探索接种 COVID-19 疫苗后出现雷诺现象的风险因素。

Vaccine Pub Date : 2024-12-02 Epub Date: 2024-10-29 DOI:10.1016/j.vaccine.2024.126470
Tzu-Chuan Ho, Shih-Chang Chuang, Kuo-Chen Hung, Chin-Chuan Chang, Kuo-Pin Chuang, Cheng-Hui Yuan, Ming-Hui Yang, Yu-Chang Tyan
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摘要

背景:最近在 COVID-19 疫苗接种者中发现了雷诺现象(RP)。目前尚不清楚雷诺现象是否由 COVID-19 疫苗直接引起。本研究旨在调查 RP 与接种 COVID-19 疫苗之间的潜在因果关系:在本研究中,我们检索了 2020 年 1 月 1 日至 2024 年 3 月 19 日期间的 PubMed、EMBASE 和 Web of Science。我们收录了与临床研究结果相关的文章,特别是病例报告和系列病例。会议摘要、编辑出版物、预印本以及与 COVID-19 疫苗接种无关的文章均被排除在外。精选过程旨在确保对RP与COVID-19疫苗接种之间的关联进行有针对性的临床相关分析:本研究最终共纳入了六篇文章,包括五篇病例报告和一篇系列病例,涉及 24 名接种疫苗后出现 RP 的患者。研究的基线特征显示,接种 COVID-19 疫苗后出现 RP 的女性多于男性(70.83% 对 29.17%)。在接种 COVID-19 疫苗后出现 RP 的患者中,87.5%(21/24)有 RP 病史或可能的易感因素。在有详细疫苗接种信息的患者(20 人)中,疫苗接种次数与 RP 的发生无关(45%(第 1 剂) vs. 30%(第 2 剂) vs. 25%(第 3 剂))。就疫苗类型而言,75%的RP患者接种了mRNA疫苗(15/20):结论:由于研究设计不受控制且样本量较小,偏倚风险增加,因此无法确定RP与COVID-19疫苗接种之间的因果关系。这些少数病例的发生可能与疫苗接种无关。不过,医生仍应警惕接种 COVID-19 疫苗后的 RP,尤其是随着接种人数的不断增加。
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Exploring risk factors for Raynaud's phenomenon post COVID-19 vaccination.

Background: Raynaud's phenomenon (RP) has recently been observed in recipients of the COVID-19 vaccine. It is unclear whether RP is directly caused by the COVID-19 vaccine. This study aims to investigate the potential causation between RP and COVID-19 vaccination.

Methods: In this study, we searched PubMed, EMBASE, and Web of Science from January 1, 2020, to March 19, 2024. We included the articles with clinical related findings, specifically case reports and case series. Conference abstracts, editorial publications, preprint, and those not specifically related to COVID-19 vaccination are excluded. The refined selection process aimed to ensure a focused and clinically relevant analysis of the association between RP and COVID-19 vaccination.

Results: A total of six articles were ultimately included in this study, comprising five case reports and one case series involving 24 patients with RP after vaccination. Baseline characteristics of the studies showed the RP post COVID-19 vaccination frequently occurred with females compared to males (70.83 vs. 29.17 %). Of the patients with RP post COVID-19 vaccination, 87.5 % (21/24) had either a history or possible predisposing factors of RP. Among the patients with detailed information of vaccination (n = 20), the number of vaccine doses was not related to RP development (45 % (1st) vs. 30 % (2nd) vs. 25 % 3rd dose). For types of vaccine, 75 % of RP were found to have received the administration of mRNA vaccine (15/20).

Conclusion: The risk of bias was increased due to the uncontrolled study designs and small sample size, making it impossible to attribute causation between RP and COVID-19 vaccination. These few cases may have occurred independently of vaccination. However, physicians should still remain vigilant for RP following COVID-19 vaccination, particularly as the number of vaccinated individuals continues to rise.

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