Chan Yi-Ju, Chen Chia-Chen, Tu Yu-Kuan, Hsu Wan-Hsuan, Tsai Ya-Wen, Liu Ting-Hui, Huang Po-Yu, Chuang Min-Hsiang, Hung Kuo-Chuan, Lee Mei-Chuan, Yu Tsung, Lai Chih-Cheng, Weng Tzu-Chieh, Wu Jheng-Yan
Department of Surgery, Division of Plastic and Reconstructive Surgery, Chi Mei Medical Center, Tainan, Taiwan.
Department of Internal Medicine, Endocrinology and Metabolism, Chi Mei Medical Center, Liouying, Tainan, Taiwan.
J Med Virol. 2024 Dec;96(12):e70119. doi: 10.1002/jmv.70119.
This study aims to evaluate the effectiveness of anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines in preventing the post-acute sequelae of SARS-CoV-2 infection (PASC), commonly known as long COVID, and reducing all-cause mortality among older patients. A retrospective cohort study was conducted using the TriNetX database. The study cohort consisted of older patients (age ≥ 65 years) with their first COVID-19 illness between January 1, 2022, and May 31, 2024. Participants were divided into vaccinated and unvaccinated groups based on their vaccination status. Propensity score matching (PSM) was used to balance baseline characteristics. Cox regression models and log-rank tests were applied to estimate the hazard ratio (HR) for PASC and all-cause mortality during 30-180 days of follow-up. The study included 189 059 geriatric patients who contracted SARS-CoV-2, with 5615 vaccinated and 183 444 unvaccinated. After PSM, each group contained 5615 patients. Vaccinated patients exhibited a significantly lower incidence of PASC symptoms (HR = 0.852, 95% CI: 0.778-0.933, p = 0.0005), particularly anxiety and depression, with a HR of 0.710 (95% CI: 0.575-0.878, p = 0.0015). Vaccination was also significantly associated with reduced all-cause mortality (HR = 0.231, 95% CI: 0.136-0.394, p < 0.0001). The findings highlight the effectiveness of COVID-19 vaccination in mitigating the development of PASC and decreasing mortality among older patients.
本研究旨在评估抗严重急性呼吸综合征冠状病毒2（SARS-CoV-2）疫苗在预防SARS-CoV-2感染后急性后遗症（PASC，俗称长期新冠）以及降低老年患者全因死亡率方面的有效性。使用TriNetX数据库进行了一项回顾性队列研究。研究队列包括2022年1月1日至2024年5月31日期间首次感染新冠病毒的老年患者（年龄≥65岁）。参与者根据其疫苗接种状况分为接种组和未接种组。采用倾向得分匹配（PSM）来平衡基线特征。应用Cox回归模型和对数秩检验来估计随访30 - 180天期间PASC和全因死亡率的风险比（HR）。该研究纳入了189059名感染SARS-CoV-2的老年患者，其中5615人接种了疫苗，183444人未接种。PSM后，每组包含5615名患者。接种疫苗的患者出现PASC症状的发生率显著较低（HR = 0.852，95%CI：0.778 - 0.933，p = 0.0005），尤其是焦虑和抑郁，HR为0.710（95%CI：0.575 - 0.878，p = 0.0015）。接种疫苗还与全因死亡率降低显著相关（HR = 0.231，95%CI：0.136 - 0.394，p < 0.0001）。这些发现突出了新冠疫苗接种在减轻PASC发展和降低老年患者死亡率方面的有效性。
