Impact of vaccination on the association of COVID-19 with cardiovascular diseases: An OpenSAFELY cohort study.
Impact of vaccination on the association of COVID-19 with cardiovascular diseases: An OpenSAFELY cohort study.
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疫苗接种对 COVID-19 与心血管疾病关联的影响：一项 OpenSAFELY 队列研究。
DOI：
10.1038/s41467-024-46497-0
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发表时间：
2024
影响因子：
16.6
通讯作者：
Cezard GI
中科院分区：
文献类型：
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作者：
Cezard GI
感染SARS-CoV-2与动脉和静脉血栓事件的风险增加有关，但接种疫苗对这种风险增加的影响尚不确定。在英国国家医疗服务体系（NHS England）的批准下，我们使用约40%的英国人口的相关电子健康记录，量化了不同疫苗接种和不同时代COVID-19诊断与心血管疾病之间的关联。我们在野生型/ α变异时代（2020年1月- 2021年6月）定义了“接种前”队列（18,210,937人），在Delta变异时代（2021年6月- 12月）定义了“接种疫苗”和“未接种疫苗”队列（分别为13,572,399人和3,161,485人）。我们发现，与未感染COVID-19之前或未感染COVID-19之前相比，在COVID-19后的1-4周内，每种动脉血栓、静脉血栓和其他心血管结局的发生率均显著升高，但在第4周之后的时间段内升高幅度较小。住院后的COVID-19风险比高于未住院的风险比，接种前和未接种疫苗的风险比高于接种疫苗的风险比。COVID-19疫苗接种可降低COVID-19感染后心血管事件的风险。在接种疫苗之前或未接种疫苗的COVID-19患者在至少两年内发生心血管事件的风险更高。
Infection with SARS-CoV-2 is associated with an increased risk of arterial and venous thrombotic events, but the implications of vaccination for this increased risk are uncertain. With the approval of NHS England, we quantified associations between COVID-19 diagnosis and cardiovascular diseases in different vaccination and variant eras using linked electronic health records for ~40% of the English population. We defined a ‘pre-vaccination’ cohort (18,210,937 people) in the wild-type/Alpha variant eras (January 2020-June 2021), and ‘vaccinated’ and ‘unvaccinated’ cohorts (13,572,399 and 3,161,485 people respectively) in the Delta variant era (June-December 2021). We showed that the incidence of each arterial thrombotic, venous thrombotic and other cardiovascular outcomes was substantially elevated during weeks 1-4 after COVID-19, compared with before or without COVID-19, but less markedly elevated in time periods beyond week 4. Hazard ratios were higher after hospitalised than non-hospitalised COVID-19 and higher in the pre-vaccination and unvaccinated cohorts than the vaccinated cohort. COVID-19 vaccination reduces the risk of cardiovascular events after COVID-19 infection. People who had COVID-19 before or without being vaccinated are at higher risk of cardiovascular events for at least two years.