PDF(Pubmed)
Abstract：
Although the COVID-19 pandemic is profoundly changing, data on the effect of vaccination and duration of protection against infection and severe disease can still be advantageous, especially for patients with COPD, who are more vulnerable to respiratory infections. The Hungarian COVID-19 registry was retrospectively investigated for risk of infection and hospitalization by time since the last vaccination, and vaccine effectiveness (VE) was calculated in adults with COPD diagnosis and an exact-matched control group during the Delta variant of concern (VOC) wave in Hungary (September-December 2021). For the matching, sex, age, major co-morbidities, vaccination status, and prior infection data were obtained on 23 August 2021. The study population included 373,962 cases divided into COPD patients (age: 66.67 ± 12.66) and a 1:1 matched group (age: 66.73 ± 12.67). In both groups, the female/male ratio was 52.2:47.7, respectively. Among the unvaccinated, there was no difference between groups in risk for infection or hospitalization. Regarding vaccinated cases, in the COPD group, a slightly faster decline in effectiveness was noted for hospitalization prevention, although in both groups, the vaccine lost its significant effect between 215 and 240 days after the last dose of vaccination. Based on a time-stratified multivariate Cox analysis of the vaccinated cases, the hazard was constantly higher in the COPD group, with an HR of 1.09 (95%: 1.05-1.14) for infection and 1.87 (95% CI: 1.59-2.19) for hospitalization. In our study, COPD patients displayed lower vaccine effectiveness against SARS-CoV-2 infection and hospitalization but a similar waning trajectory, as vaccines lost their preventive effect after 215 days. These data emphasize revaccination measures in the COPD patient population.
摘要：
尽管COVID-19大流行正在发生深刻的变化，关于疫苗接种效果和预防感染和严重疾病持续时间的数据仍然是有利的，尤其是COPD患者，他们更容易受到呼吸道感染。自上次接种疫苗以来，匈牙利COVID-19登记处对感染风险和住院风险进行了回顾性调查，在匈牙利的Delta变异型关注(VOC)波期间(2021年9月至12月),计算了诊断为COPD的成年人和完全匹配的对照组的疫苗有效性(VE).对于匹配，性别,年龄,主要合并症，疫苗接种状况,先前的感染数据是在2021年8月23日获得的。研究人群包括373,962例，分为COPD患者（年龄：66.67±12.66）和1：1匹配组（年龄：66.73±12.67）。在这两组中,女性/男性比例分别为52.2:47.7。在未接种疫苗的人群中，两组之间的感染风险和住院风险无差异.关于接种疫苗的病例，在COPD组中，住院预防的有效性下降略快，尽管在两组中，在最后一次疫苗接种后的215到240天之间，疫苗失去了显著的效果。根据对接种疫苗病例的时间分层多变量Cox分析，COPD组的风险持续较高，感染的HR为1.09（95％：1.05-1.14），住院的HR为1.87（95％CI：1.59-2.19）。在我们的研究中,COPD患者对SARS-CoV-2感染和住院的疫苗效力较低，但也有类似的下降轨迹，因为疫苗在215天后失去了预防作用。这些数据强调了COPD患者群体中的再接种措施。
