Abstract：
OBJECTIVE: We aimed to explore the association between coronavirus disease-19 (COVID-19) vaccination and long COVID according to the status of chronic multimobidity.
METHODS: A total of 1913 participants were recruited in the cross-sectional study on the basis of the Survey of Health and Retirement in Europe. COVID-19 vaccination was defined as vaccination within the last 12 months. Chronic multimorbidity was defined as history of 2 + chronic disease. The study outcome was long COVID during the 12-month follow-up. Multivariable logistic models were performed to estimate the influence of chronic multimorbidity on the association of vaccination with long COVID. Net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were calculated.
RESULTS: Chronic multimorbidity significantly modified the association of COVID-19 vaccination with long COVID (Pinteraction = 0.024). The rates of study outcome were significantly lower among vaccinated participants in the chronic multimorbidity subgroup, but not in the other subgroup. Multivariable odds ratios (95 % confidence intervals) of study outcome for unvaccination vs. vaccination were 1.494 (1.013-2.203) in those with multimorbidity and 0.915 (0.654-1.280) in those without multimorbidity, respectively. Adding COVID-19 vaccination to a model containing conventional risk factors significantly improved risk reclassification for study outcome among those with chronic multimobidity (continuous NRI was 25.39 % [P = 0.002] and IDI was 0.42 % [P = 0.075]) CONCLUSION: An inverse association of COVID-19 vaccination with long COVID was found among participants with chronic multimorbidity, but not among those without chronic multimorbidity. Chronic multimorbidity might expand the influence of unvaccination on developing long COVID among European aged ≥50 years.
METHODS: A total of 1913 participants were recruited in the cross-sectional study on the basis of the Survey of Health and Retirement in Europe. COVID-19 vaccination was defined as vaccination within the last 12 months. Chronic multimorbidity was defined as history of 2 + chronic disease. The study outcome was long COVID during the 12-month follow-up. Multivariable logistic models were performed to estimate the influence of chronic multimorbidity on the association of vaccination with long COVID. Net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were calculated.
RESULTS: Chronic multimorbidity significantly modified the association of COVID-19 vaccination with long COVID (Pinteraction = 0.024). The rates of study outcome were significantly lower among vaccinated participants in the chronic multimorbidity subgroup, but not in the other subgroup. Multivariable odds ratios (95 % confidence intervals) of study outcome for unvaccination vs. vaccination were 1.494 (1.013-2.203) in those with multimorbidity and 0.915 (0.654-1.280) in those without multimorbidity, respectively. Adding COVID-19 vaccination to a model containing conventional risk factors significantly improved risk reclassification for study outcome among those with chronic multimobidity (continuous NRI was 25.39 % [P = 0.002] and IDI was 0.42 % [P = 0.075]) CONCLUSION: An inverse association of COVID-19 vaccination with long COVID was found among participants with chronic multimorbidity, but not among those without chronic multimorbidity. Chronic multimorbidity might expand the influence of unvaccination on developing long COVID among European aged ≥50 years.
摘要：
目的：我们的目的是根据慢性多人群状态探讨19型冠状病毒病（COVID-19）疫苗接种与长期COVID之间的关系。
方法：根据欧洲健康和退休调查，在横断面研究中招募了1913名参与者。COVID-19疫苗接种定义为在过去12个月内接种疫苗。慢性多发病定义为2+慢性病史。在12个月的随访期间，研究结果是长期COVID。采用多变量Logistic模型评估慢性多发病对长期COVID疫苗接种的影响。计算净重新分类改进(NRI)和综合辨别改进(IDI)。
结果：慢性多发病显著改变了COVID-19疫苗接种与长期COVID的关联(P交互作用=0.024)。慢性多发病亚组接种疫苗的参与者的研究结果比率显著较低，但不是在另一个子组。未接种疫苗与未接种疫苗的研究结果的多变量比值比（95％置信区间）多发病者接种疫苗1.494（1.013-2.203），无多发病者接种疫苗0.915（0.654-1.280），分别。在含有常规危险因素的模型中加入COVID-19疫苗可显著改善慢性多人群研究结果的风险重新分类（连续NRI为25.39%[P=0.002]，IDI为0.42%[P=0.075]）。但不是那些没有慢性多发病的人。慢性多发病可能会扩大未接种疫苗对欧洲50岁以上人群发生长期COVID的影响。
方法：根据欧洲健康和退休调查，在横断面研究中招募了1913名参与者。COVID-19疫苗接种定义为在过去12个月内接种疫苗。慢性多发病定义为2+慢性病史。在12个月的随访期间，研究结果是长期COVID。采用多变量Logistic模型评估慢性多发病对长期COVID疫苗接种的影响。计算净重新分类改进(NRI)和综合辨别改进(IDI)。
结果：慢性多发病显著改变了COVID-19疫苗接种与长期COVID的关联(P交互作用=0.024)。慢性多发病亚组接种疫苗的参与者的研究结果比率显著较低，但不是在另一个子组。未接种疫苗与未接种疫苗的研究结果的多变量比值比（95％置信区间）多发病者接种疫苗1.494（1.013-2.203），无多发病者接种疫苗0.915（0.654-1.280），分别。在含有常规危险因素的模型中加入COVID-19疫苗可显著改善慢性多人群研究结果的风险重新分类（连续NRI为25.39%[P=0.002]，IDI为0.42%[P=0.075]）。但不是那些没有慢性多发病的人。慢性多发病可能会扩大未接种疫苗对欧洲50岁以上人群发生长期COVID的影响。
