aims to investigate the potential causation between RP and COVID-19 vaccination.

METHODS

In this study, we searched PubMed, EMBASE, and Web of Science from January 1, 2020, to March 19, 2024. We included the articles with clinical related findings, specifically case reports and case series. Conference abstracts, editorial publications, preprint, and those not specifically related to COVID-19 vaccination are excluded. The refined selection process aimed to ensure a focused and clinically relevant analysis of the association between RP and COVID-19 vaccination.

RESULTS

A total of six articles were ultimately included in this study, comprising five case reports and one case series involving 24 patients with RP after vaccination. Baseline characteristics of the studies showed the RP post COVID-19 vaccination frequently occurred with females compared to males (70.83 vs. 29.17 %). Of the patients with RP post COVID-19 vaccination, 87.5 % (21/24) had either a history or possible predisposing factors of RP. Among the patients with detailed information of vaccination (n = 20), the number of vaccine doses was not related to RP development (45 % (1st) vs. 30 % (2nd) vs. 25 % 3rd dose). For types of vaccine, 75 % of RP were found to have received the administration of mRNA vaccine (15/20).

CONCLUSION

The risk of bias was increased due to the uncontrolled study designs and small sample size, making it impossible to attribute causation between RP and COVID-19 vaccination. These few cases may have occurred independently of vaccination. However, physicians should still remain vigilant for RP following COVID-19 vaccination, particularly as the number of vaccinated individuals continues to rise.

摘要

背景

近期在新冠病毒疫苗接种者中观察到雷诺现象(RP)。目前尚不清楚RP是否由新冠病毒疫苗直接引起。本研究旨在调查RP与新冠病毒疫苗接种之间的潜在因果关系。

方法

在本研究中,我们检索了2020年1月1日至2024年3月19日期间的PubMed、EMBASE和科学网。我们纳入了具有临床相关发现的文章,特别是病例报告和病例系列。会议摘要、社论出版物、预印本以及与新冠病毒疫苗接种无特定关联的文章均被排除。精细的筛选过程旨在确保对RP与新冠病毒疫苗接种之间的关联进行有针对性且与临床相关的分析。

结果

本研究最终共纳入6篇文章,包括5篇病例报告和1篇病例系列,涉及24例接种疫苗后出现RP的患者。研究的基线特征显示,与男性相比,新冠病毒疫苗接种后发生RP的情况在女性中更为常见(70.83%对29.17%)。在新冠病毒疫苗接种后出现RP的患者中,87.5%(21/24)有RP病史或可能的易感因素。在有详细疫苗接种信息的患者中(n = 20),疫苗接种剂量与RP的发生无关(第一剂占45%,第二剂占30%,第三剂占25%)。对于疫苗类型,发现75%的RP患者接种了mRNA疫苗(15/20)。

结论

由于研究设计未受控制且样本量较小,偏倚风险增加,因此无法确定RP与新冠病毒疫苗接种之间的因果关系。这少数病例可能与疫苗接种无关而独立发生。然而,医生在新冠病毒疫苗接种后仍应警惕RP,尤其是随着接种人数持续增加。

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