COVID-19疫情下肺结核病人的COVID-19疫苗接种策略

Strategy for COVID-19 vaccination for patients with tuberculosis during the COVID-19 pandemic

COVID-19疫情流行形势依旧严峻,对于疫苗的普及接种刻不容缓。肺结核是中国高发的慢性传染病,由于病发肺部,肺结核患者合并感染COVID-19之后病情更重,治疗效果差。而目前对于肺结核患者接种COVID-19疫苗的保护效力、免疫原性及安全性仍知之甚少,也缺乏相应的循证医学证据。本文回顾了肺结核的发病机制与流行病学,探讨了肺结核患者体内的免疫状态,对目前国内外已有的对肺结核患者疫苗接种的提议进行了总结,同时结合其他特殊人群已有的疫苗接种的临床研究进行分析,探讨了COVID-19疫情下肺结核病人的疫苗接种策略和开展以肺结核患者为目标人群的COVID-19疫苗临床研究的必要性。

The pandemic of COVID-19 is still rampaging all over the world,so it is urgent to popularize vaccination.Meanwhile,pulmonary tuberculosis is one of the chronic infectious diseases with a high incidence in China.Since these diseases all occur in lung tissue,patients with TB and COVID-19 co-infection show more serious conditions and poorer treatment effects.However,we have limited knowledge about the protective efficacy,immunogenicity and safety of COVID-19 vaccine in patients with TB at present,with a lack of corresponding evidence-based medicine as well.Therefore,this paper reviews the pathogenesis and epidemiology of TB,discusses the immune status of patients with TB and summarizes the existing proposals for vaccination of patients with TB at home and abroad.Furthermore,we analyze the existing clinical trials in TB patients and other special populations,and finally discuss the strategy of vaccination for patients with TB during the COVID-19 pandemic and the necessity of clinical research on COVID-19 vaccines with target population of TB patients.