Long COVID after breakthrough SARS-CoV-2 infection.
Long COVID after breakthrough SARS-CoV-2 infection.
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DOI：
10.1038/s41591-022-01840-0
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发表时间：
2022-07
期刊：
影响因子：
82.9
通讯作者：
Xie, Yan
中科院分区：
文献类型：
--
作者：
Al-Aly, Ziyad;Bowe, Benjamin;Xie, Yan
严重急性呼吸综合征冠状病毒2 （SARS-CoV-2）感染（也称为长冠状病毒）的急性后后遗症已被描述，但疫苗接种者的突破性SARS-CoV-2感染（BTI）是否会导致急性后后遗症尚不清楚。在这项研究中，我们使用美国退伍军人事务部国家卫生保健数据库建立了33,940名BTI患者和一些没有SARS-CoV-2感染证据的对照组，包括当代（n = 4,983,491），历史（n = 5,785,273）和接种疫苗（n = 2,566,369）对照组。在感染后6个月，我们发现，与同时代的对照组相比，BTI患者在发病的前30天表现出更高的死亡风险(风险比（HR) = 1.75, 95%置信区间（CI）： 1.59, 1.93）和急性后后遗症（HR = 1.50, 95% CI: 1.46, 1.54），包括心血管、凝血和血液、胃肠道、肾脏、精神健康、代谢、肌肉骨骼和神经系统疾病。与历史和接种疫苗的对照组相比，结果是一致的。与之前未接种过疫苗的SARS-CoV-2感染者（n = 113,474）相比，BTI患者的死亡风险（HR = 0.66, 95% CI: 0.58, 0.74）和急性后后遗症（HR = 0.85, 95% CI: 0.82, 0.89）较低。总之，研究结果表明，在感染前接种疫苗只能在疾病急性期后提供部分保护；因此，依赖它作为唯一的缓解策略可能无法最佳地减少SARS-CoV-2感染的长期健康后果。研究结果强调了继续优化BTI初级预防策略的必要性，并将指导BTI患者急性期后护理途径的发展。利用美国退伍军人事务部国家医疗保健数据库进行的一项新分析表明，突破SARS-CoV-2感染后可能出现长冠状病毒；然而，与未接种疫苗的个体相比，COVID导致的死亡风险和急性后后遗症发生率大幅降低（但未完全消除）。
The post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection—also referred to as Long COVID—have been described, but whether breakthrough SARS-CoV-2 infection (BTI) in vaccinated people results in post-acute sequelae is not clear. In this study, we used the US Department of Veterans Affairs national healthcare databases to build a cohort of 33,940 individuals with BTI and several controls of people without evidence of SARS-CoV-2 infection, including contemporary (n = 4,983,491), historical (n = 5,785,273) and vaccinated (n = 2,566,369) controls. At 6 months after infection, we show that, beyond the first 30 days of illness, compared to contemporary controls, people with BTI exhibited a higher risk of death (hazard ratio (HR) = 1.75, 95% confidence interval (CI): 1.59, 1.93) and incident post-acute sequelae (HR = 1.50, 95% CI: 1.46, 1.54), including cardiovascular, coagulation and hematologic, gastrointestinal, kidney, mental health, metabolic, musculoskeletal and neurologic disorders. The results were consistent in comparisons versus the historical and vaccinated controls. Compared to people with SARS-CoV-2 infection who were not previously vaccinated (n = 113,474), people with BTI exhibited lower risks of death (HR = 0.66, 95% CI: 0.58, 0.74) and incident post-acute sequelae (HR = 0.85, 95% CI: 0.82, 0.89). Altogether, the findings suggest that vaccination before infection confers only partial protection in the post-acute phase of the disease; hence, reliance on it as a sole mitigation strategy may not optimally reduce long-term health consequences of SARS-CoV-2 infection. The findings emphasize the need for continued optimization of strategies for primary prevention of BTI and will guide development of post-acute care pathways for people with BTI. A new analysis using the US Department of Veterans Affairs national healthcare databases demonstrates that Long COVID can occur after breakthrough SARS-CoV-2 infection; however, the risk of death attributable to COVID and incidence of post-acute sequelae were substantially reduced (but not fully eliminated) compared to unvaccinated individuals.
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DOI：
10.1016/s1473-3099(21)00558-2
发表时间：
2021-11
期刊：
The Lancet. Infectious diseases
影响因子：
--
作者：
Juthani PV;Gupta A;Borges KA;Price CC;Lee AI;Won CH;Chun HJ
通讯作者：
Chun HJ
DOI：
10.1136/bmj-2021-068993
发表时间：
2022-02-16
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Xie Y;Xu E;Al-Aly Z
通讯作者：
Al-Aly Z
DOI：
10.1097/ede.0b013e3181d61eeb
发表时间：
2010-05
期刊：
Epidemiology (Cambridge, Mass.)
影响因子：
--
作者：
Lipsitch M;Tchetgen Tchetgen E;Cohen T
通讯作者：
Cohen T
影响因子：
64.8
作者：
Al-Aly, Ziyad;Xie, Yan;Bowe, Benjamin
通讯作者：
Bowe, Benjamin
影响因子：
6.7
作者：
Olvey, E. L.;Clauschee, S.;Malone, D. C.
通讯作者：
Malone, D. C.