BNT162b2 vaccine breakthrough: clinical characteristics of 152 fully vaccinated hospitalized COVID-19 patients in Israel.
BNT162b2 vaccine breakthrough: clinical characteristics of 152 fully vaccinated hospitalized COVID-19 patients in Israel.
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DOI：
10.1016/j.cmi.2021.06.036
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发表时间：
2021-11
期刊：
影响因子：
--
通讯作者：
Wiener-Well Y
中科院分区：
文献类型：
--
作者：
Brosh-Nissimov T;Orenbuch-Harroch E;Chowers M;Elbaz M;Nesher L;Stein M;Maor Y;Cohen R;Hussein K;Weinberger M;Zimhony O;Chazan B;Najjar R;Zayyad H;Rahav G;Wiener-Well Y
新冠肺炎疫苗在预防有症状的新冠肺炎、住院、重症和死亡方面显示出高效的效果。然而，少数接种疫苗的人可能会受到感染，并经历显著的发病率。疫苗突破性感染的特征尚未得到研究。我们试图描绘以色列患者的群体，他们在完全接种疫苗的情况下仍因感染新冠肺炎而住院。一项对17家医院进行的回顾性多中心队列研究包括完全接种辉瑞/BioNTech的BNT162b2疫苗的患者，他们在第二次接种疫苗后7天以上出现新冠肺炎，并需要住院。不良结局的风险被定义为机械通风或死亡的组合，被评估。共有152名患者纳入研究，占以色列住院完全接种疫苗患者的一半。预后不良38例，病死率22%(34/152)。值得注意的是，该队列的特点是易患严重新冠肺炎的高共患率，包括高血压(108；71%)、糖尿病(73；48%)、充血性心力衰竭(41；27%)、慢性肾脏和肺病(37；24%)、痴呆症(29；19%)和癌症(36；24%)，只有6人(4%)没有并存。60例(40%)患者免疫功能低下。较高的病毒载量与不良结局的显著风险相关。接受抗CD20治疗的患者和抗Spike抗体滴度较低的患者风险也较高，但这些差异没有达到统计学意义。我们发现，严重的新冠肺炎感染与高死亡率相关，可能发生在少数完全接种疫苗的多个并存患者中。与先前报道的未接种疫苗的新冠肺炎住院患者相比，我们的患者合并疾病和免疫抑制的比率更高。进一步描述这一弱势群体的特征可能有助于制定指南，通过继续保持社会距离或通过额外的主动或被动疫苗接种来加强对他们的保护。
The mRNA coronavirus disease 2019 (COVID-19) vaccines have shown high effectiveness in the prevention of symptomatic COVID-19, hospitalization, severe disease and death. Nevertheless, a minority of vaccinated individuals might become infected and experience significant morbidity. Characteristics of vaccine breakthrough infections have not been studied. We sought to portray the population of Israeli patients, who were hospitalized with COVID-19 despite full vaccination. A retrospective multicentre cohort study of 17 hospitals included patients fully vaccinated with Pfizer/BioNTech's BNT162b2 vaccine who developed COVID-19 more than 7 days after the second vaccine dose and required hospitalization. The risk for poor outcome, defined as a composite of mechanical ventilation or death, was assessed. A total of 152 patients were included, accounting for half of hospitalized fully vaccinated patients in Israel. Poor outcome was noted in 38 patients and mortality rate reached 22% (34/152). Notably, the cohort was characterized by a high rate of co-morbidities predisposing to severe COVID-19, including hypertension (108; 71%), diabetes (73; 48%), congestive heart failure (41; 27%), chronic kidney and lung diseases (37; 24% each), dementia (29; 19%) and cancer (36; 24%), and only six (4%) had no co-morbidities. Sixty (40%) of the patients were immunocompromised. Higher viral load was associated with a significant risk for poor outcome. Risk also appeared higher in patients receiving anti-CD20 treatment and in patients with low titres of anti-Spike IgG, but these differences did not reach statistical significance. We found that severe COVID-19 infection, associated with a high mortality rate, might develop in a minority of fully vaccinated individuals with multiple co-morbidities. Our patients had a higher rate of co-morbidities and immunosuppression compared with previously reported non-vaccinated hospitalized individuals with COVID-19. Further characterization of this vulnerable population may help to develop guidance to augment their protection, either by continued social distancing, or by additional active or passive vaccinations.
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影响因子：
33.9
作者：
Tenforde, Mark W.;Olson, Samantha M.;Self, Wesley H.;Talbot, H. Keipp;Lindsell, Christopher J.;Steingrub, Jay S.;Shapiro, Nathan, I;Ginde, Adit A.;Douin, David J.;Prekker, Matthew E.;Brown, Samuel M.;Peltan, Ithan D.;Gong, Michelle N.;Mohamed, Amira;Khan, Akram;Aline, Matthew C.;Files, D. Clark;Gibbs, Kevin W.;Stubblefield, William B.;Casey, Jonathan D.;Rice, Todd W.;Grijalva, Carlos G.;Hager, David N.;Shehu, Arber;Qadir, Nida;Chang, Steven Y.;Wilson, Jennifer G.;Gaglani, Manjusha;Murthy, Kempapura;Calhoun, Nicole;Monto, Arnold S.;Martin, Emily T.;Malani, Anurag;Zimmerman, Richard K.;Silveira, Fernanda P.;Middleton, Donald B.;Zhu, Yuwei;Wyatt, Dayna;Stephenson, Meagan;Baughman, Adrienne;Womack, Kelsey N.;Hart, Kimberly W.;Kobayashi, Miwako;Verani, Jennifer R.;Patel, Manish M.
通讯作者：
Patel, Manish M.
BNT162B2 mRNA COVID-19疫苗的安全性和功效。
DOI：
10.1056/nejmoa2034577
发表时间：
2020-12-31
期刊：
The New England journal of medicine
影响因子：
--
作者：
Polack FP;Thomas SJ;Kitchin N;Absalon J;Gurtman A;Lockhart S;Perez JL;Pérez Marc G;Moreira ED;Zerbini C;Bailey R;Swanson KA;Roychoudhury S;Koury K;Li P;Kalina WV;Cooper D;Frenck RW Jr;Hammitt LL;Türeci Ö;Nell H;Schaefer A;Ünal S;Tresnan DB;Mather S;Dormitzer PR;Şahin U;Jansen KU;Gruber WC;C4591001 Clinical Trial Group
通讯作者：
C4591001 Clinical Trial Group
影响因子：
25.7
作者：
Rabinowich L;Grupper A;Baruch R;Ben-Yehoyada M;Halperin T;Turner D;Katchman E;Levi S;Houri I;Lubezky N;Shibolet O;Katchman H
通讯作者：
Katchman H
影响因子：
8.8
作者：
Grupper, Ayelet;Rabinowich, Liane;Katchman, Helena
通讯作者：
Katchman, Helena
DOI：
10.1016/s0140-6736(21)00677-2
发表时间：
2021-05-01
期刊：
Lancet (London, England)
影响因子：
--
作者：
Vasileiou E;Simpson CR;Shi T;Kerr S;Agrawal U;Akbari A;Bedston S;Beggs J;Bradley D;Chuter A;de Lusignan S;Docherty AB;Ford D;Hobbs FR;Joy M;Katikireddi SV;Marple J;McCowan C;McGagh D;McMenamin J;Moore E;Murray JL;Pan J;Ritchie L;Shah SA;Stock S;Torabi F;Tsang RS;Wood R;Woolhouse M;Robertson C;Sheikh A
通讯作者：
Sheikh A