Salvatore De Masi, Roberto Da Cas, Francesca Menniti Ippolito, Giovanni Baglio, Carmine Zoccali, Flavia Chiarotti, Massimo Fabiani, Francesca Colavita, Concetta Castilletti, Mario Salomone, Alfonso Mele, Piergiorgio Messa
{"title":"COVID-19 疫苗对血液透析患者的影响:一项意大利多中心队列研究。","authors":"Salvatore De Masi, Roberto Da Cas, Francesca Menniti Ippolito, Giovanni Baglio, Carmine Zoccali, Flavia Chiarotti, Massimo Fabiani, Francesca Colavita, Concetta Castilletti, Mario Salomone, Alfonso Mele, Piergiorgio Messa","doi":"10.1007/s40620-024-02007-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to evaluate the impact on the national health system of COVID-19 infection in vaccinated patients undergoing haemodialysis.</p><p><strong>Methods: </strong>From the cohort of vaccinated dialysis patients enrolled in 118 dialysis centres, we calculated hospitalisation incidence in COVID-19-infected subjects. COVID-19-related hospitalisations and ICU admissions were analysed over two time periods (prior to administration of the third dose and following administration of the third dose of vaccine) and adjusted for several co-variates. Using the general population as the reference, we then calculated the Standardized Incidence Ratio (SIR) of hospitalisation.</p><p><strong>Results: </strong>Eighty-two subjects out of 1096 infected patients were hospitalised (7.5%) and sixty-four hospitalisations occurred among the 824 infected persons after the third dose. Age ≥ 60 years (Adj RR 2.91; 95% CI 1.34-6.30) and lung disease (Adj RR = 2.45; 95% CI 1.32-4.54) were the only risk factors associated with hospitalisation. The risk of ICU admission in the second time period (Time 2) was reduced by 86% (RR = 0.14; 95% CI 0.03-0.71) compared to the first time period (Time 1). The SIR of hospitalisation (SIR 14.51; 95% CI 11.37-17.65) and ICU admission (SIR 14.58; 95% CI 2.91-26.24) showed an increase in the number of events in dialysis patients compared to the general population.</p><p><strong>Conclusions: </strong>Our analysis revealed that while the second variant of the virus increased infection rates, it was concurrently associated with mitigated severity of infections. Dialysis patients exhibited a higher susceptibility to both COVID-19 hospitalisation and ICU admission than the general population throughout the pandemic.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.7000,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of COVID-19 vaccines in patients on hemodialysis: an Italian multicentre cohort study.\",\"authors\":\"Salvatore De Masi, Roberto Da Cas, Francesca Menniti Ippolito, Giovanni Baglio, Carmine Zoccali, Flavia Chiarotti, Massimo Fabiani, Francesca Colavita, Concetta Castilletti, Mario Salomone, Alfonso Mele, Piergiorgio Messa\",\"doi\":\"10.1007/s40620-024-02007-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The aim of this study was to evaluate the impact on the national health system of COVID-19 infection in vaccinated patients undergoing haemodialysis.</p><p><strong>Methods: </strong>From the cohort of vaccinated dialysis patients enrolled in 118 dialysis centres, we calculated hospitalisation incidence in COVID-19-infected subjects. COVID-19-related hospitalisations and ICU admissions were analysed over two time periods (prior to administration of the third dose and following administration of the third dose of vaccine) and adjusted for several co-variates. Using the general population as the reference, we then calculated the Standardized Incidence Ratio (SIR) of hospitalisation.</p><p><strong>Results: </strong>Eighty-two subjects out of 1096 infected patients were hospitalised (7.5%) and sixty-four hospitalisations occurred among the 824 infected persons after the third dose. Age ≥ 60 years (Adj RR 2.91; 95% CI 1.34-6.30) and lung disease (Adj RR = 2.45; 95% CI 1.32-4.54) were the only risk factors associated with hospitalisation. The risk of ICU admission in the second time period (Time 2) was reduced by 86% (RR = 0.14; 95% CI 0.03-0.71) compared to the first time period (Time 1). The SIR of hospitalisation (SIR 14.51; 95% CI 11.37-17.65) and ICU admission (SIR 14.58; 95% CI 2.91-26.24) showed an increase in the number of events in dialysis patients compared to the general population.</p><p><strong>Conclusions: </strong>Our analysis revealed that while the second variant of the virus increased infection rates, it was concurrently associated with mitigated severity of infections. Dialysis patients exhibited a higher susceptibility to both COVID-19 hospitalisation and ICU admission than the general population throughout the pandemic.</p>\",\"PeriodicalId\":16542,\"journal\":{\"name\":\"Journal of Nephrology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2024-07-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Nephrology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s40620-024-02007-5\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Nephrology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s40620-024-02007-5","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景本研究旨在评估接受血液透析的疫苗接种患者感染 COVID-19 对国家卫生系统的影响:我们从 118 个透析中心登记的已接种疫苗的透析患者队列中计算了 COVID-19 感染者的住院发生率。在两个时间段内(接种第三剂疫苗之前和接种第三剂疫苗之后)分析了与 COVID-19 相关的住院率和重症监护室入院率,并对几个协变量进行了调整。然后,我们以普通人群为参照,计算了住院的标准化发病率(SIR):结果:1096 名感染者中有 82 人住院(7.5%),824 名感染者中有 64 人在接种第三剂疫苗后住院。年龄≥60岁(Adj RR 2.91; 95% CI 1.34-6.30)和肺部疾病(Adj RR = 2.45; 95% CI 1.32-4.54)是唯一与住院相关的风险因素。与第一阶段(第一阶段)相比,第二阶段(第二阶段)入住 ICU 的风险降低了 86% (RR = 0.14; 95% CI 0.03-0.71)。住院的 SIR(SIR 14.51;95% CI 11.37-17.65)和入住 ICU 的 SIR(SIR 14.58;95% CI 2.91-26.24)显示,与普通人群相比,透析患者的事件数量有所增加:我们的分析表明,虽然病毒的第二变种增加了感染率,但同时也减轻了感染的严重程度。在整个大流行期间,透析患者比普通人群更容易感染 COVID-19 住院和入住重症监护病房。
Impact of COVID-19 vaccines in patients on hemodialysis: an Italian multicentre cohort study.
Background: The aim of this study was to evaluate the impact on the national health system of COVID-19 infection in vaccinated patients undergoing haemodialysis.
Methods: From the cohort of vaccinated dialysis patients enrolled in 118 dialysis centres, we calculated hospitalisation incidence in COVID-19-infected subjects. COVID-19-related hospitalisations and ICU admissions were analysed over two time periods (prior to administration of the third dose and following administration of the third dose of vaccine) and adjusted for several co-variates. Using the general population as the reference, we then calculated the Standardized Incidence Ratio (SIR) of hospitalisation.
Results: Eighty-two subjects out of 1096 infected patients were hospitalised (7.5%) and sixty-four hospitalisations occurred among the 824 infected persons after the third dose. Age ≥ 60 years (Adj RR 2.91; 95% CI 1.34-6.30) and lung disease (Adj RR = 2.45; 95% CI 1.32-4.54) were the only risk factors associated with hospitalisation. The risk of ICU admission in the second time period (Time 2) was reduced by 86% (RR = 0.14; 95% CI 0.03-0.71) compared to the first time period (Time 1). The SIR of hospitalisation (SIR 14.51; 95% CI 11.37-17.65) and ICU admission (SIR 14.58; 95% CI 2.91-26.24) showed an increase in the number of events in dialysis patients compared to the general population.
Conclusions: Our analysis revealed that while the second variant of the virus increased infection rates, it was concurrently associated with mitigated severity of infections. Dialysis patients exhibited a higher susceptibility to both COVID-19 hospitalisation and ICU admission than the general population throughout the pandemic.
期刊介绍:
Journal of Nephrology is a bimonthly journal that considers publication of peer reviewed original manuscripts dealing with both clinical and laboratory investigations of relevance to the broad fields of Nephrology, Dialysis and Transplantation. It is the Official Journal of the Italian Society of Nephrology (SIN).