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新冠病毒感染和疫苗接种后血管性结缔组织疾病中的心血管并发症

Cardiovascular complications in vascular connective tissue disorders after COVID-19 infection and vaccination.

作者信息

Guerrerio Anthony L, Mateja Allyson, MacCarrick Gretchen, Fintzi Jonathan, Brittain Erica, Frischmeyer-Guerrerio Pamela A, Dietz Harry C

机构信息

Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.

Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research. Frederick, Maryland, United States of America.

出版信息

PLoS One. 2024 Dec 20;19(12):e0315499. doi: 10.1371/journal.pone.0315499. eCollection 2024.

Abstract

BACKGROUND

COVID-19 infection and vaccination have been reported to confer an elevated risk for cardiovascular events (CVE). We sought to determine whether individuals with an underlying vascular connective tissue disorder including Marfan syndrome (MFS), Loeys-Dietz syndrome (LDS), or vascular Ehlers Danlos syndrome (vEDS) are at increased risk for cardiac events after COVID-19 infection or vaccination.

METHODS

325 respondents self-reported data through a cross-sectional, web-based survey available from 22 November 2021, through 15 March 2022 regarding COVID-19 illness and vaccinations, the occurrence of any CVE, and adverse events following vaccination. The data were analyzed using a Cox proportional hazards model with time varying indicators for COVID-19 illness/vaccination in the preceding 30 days.

RESULTS

COVID-19 illness was significantly associated with an increased rate of a new abnormal heart rhythm 30 days following infection. No other CVEs were reported in the 90 days after COVID-19 illness. We did not find evidence of an increased rate of any CVE in the 30 days following any COVID-19 vaccination dose.

CONCLUSION

In respondents with MFS, LDS, or vEDS, we uncovered no evidence of an increase in CVEs in the 30 days following COVID-19 illness, with the possible exception of dysrhythmia. In light of the absence of a substantial increase in self-reported CVEs in the 30 days following COVID-19 vaccination, these data are in keeping with the recommendation from the Marfan Foundation Professional Advisory Board that all eligible persons be vaccinated for COVID-19.

摘要

背景

据报道,新型冠状病毒肺炎(COVID-19)感染和疫苗接种会增加心血管事件(CVE)的风险。我们试图确定患有潜在血管结缔组织疾病(包括马凡综合征(MFS)、洛伊斯-迪茨综合征(LDS)或血管性埃勒斯-当洛综合征(vEDS))的个体在感染COVID-19或接种疫苗后发生心脏事件的风险是否增加。

方法

325名受访者通过一项横断面网络调查自行报告数据,该调查于2021年11月22日至2022年3月15日进行,内容涉及COVID-19疾病和疫苗接种情况、任何心血管事件的发生情况以及接种疫苗后的不良事件。使用Cox比例风险模型对数据进行分析,该模型具有前30天内COVID-19疾病/疫苗接种的时间变化指标。

结果

COVID-19疾病与感染后30天新出现异常心律的发生率显著增加相关。在COVID-19疾病后的90天内未报告其他心血管事件。我们没有发现任何一剂COVID-19疫苗接种后30天内任何心血管事件发生率增加的证据。

结论

在患有MFS、LDS或vEDS的受访者中,我们没有发现COVID-19疾病后30天内心血管事件增加的证据,可能心律失常除外。鉴于COVID-19疫苗接种后30天内自我报告的心血管事件没有大幅增加,这些数据与马凡基金会专业咨询委员会的建议一致,即所有符合条件的人都应接种COVID-19疫苗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61a3/11661621/00045ffc4db4/pone.0315499.g001.jpg

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