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新冠疫苗在预防新冠后状况方面的有效性:最新研究的系统文献综述与荟萃分析

The effectiveness of COVID-19 vaccine in the prevention of post-COVID conditions: a systematic literature review and meta-analysis of the latest research.

作者信息

Marra Alexandre R, Kobayashi Takaaki, Callado Gustavo Yano, Pardo Isabele, Gutfreund Maria Celidonio, Hsieh Mariana Kim, Lin Vivian, Alsuhaibani Mohammed, Hasegawa Shinya, Tholany Joseph, Perencevich Eli N, Salinas Jorge L, Edmond Michael B, Rizzo Luiz Vicente

机构信息

Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA.

Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.

出版信息

Antimicrob Steward Healthc Epidemiol. 2023 Oct 13;3(1):e168. doi: 10.1017/ash.2023.447. eCollection 2023.

Abstract

OBJECTIVE

We performed a systematic literature review and meta-analysis on the effectiveness of coronavirus disease 2019 (COVID-19) vaccination against post-COVID conditions (long COVID) among fully vaccinated individuals.

DESIGN

Systematic literature review/meta-analysis.

METHODS

We searched PubMed, Cumulative Index to Nursing and Allied Health, EMBASE, Cochrane Central Register of Controlled Trials, Scopus, and Web of Science from December 1, 2019, to June 2, 2023, for studies evaluating the COVID-19 vaccine effectiveness (VE) against post-COVID conditions among fully vaccinated individuals who received two doses of COVID-19 vaccine. A post-COVID condition was defined as any symptom that was present four or more weeks after COVID-19 infection. We calculated the pooled diagnostic odds ratio (DOR) (95% confidence interval) for post-COVID conditions between fully vaccinated and unvaccinated individuals. Vaccine effectiveness was estimated as 100% x (1-DOR).

RESULTS

Thirty-two studies with 775,931 individuals evaluated the effect of vaccination on post-COVID conditions, of which, twenty-four studies were included in the meta-analysis. The pooled DOR for post-COVID conditions among fully vaccinated individuals was 0.680 (95% CI: 0.523-0.885) with an estimated VE of 32.0% (11.5%-47.7%). Vaccine effectiveness was 36.9% (23.1%-48.2%) among those who received two doses of COVID-19 vaccine before COVID-19 infection and 68.7% (64.7%-72.2%) among those who received three doses before COVID-19 infection. The stratified analysis demonstrated no protection against post-COVID conditions among those who received COVID-19 vaccination after COVID-19 infection.

CONCLUSIONS

Receiving a complete COVID-19 vaccination prior to contracting the virus resulted in a significant reduction in post-COVID conditions throughout the study period, including during the Omicron era. Vaccine effectiveness demonstrated an increase when supplementary doses were administered.

摘要

目的

我们对2019冠状病毒病(COVID-19)疫苗接种对完全接种疫苗个体的COVID后状况(长新冠)的有效性进行了系统的文献综述和荟萃分析。

设计

系统文献综述/荟萃分析。

方法

我们检索了2019年12月1日至2023年6月2日期间的PubMed、护理及相关健康累积索引、EMBASE、Cochrane对照试验中央注册库、Scopus和科学网,以查找评估COVID-19疫苗接种对接受两剂COVID-19疫苗的完全接种疫苗个体的COVID后状况的疫苗有效性(VE)的研究。COVID后状况定义为COVID-19感染后四周或更长时间出现的任何症状。我们计算了完全接种疫苗个体与未接种疫苗个体之间COVID后状况的合并诊断比值比(DOR)(95%置信区间)。疫苗有效性估计为100%×(1-DOR)。

结果

32项研究共775931名个体评估了疫苗接种对COVID后状况的影响,其中24项研究纳入荟萃分析。完全接种疫苗个体中COVID后状况的合并DOR为0.680(95%CI:0.523-0.885),估计VE为32.0%(11.5%-47.7%)。在COVID-19感染前接受两剂COVID-19疫苗的个体中,疫苗有效性为36.9%(23.1%-48.2%),在COVID-19感染前接受三剂疫苗的个体中为68.7%(64.7%-72.2%)。分层分析表明,在COVID-19感染后接种COVID-19疫苗的个体中,对COVID后状况没有保护作用。

结论

在感染病毒之前完成COVID-19疫苗接种可在整个研究期间,包括在奥密克戎时代,显著减少COVID后状况。接种补充剂后疫苗有效性有所提高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2598/10644173/7dea778f5fa6/S2732494X23004473_fig1.jpg

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