SARS-CoV-2疫苗接种与流感疫苗接种后持续症状性COVID-19和COVID-19后综合征个体的症状演变

IF 14.3 1区医学 Q1 INFECTIOUS DISEASES

Journal of Infection Pub Date : 2025-02-01 DOI:10.1016/j.jinf.2024.106406

Khaled Rjoob , Michela Antonelli , Benjamin Murray , Erika Molteni , Nathan Cheetham , Liane S. Canas , Marc Modat , Joan Capdevila Pujol , Christina Hu , Vicky Bowyer , Jonathan Wolf , Tim D. Spector , Sébastien Ourselin , Alexander Hammers , Emma L. Duncan , Claire J. Steves , Carole H. Sudre

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引用次数: 0

摘要

背景：COVID-19症状可能在急性SARS-CoV-2感染后持续存在，如持续症状性COVID-19 [OSC]（症状持续时间4-12周）和后covid综合征[PCS]（症状持续时间≥12周）。接种SARS-CoV-2疫苗可降低接种后感染SARS-CoV-2的个体的OSC/PCS。目前尚不清楚，接种SARS-CoV-2疫苗或任何其他疫苗（如流感疫苗）是否会影响已经出现OSC/PCS的个体的症状，而不仅仅是自然症状演变。方法：使用ZOE COVID症状研究应用程序的数据，对前瞻性报告的OSC/PCS个体进行了两项比较分析：A)首次接种SARS-CoV-2疫苗的个体与未接种疫苗的个体的症状，与年龄、性别、BMI和测试周相匹配（每组n=1679）；B)与未接种疫苗的个体相比，接种流感疫苗的个体的症状，年龄、性别、BMI、检测周数和SARS-CoV-2疫苗接种次数相匹配（每组n=692）。在这两项分析中，均将接种疫苗日期（或未接种疫苗组出现症状的等效时间）视为指标时间，并通过比较接种前和接种后第二周的症状来测量症状演变。症状是根据所考虑的时间段内的患病率和负担来考虑的；所有结果都经过多次比较调整。结果：首次接种SARS-CoV-2疫苗后，OSC/PCS患者的许多症状改善速度快于自然病史消退，包括常见的疲劳症状(p结论：在OSC/PCS患者中，接种SARS-CoV-2疫苗可改善症状消退；然而，在其他疫苗接种后没有观察到这种效果。

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Symptom evolution in individuals with ongoing symptomatic COVID-19 and post-COVID-19 syndrome after SARS-CoV-2 vaccination versus influenza vaccination

Background

COVID-19 symptoms may persist beyond acute SARS-CoV-2 infection, as ongoing symptomatic COVID-19 [OSC] (symptom duration 4–12 weeks) and post-COVID syndrome [PCS] (symptom duration ≥12 weeks). Vaccination against SARS-CoV-2 decreases OSC/PCS in individuals subsequently infected with SARS-CoV-2 post-vaccination. Whether vaccination against SARS-CoV-2, or any other vaccinations (such as against influenza) affects symptoms in individuals already experiencing OSC/PCS, more than natural symptom evolution, is unknown.

Method

Using data from the ZOE COVID Symptom Study app, two comparative analyses were carried out, both in prospectively-reporting individuals with OSC/PCS: A) symptoms in individuals receiving first vaccination against SARS-CoV-2, compared with unvaccinated individuals, matched for age, sex, BMI and week of test (n=1679 in each group); B) symptoms in individuals receiving vaccination against influenza, compared with unvaccinated individuals, matched for age, sex, BMI, week of test and number of SARS-CoV-2 vaccinations (n=692 in each group). In both analyses, vaccination date (or equivalent time from start of symptoms in the unvaccinated group) was considered as the index time, and symptom evolution was measured by comparing symptoms during the second week before and second week after vaccination. Symptoms were considered by prevalence and burden over the considered periods; all results were adjusted for multiple comparisons.

Results

After first vaccination against SARS-CoV-2, many symptoms in individuals with OSC/PCS improved more rapidly than natural history resolution, including the commonly reported symptoms of fatigue (p<0.0001, β=-−0.9 [95% CI: −1.86; −0.67]) and myalgia (p<0.001, β=−0.3 [95% CI: −0.50; −0.12]). No symptom worsened after vaccination. In contrast, there was no improvement in OSC/PCS symptoms beyond natural history resolution after vaccination against influenza.

Conclusion

In individuals with OSC/PCS, symptom resolution improved after vaccination against SARS-CoV-2 ; this was not observed, however, after other vaccinations.

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来源期刊

Journal of Infection 医学-传染病学

CiteScore

45.90

自引率

3.20%

发文量

475

审稿时长

16 days

期刊介绍： The Journal of Infection publishes original papers on all aspects of infection - clinical, microbiological and epidemiological. The Journal seeks to bring together knowledge from all specialties involved in infection research and clinical practice, and present the best work in the ever-changing field of infection. Each issue brings you Editorials that describe current or controversial topics of interest, high quality Reviews to keep you in touch with the latest developments in specific fields of interest, an Epidemiology section reporting studies in the hospital and the general community, and a lively correspondence section.