[免疫功能低下人群预防COVID-19未解决的挑战:来自葡萄牙的共识分析]。

IF 1 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL
Acta medica portuguesa Pub Date : 2025-09-01 Epub Date: 2025-07-30 DOI:10.20344/amp.9949
Ana Soraia Cunha, Beatriz Raposo, João V Cordeiro, Maria João Marques, Ana Rita Pedro
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引用次数: 0

摘要

由严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)引起的COVID-19大流行造成了严重的疾病负担和死亡率。尽管疫苗接种取得了成功,但新的病毒变体仍然存在,严重影响未接种疫苗和免疫功能低下的个体(ICI)。这些高危人群面临着较高的死亡率和住院率。大流行后,保持警惕和采取有针对性的卫生措施仍然至关重要。本研究的目的是就ICI中未满足的COVID-19预防需求达成共识。方法:采用德尔菲法对医生、卫生管理人员、政策制定者、公共卫生专家、医学学会成员和患者组织等45名专家进行调查。对于每个确定的战略,65%的人达成了共识,使用的量表从“非常同意”到“非常不同意”。进行了三轮德尔菲调查,以解决四个关键问题:确定ICI在COVID-19预防方面未满足的需求;确定将ICI区分为易感群体的特征;确定COVID-19在ICI中的主要结局;并提出保护ICI的行动计划。第一轮是对预先确定的指标进行投票。第二轮和第三轮涉及分析收集到的信息,并对每个指标进行投票以达成共识。结果:留置率达80%。在分析的89项有效指标中,23项达到共识。其中包括:八项指标,强调提高对COVID-19和疫苗接种结果的认识,确保安全和理解,以及制定针对ICI的有针对性的免疫战略的重要性;识别ICI易感人群的五项指标,如接受化疗或放疗的个体、原发性免疫缺陷者、实体器官移植接受者、慢性肾脏疾病患者和骨髓移植接受者;两项指标显示临床结果的改善和住院率的降低;以及八项指标,建议开发有效的治疗方法、更多的免疫原性疫苗和ICI病毒感染的治疗方法。结论:本研究强调了针对性免疫策略、监测和针对性教育的重要性,以满足ICI的不同需求。这些发现为在COVID-19大流行期间和之后有效管理和保护ICI的未来政策奠定了基础。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Unmet Challenges in COVID-19 Prevention for Immunocompromised Individuals: A Consensus Analysis from Portugal].

Introduction: The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), resulted in significant disease burden and mortality. Despite vaccination successes, new virus variants persist, affecting unvaccinated and immunocompromised individuals (ICI) severely. These high-risk groups face elevated mortality and hospitalization rates. Vigilance and targeted health measures remain crucial post-pandemic. The aim of this study was to develop consensus on the unmet needs in COVID-19 prevention among ICI.

Methods: We performed a Delphi study involving 45 experts, including physicians, health managers, policymakers, public health experts, members of medical societies and patient organizations. Consensus was achieved at 65% for each identified strategy using a scale ranging from "strongly agree" to "strongly disagree." Three Delphi rounds were conducted to address four key questions: identifying unmet needs in COVID-19 prevention for ICI; identifying the characteristics that distinguish ICI as a susceptible group; determining the main outcomes of COVID-19 in ICI; and indicating action plans for protecting ICI. The first round involved voting on pre-identified indicators. The second and third rounds involved analyzing the gathered information and voting on each indicator to achieve consensus.

Results: A retention rate of 80% was achieved. Out of 89 valid indicators analyzed, 23 achieved consensus. These included: eight indicators highlighting the importance of raising awareness about COVID-19 and vaccination outcomes, ensuring safety and understanding, and developing targeted immunization strategies for ICI; five indicators identifying susceptible groups within ICI, such as individuals undergoing chemotherapy or radiotherapy, those with primary immunodeficiencies, solid organ transplant recipients, patients with chronic kidney disease, and bone marrow transplant recipients; two indicators showing improvements in clinical outcomes and reduced hospitalizations; and eight indicators recommending the development of effective therapies, more immunogenic vaccines, and treatments for viral infections in ICI.

Conclusion: The study emphasized the importance of targeted immunization strategies, monitoring, and tailored education to address diverse needs of ICI. These findings provide a foundation for future policies to effectively manage and protect ICI during and beyond the COVID-19 pandemic.

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来源期刊
Acta medica portuguesa
Acta medica portuguesa MEDICINE, GENERAL & INTERNAL-
CiteScore
1.90
自引率
16.70%
发文量
256
审稿时长
6-12 weeks
期刊介绍: The aim of Acta Médica Portuguesa is to publish original research and review articles in biomedical areas of the highest standard, covering several domains of medical knowledge, with the purpose to help doctors improve medical care. In order to accomplish these aims, Acta Médica Portuguesa publishes original articles, review articles, case reports and editorials, among others, with a focus on clinical, scientific, social, political and economic factors affecting health. Acta Médica Portuguesa will be happy to consider manuscripts for publication from authors anywhere in the world.
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