接种COVID-19疫苗对新型冠状病毒感染病程和结果的影响:对住院患者实验室和临床指标的回顾性分析

A. Fomicheva, N. Pimenov, A. Tsygankova, Natalia Tsapkova, Darya Rokhlina, E. Volchkova, S. Krasnova, V. Chulanov
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摘要

目的:评估在SARS-CoV-2 Omicron占主导地位期间接种COVID-19疫苗对住院病人目前感染新型冠状病毒的严重程度和结果的影响。材料与方法:病例对照研究包括 2022 年 2 月 1 日至 2022 年 7 月 31 日在莫斯科传染病医院住院并诊断为 COVID-19 (U07.1)的成年患者(N = 119)。主对照组包括接种过两剂 Sputnik V 疫苗的人(N = 59)。对照组包括未接种疫苗的患者(60 人)。患者年龄中位数为 66 岁 [IQR:41-66],58.8% 为女性。分类变量采用卡方检验,连续变量采用曼-惠特尼检验。P值为0.05时具有统计学意义。结果:与未接种疫苗者相比,接种疫苗者发生病毒性肺炎的几率较低(分别为 46.7% 和 18.6%,P=0.007)。接种疫苗的患者中无肺部损伤(KT-0)的比例(72.0%)明显高于未接种疫苗的患者(42.9%)(P=0.003)。接种疫苗组患者入院时的 C 反应蛋白水平较低(29.1 [7.4-68, 6] mg/L 和 75.1 [32.4-104.0] mg/L,P0.001),而住院期间的 C 反应蛋白水平最高(38.2 [12.0-84.0] mg/L 和 92.2 [45.3-137.4] mg/L,P0.001)。与未接种疫苗的患者相比,6个月前接种过疫苗的患者出院前的D-二聚体水平较低(157.0 [107.0-297.0] ng/ml和316.0 [125.0-556.0] ng/ml,P=0.014)。对照组的死亡频率(11.7%)是主要组(1.7%)的 6.9 倍(p=0.030)。结论:与未接种疫苗的患者相比,在 Omicron SARS-CoV-2 占主导地位期间,完成 Sputnik V 疫苗初级接种疗程的患者 COVID-19 不良病程的预后指标(C 反应蛋白、D-二聚体)水平较低,肺部和死亡病例的发生率也有所下降。
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The effect of vaccination against the COVID-19 on the course and outcomes of a new coronavirus infection: a retrospective analysis of laboratory and clinical indicators of hospitalized patients
Aims: to assess the effect of vaccination against the COVID-19 on the severity of the current and the outcome of a new coronavirus infection in hospitalized patients during the dominance of the SARS-CoV-2 Omicron. Materials and methods: study of the type of case-control included adult patients hospitalized in the infectious hospital of Moscow from February 1, 2022 to July 31, 2022 with a diagnosis of COVID-19 (U07.1) (N = 119). The main group included persons vaccinated with 2 doses of the Sputnik V vaccine (n = 59). Unvaccinated patients were included in the control group (n = 60). The median age of patients amounted to 66 years [IQR: 41-66], 58.8% were female. Chi square test for categorical and Mann Whitney test for continuous variables were applied for the analysis. P values 0,05 were considered statistically significant. Results: viral pneumonia was less likely to develop in vaccinated persons compared to unvaccinated persons (46.7% and 18.6%, respectively, p=0.007). The share of patients without lung damage (KT-0) among vaccinated (72.0%) was significantly higher than that of unvaccinated patients (42.9%) (p=0.003). In the group of vaccinated the levels of C-reactive protein, when entering the hospital was lower (29.1 [7.4-68, 6] mg/L and 75.1 [32.4-104.0] mg/L, p0.001), as the highest level of C-reactive protein during hospitalization (38.2 [12.0-84.0] mg/L and 92.2 [45.3-137.4] mg/L, p0.001). The level of D-dimer before discharge was lower in group of patients vaccinated ≤6 months ago compared with unvaccinated (157.0 [107.0-297.0] ng/ml and 316.0 [125.0-556.0] ng/ml, p=0.014). The frequency of deaths in the control group (11.7%) was 6.9 times higher compared to the main group (1.7%) (p=0.030). Conclusions: the completed primary vaccination course of the Sputnik V vaccine provided lower levels of prognostic markers of the adverse course of COVID-19 (C-reactive protein, D-dimer), as well as a decrease in the frequency of pulmonary and fatal outcome compared to unvaccinated patients during the dominance of the Omicron SARS-CoV-2.
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