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癌症患者的 COVID-19 疫苗接种:叙述性综述。

COVID-19 vaccination in cancer patients: a narrative review.

机构信息

Department of Clinical Immunology and Allergy, Nawaloka Hospital Research and Education Foundation, Nawaloka Hospitals, Colombo, Sri Lanka.

Department of Surgery, Faculty of Medicine, University of Colombo, Sri Lanka.

出版信息

J Int Med Res. 2022 Mar;50(3):3000605221086155. doi: 10.1177/03000605221086155.

Abstract

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has affected over 220 million individuals worldwide, and has been shown to cause increased disease severity and mortality in patients with active cancer versus healthy individuals. Vaccination is important in reducing COVID-19-associated morbidity and mortality. Thus, the aim of this article was to review the existing knowledge on effectiveness, immunogenicity and safety of COVID-19 vaccines in patients with cancer. Fifty-four articles were included following a search of PubMed and Google Scholar databases for studies published between January 2020 and September 2021 that investigated humoral and cell-mediated immune responses following COVID-19 vaccination in patients with cancer. Immunogenicity of vaccines was found to be lower in patients with cancer versus healthy individuals, and humoral immune responses were inferior in those with haematological versus solid cancers. Patient-, disease-, and treatment-related factors associated with poorer vaccine responses should be identified and corrected or mitigated when possible. Consideration should be given to offering patients with cancer second doses of COVID vaccine at shorter intervals than in healthy individuals. Patients with cancer warrant a third vaccine dose and must be prioritized in vaccination schedules. Vaccine adverse effect profiles are comparable between patients with cancer and healthy individuals.

摘要

新型冠状病毒病(COVID-19)由严重急性呼吸综合征冠状病毒 2 型(SARS-CoV-2)引起,已在全球范围内影响了超过 2.2 亿人,并且已显示出与健康个体相比,患有活动性癌症的患者疾病严重程度和死亡率更高。疫苗接种对于降低 COVID-19 相关发病率和死亡率至关重要。因此,本文的目的是回顾现有关于癌症患者 COVID-19 疫苗的有效性、免疫原性和安全性的知识。通过在 PubMed 和 Google Scholar 数据库中搜索 2020 年 1 月至 2021 年 9 月期间发表的研究,共纳入了 54 篇文章,这些研究调查了癌症患者接种 COVID-19 疫苗后体液和细胞介导的免疫反应。与健康个体相比,癌症患者的疫苗免疫原性较低,与实体瘤相比,血液系统肿瘤患者的体液免疫反应更差。应确定与较差疫苗反应相关的患者、疾病和治疗相关因素,并在可能的情况下加以纠正或减轻。应考虑在比健康个体更短的时间间隔内向癌症患者提供第二剂 COVID 疫苗。癌症患者需要接种第三剂疫苗,并且应在疫苗接种计划中优先考虑。癌症患者和健康个体的疫苗不良反应谱相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de91/8943636/052b8ca8c733/10.1177_03000605221086155-fig1.jpg

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