接种 COVID-19 疫苗 (ChAdOx1-S) 与血栓栓塞、血小板减少和出血事件之间的关系:流行病学分析研究的系统回顾和元分析

IF 0.9 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Indian Journal of Community Medicine Pub Date : 2024-07-01 DOI:10.4103/ijcm.ijcm_676_23
R. Vaman, Muthusamy S. Kumar, K. Jeyashree, Ashok Periasami, RizwanSuliankachi Abdulkader, Manoj V. Murhekar
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引用次数: 0

摘要

我们对流行病学分析研究进行了系统回顾,以评估接种 ChAdOx1-S 疫苗与血栓栓塞、血小板减少和出血事件之间的关联。我们在 Medline、Embase、Google Scholar、WHO-COVID-19 数据库和 medRxiv 中检索了评估 ChAdOx1-S 与血管事件之间关系的研究。主要研究结果为脑静脉窦血栓、外周静脉血栓(PVT)和血小板减少。两位独立审稿人筛选了符合条件的研究,提取了数据并评估了偏倚风险。采用DerSimonian-Laird随机效应模型分别对第一剂和第二剂的发病率比(IRR)进行汇总。异质性采用I2统计量进行评估。共纳入 20 项研究,其中 11 项为自控病例系列研究,9 项为队列研究(2.54 亿参与者)。17 项研究的汇总结果显示,与对照组相比,接种 ChAdOx1-S 疫苗的人群发生脑血管血栓(IRR = 3.5,95% CI = 2.2-5.4,I2 = 79%)、PVT(IRR = 2.0,95% CI = 1.1-3.5,I2 = 95%)和血小板减少症(IRR = 1.6,95% CI = 1.4-1.9,I2 = 93%)的风险较高。接种第二剂后或次要结果的风险未见增加。接种第一剂 ChAdOx1-S 疫苗后,脑静脉窦血栓形成、PVT 和血小板减少的风险增加的证据具有中度到高度的确定性。 系统综述注册:PREMCOCO CRD42022372768。
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Association between COVID-19 Vaccination (ChAdOx1-S) and Thromboembolic, Thrombocytopenic, Hemorrhagic Events: A Systematic Review and Meta-analysis of Analytical Epidemiological Studies
We conducted a systematic review of analytical epidemiological studies to assess the association between ChAdOx1-S vaccination and thromboembolic, thrombocytopenic, and hemorrhagic events. We searched Medline, Embase, Google Scholar, WHO-COVID-19 database, and medRxiv for studies evaluating the association between ChAdOx1-S and vascular events. Primary outcomes of interest were cerebral venous sinus thrombosis, peripheral venous thrombosis (PVT), and thrombocytopenia. Two independent reviewers screened for eligible studies, extracted data, and assessed the risk of bias. The DerSimonian-Laird random effects model was used to pool the incidence rate ratios (IRRs) separately for the first and second doses. Heterogeneity was assessed using I2 statistics. Twenty studies were included, of which 11 were self-controlled case series, and nine were cohort studies (254 million participants). Pooling of 17 studies showed a higher risk of cerebrovascular thrombosis (IRR = 3.5, 95% CI = 2.2–5.4, I2 = 79%), PVT (IRR = 2.0, 95% CI = 1.1–3.5, I2 = 95%) and thrombocytopenia (IRR = 1.6, 95% CI = 1.4–1.9, I2 = 93%) among those who received ChAdOx1-S vaccination as compared to controls. No increased risk was seen after the second dose or for secondary outcomes. There is moderate-to-high certainty of the evidence for the increased risk of cerebral venous sinus thrombosis, PVT, and thrombocytopenia following the first dose of the ChAdOx1-S vaccine. Systematic Review Registration: PROSPERO CRD42022372768.
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来源期刊
Indian Journal of Community Medicine
Indian Journal of Community Medicine PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
1.30
自引率
0.00%
发文量
85
审稿时长
49 weeks
期刊介绍: The Indian Journal of Community Medicine (IJCM, ISSN 0970-0218), is the official organ & the only official journal of the Indian Association of Preventive and Social Medicine (IAPSM). It is a peer-reviewed journal which is published Quarterly. The journal publishes original research articles, focusing on family health care, epidemiology, biostatistics, public health administration, health care delivery, national health problems, medical anthropology and social medicine, invited annotations and comments, invited papers on recent advances, clinical and epidemiological diagnosis and management; editorial correspondence and book reviews.
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