高海拔居民对 COVID-19 疫苗的死亡风险反应:回顾性队列研究。

IF 1.6 4区 医学 Q4 BIOPHYSICS High altitude medicine & biology Pub Date : 2024-07-23 DOI:10.1089/ham.2024.0045
Cinthya Vásquez-Velásquez, Diego Fano-Sizgorich, Gustavo F Gonzales
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引用次数: 0

摘要

Vásquez-Velásquez, Cinthya, Diego Fano-Sizgorich, and Gustavo F Gonzales.高海拔居民对 COVID-19 疫苗的死亡风险反应:回顾性队列研究。00:00-00, 2024.背景:秘鲁是全球冠状病毒病 2019(COVID-19)大流行导致死亡率最高的国家之一。接种疫苗可大大降低死亡率。然而,在不同的海拔高度,疫苗接种的效果可能不同。本研究旨在评估海拔高度对秘鲁疫苗接种与 COVID-19 死亡率之间关系的影响。研究方法:利用秘鲁卫生部提供的死亡、COVID-19 病例、住院和疫苗接种的开放式数据库,进行回顾性队列研究。对已接种疫苗和未接种疫苗的患者因 COVID-19 死亡的情况进行了评估。使用具有稳健方差的泊松系广义线性模型计算粗略相对风险 (RR) 和调整相对风险 (aRR)。模型根据年龄、性别、大流行波及人类发展指数进行了调整。为评估海拔高度的交互作用,对该变量进行了分层分析。海拔变量分为:0-499 米(828 298 例)、500-1 499 米(64 735 例)、1 500-2 499 米(106 572 例)和≥2 500 米(179 004 例)。最终研究样本包括 1,362,350 个病例。研究结果疫苗接种第二剂(aRR:0.41,95% 置信区间[CI]:0.38-0.44)和第三剂(aRR:0.21,95% 置信区间[CI]:0.20-0.23)可显著降低死亡风险。在调整和交互模型中可以发现,与海平面相比,中海拔和高海拔地区的死亡风险更高(aRR 分别为 2.58 和 2.03)。同样,与低海拔人群相比,两剂组在中海拔(1 500-2 499 米)的 aRR 为 1.22,在高海拔(≥2 500 米)的 aRR 为 1.6。结论海拔高度可能会改变 SARS-CoV-2 疫苗对 COVID-19 死亡的保护作用。
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Death Risk Response of High-Altitude Resident Populations to COVID-19 Vaccine: A Retrospective Cohort Study.

Vásquez-Velásquez, Cinthya, Diego Fano-Sizgorich, and Gustavo F Gonzales. Death risk response of high-altitude resident populations to COVID-19 vaccine: Retrospective cohort study. High Alt Med Biol. 00:00-00, 2024. Background: Peru had one of the highest mortality rates caused by the coronavirus disease 2019 (COVID-19) pandemic worldwide. Vaccination significantly reduces mortality. However, the effectiveness of vaccination might differ at different altitudinal levels. The study aimed to evaluate the effect modification of altitude on the association between vaccination and COVID-19 mortality in Peru. Methodology: A retrospective cohort, using open access databases of deaths, COVID-19 cases, hospitalizations, and vaccination was obtained from the Peruvian Ministry of Health. Deaths due to COVID-19 were evaluated in vaccinated and nonvaccinated patients. Crude (RR) and adjusted relative risks (aRR) were calculated using generalized linear models of Poisson family with robust variances. Models were adjusted for age, sex, pandemic wave, and Human Development Index. To evaluate the interaction by altitude, a stratified analysis by this variable was performed. The variable altitude was categorized as, 0-499 m (828,298 cases), 500-1,499 m (64,735 cases), 1,500-2,499 m (106,572 cases), and ≥2,500 m (179,004 cases). The final sample studied included 1,362,350 cases. Results: The vaccine showed a considerable reduction of death risk with the second (aRR: 0.41, 95% confidence interval [CI]: 0.38-0.44) and third doses (aRR: 0.21, 95% CI: 0.20-0.23). In the adjusted and interaction model, it can be observed that medium and high altitude present a higher risk of death compared to sea level (aRR: 2.58 and 2.03, respectively). Likewise, the two doses' group presents an aRR:1.22 for medium altitude (1,500-2,499 m) and 1.6 for high altitude (≥2,500 m), compared with low-altitude population, suggesting that the action of vaccination at high altitude is altered by the effect of the altitude itself. Conclusions: Altitude might modify the protective effect of SARS-CoV-2 vaccine against COVID-19 death.

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来源期刊
High altitude medicine & biology
High altitude medicine & biology 医学-公共卫生、环境卫生与职业卫生
CiteScore
3.80
自引率
9.50%
发文量
44
审稿时长
>12 weeks
期刊介绍: High Altitude Medicine & Biology is the only peer-reviewed journal covering the medical and biological issues that impact human life at high altitudes. The Journal delivers critical findings on the impact of high altitude on lung and heart disease, appetite and weight loss, pulmonary and cerebral edema, hypertension, dehydration, infertility, and other diseases. It covers the full spectrum of high altitude life sciences from pathology to human and animal ecology.
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