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关于新冠病毒疫苗与神经系统疾病关联的多中心病例对照研究(COVIVAX)。

Multicentre case-control study on the association between COVID-19 vaccines and neurological disorders (COVIVAX).

作者信息

Pupillo Elisabetta, Bianchi Elisa, Beghi Ettore, Pedrazzini Francesco Andrea, Giglio Angela, Schilke Edoardo Dalmato, Percetti Marco, Colleoni Carlo Morotti, Mainini Gabriele, Calabresi Paolo, Primiano Guido, Frisullo Giovanni, Padovani Alessandro, Cristillo Viviana, Pilotto Andrea, Arici Davide, Gipponi Stefano, Tedeschi Gioacchino, d'Ambrosio Alessandro, Melisi Rosario Domenico, Gallo Antonio, Bisecco Alvino, Salmaggi Andrea, Basilico Paola, Scaccabarozzi Chiara, Kiferle Lorenzo, Valenti Raffaella, Avino Gianluca, Borghi Annamaria, Contardi Sara, Zini Andrea, Ferrarese Carlo, Beretta Simone

机构信息

Dipartimento di Neuroscienze, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.

Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.

出版信息

Sci Rep. 2025 Feb 4;15(1):4179. doi: 10.1038/s41598-025-88837-0.

Abstract

The COVIVAX study assessed the association between COVID-19 vaccination and the risk of common neurological disorders in a multicenter case-control design. Vaccination exposure was compared between individuals with a first diagnosis of a neurological disorder (cases) and age- and sex-matched controls. A total of 624 participants were enrolled, and after random 1:1 matching 265 cases and 265 matched controls (total 530 participants) were included in the analyses. The most frequent neurological diagnosis in cases were stroke (60.4%), multiple sclerosis (11.3%) and seizures (6.4%). The proportion of vaccinated participants was 72.1% among cases and 79.6% among controls. A protective role of vaccination on the risk of developing a new neurological disorder was detected in the unadjusted analysis (OR 0.50; 95% CI 0.29-0.86; p = 0.0114). After adjustment for confounders, the number of vaccination doses received was associated with a reduced risk of developing new neurological disorders for participants aged over 60 years ( p = 0.0472; OR 0.14, 95% CI 0.03-0.68), with pre-existing comorbidities (p = 0.0122; OR 0.04, 95% CI 0.01-0.99) and for stroke (p = 0.0232; OR 0.04, 95% CI 0.02-0.97). The COVIVAX study provided no warning sign regarding an increase in the risk of developing new neurological disorders following COVID-19 vaccination of any type or doses. A potentially protective effect of multiple doses of COVID-19 vaccines against the risk of stroke in people aged over 60 needs to be confirmed by further studies.

摘要

COVIVAX研究采用多中心病例对照设计,评估了新冠病毒疫苗接种与常见神经系统疾病风险之间的关联。将首次诊断为神经系统疾病的个体(病例)与年龄和性别匹配的对照进行疫苗接种暴露比较。共招募了624名参与者,经过随机1:1匹配后,分析纳入了265例病例和265名匹配对照(共530名参与者)。病例中最常见的神经系统诊断为中风(60.4%)、多发性硬化症(11.3%)和癫痫发作(6.4%)。病例中接种疫苗的参与者比例为72.1%,对照中为79.6%。在未调整分析中检测到疫苗接种对新发神经系统疾病风险具有保护作用(比值比0.50;95%置信区间0.29 - 0.86;p = 0.0114)。在调整混杂因素后,60岁以上参与者、有基础合并症者以及中风患者接种疫苗的剂量数与新发神经系统疾病风险降低相关(60岁以上参与者:p = 0.0472;比值比0.14,95%置信区间0.03 - 0.68;有基础合并症者:p = 0.0122;比值比0.04,95%置信区间0.01 - 0.99;中风患者:p = 0.0232;比值比0.04,95%置信区间0.02 - 0.97)。COVIVAX研究未发现任何类型或剂量的新冠病毒疫苗接种后新发神经系统疾病风险增加的警示信号。多剂新冠病毒疫苗对60岁以上人群中风风险的潜在保护作用需要进一步研究证实。

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