在心肺旁路下进行心血管手术前接种 SARS-CoV-2 疫苗的最佳时机。

IF 1.4 4区 医学 Q4 ENGINEERING, BIOMEDICAL International Journal of Artificial Organs Pub Date : 2024-03-01 Epub Date: 2024-02-28 DOI:10.1177/03913988241234475
Ryosuke Hayashi, Yoshiyuki Takami, Hidetsugu Fujigaki, Kentaro Amano, Kiyotoshi Akita, Koji Yamana, Atsuo Maekawa, Kuniaki Saito, Yasushi Takagi
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引用次数: 0

摘要

背景:针对严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)的 mRNA 疫苗开始普及。我们研究了心肺旁路(CPB)下心脏手术候选者接种 SARS-COV-2 的最佳时机:方法:在 2021 年 7 月至 2022 年 2 月期间接受 CPB 手术的 100 例术前接种疫苗的患者中,测量了针对受体结合域的 IgG(RBD-IgG),其阈值大于 100 结合抗体单位(BAU)/毫升才算达到充分免疫:结果:包括 87 支 BNT162b2(辉瑞/BioNTech)和 13 支 mRNA-1273 (Moderna)在内的疫苗在手术前 98.8 ± 59.4 天接种。术前、术后 1 天和术后 1 个月的 RBD-IgG 滴度中位数分别为 166.8、100.0 和 84.0 BAU/mL。从接种疫苗到手术的待命间隔(SBI)与手术前的 RBD-IgG 滴度呈显著负相关(手术前 100 BAU/mL 的 p = 0.03)。在所有围手术期,SBI患者(n = 48)的RBD-IgG(>100 BAU/mL)均明显高于SBI ⩾81天的患者(n = 52):结论:虽然 40% 的 RBD-IgG 滴度在 CPB 手术后 1 天降低,但在手术前 81 天内接种 SARS-COV-2 疫苗的患者即使在手术后 1 个月内也能保持理想的 RBD-IgG 水平。因此,将手术时间安排在接种后 81 天内可能非常重要。
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Optimal timing of SARS-CoV-2 vaccination prior to cardiovascular surgery under cardiopulmonary bypass.

Background: mRNA vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) became common. We investigated the optimal timing for inoculation against SARS-COV-2 in the candidates for cardiac surgery under cardiopulmonary bypass (CPB).

Methods: In 100 patients with preoperative vaccination, who underwent CPB surgery between July 2021 and February 2022, the IgG against the receptor binding domain (RBD-IgG), with a threshold of >100 binding antibody unit (BAU)/mL for adequate immunity, was measured.

Results: The vaccines, including 87 BNT162b2 (Pfizer/BioNTech) and 13 mRNA-1273 (Moderna), were inoculated at 98.8 ± 59.4 days before surgery. The median RBD-IgG titers before surgery, 1 day after surgery, and 1 month after surgery were 166.8, 100.0, and 84.0 BAU/mL, respectively. The standby interval (SBI) from the vaccination to the surgery showed a significantly negative correlations with the RBD-IgG titer before the surgery (p < 0.001). A cut-off SBI for RBD-IgG >100 BAU/mL before surgery was <81 days with a sensitivity of 76%, specificity of 62%, and area under ROC value of 0.73 (p = 0.03). The patients with SBI <81 days (n = 48) had significantly higher RBD-IgG (>100 BAU/mL) than those with SBI ⩾81 days (n = 52) at all perioperative periods.

Conclusions: Although 40% of the RBD-IgG titers reduce 1 day after CPB surgery, the patients who received the SARS-COV-2 vaccination within an 81-day window prior to the surgery maintained a desirable RBD-IgG level, even up to 1 month after surgery. It may be important to schedule the surgery no later than 81 days after the vaccination.

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来源期刊
International Journal of Artificial Organs
International Journal of Artificial Organs 医学-工程:生物医学
CiteScore
3.40
自引率
5.90%
发文量
92
审稿时长
3 months
期刊介绍: The International Journal of Artificial Organs (IJAO) publishes peer-reviewed research and clinical, experimental and theoretical, contributions to the field of artificial, bioartificial and tissue-engineered organs. The mission of the IJAO is to foster the development and optimization of artificial, bioartificial and tissue-engineered organs, for implantation or use in procedures, to treat functional deficits of all human tissues and organs.
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