Chen Yunhui, Luo Wanxia, Huang Qiyu, Chen Yueming, Yao Weiping
Pulmonary and Critical Care Medicine, Foshan Sanshui District People's Hospital, Foshan, CHN.
Medical Services Section, Foshan Sanshui District People's Hospital, Foshan, CHN.
Cureus. 2024 Nov 21;16(11):e74182. doi: 10.7759/cureus.74182. eCollection 2024 Nov.
Objective To assess the protective effect of COVID-19 vaccines in patients with varying immune states by analyzing lactate dehydrogenase (LDH), C-reactive protein (CRP), and D-dimer (D-Di) levels in COVID-19-infected individuals under different vaccination scenarios and immune statuses. Methods This is a single-center retrospective study involving 338 SARS-CoV-2-infected patients treated at a tertiary medical center in Foshan, China, between November 2022 and January 2023. The primary outcome was the vaccine's protective effect on LDH, CRP, and D-Di levels. Results Vaccinated patients had shorter hospital stays and less severe lung involvement (P < 0.05), particularly in immunocompromised individuals. In immunocompromised patients, LDH and CRP levels were elevated, but in the vaccine group, fewer patients developed abnormally high CRP, D-Di, and coagulation-related complications. Vaccination reduced LDH and CRP levels in immunocompetent patients and lowered CRP levels regardless of immune status. In addition, people who are both immunocompromised and vaccinated have a higher risk of developing microthrombosis. Conclusions COVID-19 vaccination generally improves LDH, CRP, and D-Di levels, particularly in immunocompromised patients, supporting vaccination efforts. However, a subset of immunocompromised and vaccinated patients exhibited higher D-Di levels upon hospital admission, suggesting a complex interplay between vaccination, immune status, and the risk of microthrombosis. This finding emphasizes the need for further investigation into the role of immune function in disease severity and vaccine response.
目的 通过分析不同疫苗接种情况和免疫状态下新冠病毒感染个体的乳酸脱氢酶（LDH）、C反应蛋白（CRP）和D-二聚体（D-Di）水平，评估新冠疫苗对不同免疫状态患者的保护作用。方法 这是一项单中心回顾性研究，纳入了2022年11月至2023年1月在中国佛山一家三级医疗中心接受治疗的338例新冠病毒感染患者。主要结局是疫苗对LDH、CRP和D-Di水平的保护作用。结果 接种疫苗的患者住院时间较短，肺部受累程度较轻（P<0.05），尤其是在免疫功能低下的个体中。在免疫功能低下的患者中，LDH和CRP水平升高，但在疫苗组中，出现异常高CRP、D-Di和凝血相关并发症的患者较少。接种疫苗降低了免疫功能正常患者的LDH和CRP水平，且无论免疫状态如何均降低了CRP水平。此外，免疫功能低下且接种疫苗的人群发生微血栓形成的风险较高。结论 新冠疫苗总体上改善了LDH、CRP和D-Di水平，尤其是在免疫功能低下的患者中，支持疫苗接种工作。然而，一部分免疫功能低下且接种疫苗的患者入院时D-Di水平较高，提示疫苗接种、免疫状态和微血栓形成风险之间存在复杂的相互作用。这一发现强调需要进一步研究免疫功能在疾病严重程度和疫苗反应中的作用。
