通过随机对照试验比较现有 COVID-19 疫苗的疗效和不良事件:最新系统综述和网络元分析

IF 1.4 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Shima Hossaini, Fariba Keramat, Zahra Cheraghi, Bushra Zareie, A. Doosti-Irani
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引用次数: 0

摘要

背景:迄今为止,世界上已开发并批准了不同的疫苗来应对 COVID-19。这项最新的网络荟萃分析(NMA)旨在同时对所有可用疫苗的疗效和并发症进行比较和排序。研究设计:系统综述。研究方法:检索了截至 2023 年 9 月的三大国际数据库,包括 Web of Science、Medline via PubMed 和 Scopus。从流行病学效应修饰因子的角度对过渡性假设进行了定性评估。本研究关注的暴露是接种任何可用的 COVID-19 疫苗,关注的主要结果是症状性 COVID-19 的发病率。在本 NMA 中,症状性 COVID-19 的相对风险用于总结疫苗在预防 COVID-19 方面的功效。数据采用基于频数的方法进行分析,结果采用随机效应模型进行报告。最后,使用 P 分数对疫苗进行了排名。结果在检索到的 3682 篇参考文献中,共有 34 篇随机对照试验 (RCT) 符合本系统综述和 NMA 的资格标准。根据 NMA 的结果,mRNA-1273 是预防 COVID-19 最有效的疫苗,P 值最高(0.93)。与安慰剂相比,mRNA-1273 的相对风险 (RR) 为 0.07(95% 置信区间 [CI]:0.03, 0.17)。排名第二和第三的疫苗是 BNT-162b2(RR=0.08;95% CI:0.04,0.15;P-score=0.93)和 Gam-COVID-Vac(0.09;95% CI:0.03,0.25;0.88)。结论根据该 NMA 的结果,似乎所有可用疫苗都能有效预防 COVID-19。不过,排名前三的疫苗分别是 mRNA-1273、BNT-162b2 和 Gam-COVID-Vac。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparing the Efficacy and Adverse Events of Available COVID-19 Vaccines Through Randomized Controlled Trials: Updated Systematic Review and Network Meta-analysis
Background: Different vaccines have so far been developed and approved to cope with COVID-19 in the world. The aim of this updated network meta-analysis (NMA) was to compare and rank all available vaccines in terms of efficacy and complications simultaneously. Study Design: A systematic review. Methods: Three major international databases, including Web of Science, Medline via PubMed, and Scopus, were searched through September 2023. The transitivity assumption was evaluated qualitatively in terms of epidemiologic effect modifiers. The exposure of interest in this study was receiving any available COVID-19 vaccine, and the primary outcome of interest was the incidence of symptomatic COVID-19. In this NMA, the relative risk of symptomatic COVID-19 was used to summarize the efficacy of vaccines in preventing COVID-19. The data were analyzed using the frequentist-based approach, and the results were reported using a random-effects model. Finally, the vaccines were ranked using a P-score. Results: In total, 34 randomized controlled trials (RCTs) met the eligibility criteria for this systematic review and NMA out of 3682 retrieved references. Based on the results of the NMA, mRNA-1273 was the most effective vaccine in preventing COVID-19 and demonstrated the highest P-score (0.93). The relative risk (RR) for mRNA-1273 versus placebo was 0.07 (95% confidence interval [CI]: 0.03, 0.17). The second and third-ranked vaccines were BNT-162b2 (RR=0.08; 95% CI: 0.04, 0.15; P-score=0.93) and Gam-COVID-Vac (0.09; 95% CI: 0.03, 0.25; 0.88). Conclusion: Based on the results of this NMA, it seems that all available vaccines were effective in COVID-19 prevention. However, the top three ranked vaccines were mRNA-1273, BNT-162b2, and Gam-COVID-Vac, respectively.
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来源期刊
Journal of research in health sciences
Journal of research in health sciences PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
2.30
自引率
13.30%
发文量
7
期刊介绍: The Journal of Research in Health Sciences (JRHS) is the official journal of the School of Public Health; Hamadan University of Medical Sciences, which is published quarterly. Since 2017, JRHS is published electronically. JRHS is a peer-reviewed, scientific publication which is produced quarterly and is a multidisciplinary journal in the field of public health, publishing contributions from Epidemiology, Biostatistics, Public Health, Occupational Health, Environmental Health, Health Education, and Preventive and Social Medicine. We do not publish clinical trials, nursing studies, animal studies, qualitative studies, nutritional studies, health insurance, and hospital management. In addition, we do not publish the results of laboratory and chemical studies in the field of ergonomics, occupational health, and environmental health
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