COVID-19 Vaccination Associated With Reduced Postoperative SARS-CoV-2 Infection and Morbidity.
COVID-19 Vaccination Associated With Reduced Postoperative SARS-CoV-2 Infection and Morbidity.
复制标题
DOI：
10.1097/sla.0000000000005176
复制
发表时间：
2022-01-01
影响因子：
9
通讯作者：
Lal BK
中科院分区：
文献类型：
--
作者：
Prasad NK;Lake R;Englum BR;Turner DJ;Siddiqui T;Mayorga-Carlin M;Sorkin JD;Lal BK
本研究的目的是确定COVID-19疫苗接种对美国接受手术的患者的术后死亡率、肺部和血栓性并发症、再入院率和住院时间的影响。虽然接种疫苗可以预防COVID-19，但人们对其对术后并发症的影响知之甚少。这是一项全国性的观察性队列研究，涉及全国1,255个退伍军人事务机构。我们比较了在第二剂辉瑞BioNTech或Moderna疫苗后至少2周接受手术的患者与当代倾向评分匹配的对照组。 主要终点为30天死亡率和术后COVID-19感染。次要终点为肺部或血栓性并发症、再入院和住院时间。30，681例患者符合入选标准。匹配后，接种组有3，104人（1，903人接种辉瑞BioNTech，1，201人接种Moderna疫苗），对照组有7，438人。全面接种COVID-19疫苗与术后30天COVID-19感染率较低相关（发生率比和95%置信区间，0.09 [0.01，0.44]），肺部并发症（0.54 [0.39，0.72]）、血栓性并发症（0.68 [0.46，0.99]）和住院时间缩短（0.78 [0.69，0.89]）。手术前COVID-19检测呈阳性的接种疫苗患者的并发症也较低，但与对照组相比，事件太少，无法检测到显著差异。COVID-19疫苗接种与较低的术后发病率相关。这种益处在手术前从未感染过COVID-19的个体中最为明显。
The purpose of this study was to determine the effect of COVID-19 vaccination on postoperative mortality, pulmonary and thrombotic complications, readmissions and hospital lengths of stay among patients undergoing surgery in the United States. While vaccination prevents COVID-19, little is known about its impact on postoperative complications. This is a nationwide observational cohort study of all 1,255 Veterans Affairs facilities nationwide. We compared patients undergoing surgery at least 2 weeks after their second dose of the Pfizer BioNTech or Moderna vaccines, to contemporary propensity score matched controls. Primary endpoints were 30-day mortality and postoperative COVID-19 infection. Secondary endpoints were pulmonary or thrombotic complications, readmissions, and hospital lengths of stay. 30,681 patients met inclusion criteria. After matching, there were 3,104 in the vaccination group (1,903 received the Pfizer BioNTech, and 1,201 received the Moderna vaccine) and 7,438 controls. Full COVID-19 vaccination was associated with lower rates of postoperative 30-day COVID-19 infection (Incidence Rate Ratio and 95% confidence intervals, 0.09 [0.01,0.44]), pulmonary complications (0.54 [0.39, 0.72]), thrombotic complications (0.68 [0.46, 0.99]) and decreased hospital lengths of stay (0.78 [0.69, 0.89]). Complications were also low in vaccinated patients who tested COVID-19 positive before surgery but events were too few to detect a significant difference compared to controls. COVID-19 vaccination is associated with lower rates of postoperative morbidity. The benefit is most pronounced among individuals who have never had a COVID-19 infection before surgery.