背景:在文献中,COVID-19患者中疱疹病毒(HHV)的再激活是显而易见的。已经发表了一些关于这些病毒(HSV,VZV,EBV,和CMV)在接种COVID-19疫苗的人群中。在这项研究中,我们的目的是回顾目前的证据,以评估HHVs的再激活是否与COVID-19疫苗的既往给药相关.
方法:于2022年9月25日在PubMed/MEDLINE进行了系统搜索,WebofScience,和EMBASE。我们纳入了所有的观察性研究,病例报告,以及报告在施用COVID-19疫苗后人类疱疹病毒重新激活的病例系列。
结果:我们的系统搜索显示80篇文章符合资格标准。在评估的COVID-19疫苗中,大多数疫苗是基于mRNA的。来自观察性研究的证据表明,COVID-19疫苗的施用与VZV和HSV再激活之间可能存在关系。我们的比例荟萃分析结果显示,接受COVID-19疫苗接种者的VZV再激活率为每1000次疫苗接种14人(95%CI2.97-32.80)。此外,我们对HSV再激活的荟萃分析显示,每1000次接种疫苗中有16人的比例(95%CI1.06~46.4).此外,病例报告/系列的证据显示149例HHV再激活.有几种疫苗引起再激活,包括BNT162b2mRNA或Pfizer-BioNTech(n=76),牛津-阿斯利康(n=22),mRNA-1273或Moderna(n=17),Sinovac(n=4),BBIBP-CorV或国药(n=3),Covaxin(n=3),Covishield(n=3),和约翰逊和约翰逊(n=1)。重新激活的HHV包括水痘-带状疱疹病毒(VZV)(n=114),巨细胞病毒(CMV)(n=15),单纯疱疹病毒(HSV)(n=14),EB病毒(EBV)(n=6),和HHV-6(n=2)。大多数病例在第一次接种疫苗后报告了他们的疾病。许多患者报告有合并症,其中高血压,糖尿病,血脂异常,水痘,房颤是常见的。
结论:结论:我们的研究表明,COVID-19疫苗接种与疱疹病毒再激活之间可能存在关联.VZV和HSV的证据得到了观察性研究的支持。然而,关于其他疱疹病毒(EBV和CMV),需要进一步研究,特别是观察性研究和临床试验,以阐明COVID-19疫苗接种和其再激活之间的相互作用.
BACKGROUND: The reactivation of herpesviruses (HHV) in COVID-19 patients is evident in the literature. Several reports have been published regarding the reactivation of these viruses (HSV, VZV, EBV, and CMV) among those who got COVID-19 vaccines. In this study, we aimed to
review the current evidence to assess whether HHVs reactivation has any association with the prior administration of COVID-19 vaccines.
METHODS: A systematic search was conducted on 25 September 2022 in PubMed/MEDLINE, Web of Science, and EMBASE. We included all observational studies, case reports, and case series which reported the reactivation of human herpesviruses following administration of COVID-19 vaccines.
RESULTS: Our systematic search showed 80 articles that meet the eligibility criteria. Among the evaluated COVID-19 vaccines, most of the vaccines were mRNA based. Evidence from observational studies showed the possible relation between COVID-19 vaccine administration and VZV and HSV reactivation. The results of our proportion meta-analysis showed that the rate of VZV reactivation among those who received the COVID-19 vaccine was 14 persons per 1000 vaccinations (95% CI 2.97-32.80). Moreover, our meta-analysis for HSV reactivation showed the rate of 16 persons per 1000 vaccinations (95% CI 1.06-46.4). Furthermore, the evidence from case reports/series showed 149 cases of HHV reactivation. There were several vaccines that caused reactivation including BNT162b2 mRNA or Pfizer-BioNTech (n = 76), Oxford-AstraZeneca (n = 22), mRNA-1273 or Moderna (n = 17), Sinovac (n = 4), BBIBP-CorV or Sinopharm (n = 3), Covaxin (n = 3), Covishield (n = 3), and Johnson and Johnson (n = 1). Reactivated HHVs included varicella-zoster virus (VZV) (n = 114), cytomegalovirus (CMV) (n = 15), herpes simplex virus (HSV) (n = 14), Epstein-Barr virus (EBV) (n = 6), and HHV-6 (n = 2). Most cases reported their disease after the first dose of the vaccine. Many patients reported having comorbidities, of which hypertension, diabetes mellitus, dyslipidemia, chicken pox, and atrial fibrillation were common.
CONCLUSIONS: In conclusion, our study showed the possible association between COVID-19 vaccination and herpesvirus reactivation. The evidence for VZV and HSV was supported by observational studies. However, regarding other herpesviruses (EBV and CMV), further research especially from observational studies and clinical trials is required to elucidate the interaction between COVID-19 vaccination and their reactivation.