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严重急性呼吸综合征冠状病毒2的病理生理学与疫苗接种后的严重程度:一项系统综述

SARS-CoV-2 pathophysiology and post-vaccination severity: a systematic review.

作者信息

Rustagi Vanshika, Gupta Shradheya R R, Talwar Chandni, Singh Archana, Xiao Zhen-Zhu, Jamwal Rahul, Bala Kiran, Bhaskar Akash Kumar, Nagar Shekhar, Singh Indrakant K

机构信息

Department of Zoology, Deshbandhu College, University of Delhi, New Delhi, 110019, India.

Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, 77030, USA.

出版信息

Immunol Res. 2024 Dec 18;73(1):17. doi: 10.1007/s12026-024-09553-x.

Abstract

Currently, COVID-19 is still striking after 4 years of prevalence, with millions of cases and thousands of fatalities being recorded every month. The virus can impact other major organ systems, including the gastrointestinal tract (GIT), cardiovascular, central nervous system, renal, and hepatobiliary systems. The resulting organ dysfunction from SARS-CoV-2 may be attributed to one or a combination of mechanisms, such as direct viral toxicity, disruptions in the renin-angiotensin-aldosterone system (RAAS), thrombosis, immune dysregulation, and ischemic injury due to vasculitis. SARS-CoV-2 vaccines effectively reduce the severity of the disease, hospitalizations, and mortality. As of October 2024, 13.58 billion vaccine doses have been administered, with an average of 6959 daily doses. Also, the boosters are given after the primary immunization in a homologous and heterologous manner. The vaccines imposed severe potential health side effects such as clotting or obstruction of blood vessels termed arterial or venous thrombosis, autoimmune damage of nerve cells (Guillain-Barré syndrome; GBS), intense activation of coagulation system (vaccine-induced thrombotic thrombocytopenia), acute ischemic stroke (AIS) and cerebral venous sinus thrombosis (CVST), myocarditis, pericarditis, and glomerular disease. Overall, it is essential to highlight that the significant benefits of COVID-19 vaccination far outweigh the low risk of conditions. mRNA-based vaccine technology has emerged as a rapidly deployable vaccine candidate and a viable alternative to existing vaccines. It has a very low probability of adverse health effects, confirmed by data represented by Preferred Reporting Items for Systematic Reviews and Meta-Analyses, Vaccine Adverse Event Reporting System (VAERS), Yellow card approved under CDC, WHO.

摘要

目前,新冠病毒在流行4年后仍在肆虐,每月记录有数百万病例和数千人死亡。该病毒可影响其他主要器官系统,包括胃肠道、心血管、中枢神经、肾脏和肝胆系统。新型冠状病毒导致的器官功能障碍可能归因于一种或多种机制,如直接病毒毒性、肾素-血管紧张素-醛固酮系统(RAAS)紊乱、血栓形成、免疫失调以及血管炎导致的缺血性损伤。新冠病毒疫苗有效降低了疾病的严重程度、住院率和死亡率。截至2024年10月,已接种135.8亿剂疫苗,平均每天接种6959剂。此外,加强针在初次免疫后以同源和异源方式接种。这些疫苗带来了严重的潜在健康副作用,如血管凝血或阻塞,称为动脉或静脉血栓形成、神经细胞自身免疫损伤(吉兰-巴雷综合征;GBS)、凝血系统强烈激活(疫苗诱导的血栓性血小板减少症)及急性缺血性中风(AIS)和脑静脉窦血栓形成(CVST)、心肌炎、心包炎和肾小球疾病。总体而言,必须强调的是,新冠病毒疫苗接种的显著益处远远超过这些疾病的低风险。基于信使核糖核酸的疫苗技术已成为一种可快速部署的候选疫苗,是现有疫苗的可行替代方案。系统评价和荟萃分析的首选报告项目、疫苗不良事件报告系统(VAERS)、美国疾病控制与预防中心(CDC)批准的黄卡、世界卫生组织(WHO)所代表的数据证实,其对健康产生不良影响的可能性非常低。

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