新冠灭活疫苗预防肾移植受者奥密克戎变异株感染的临床分析

A clinical analysis of inactivated COVID-19 vaccine for prevention of infection caused by Omicron variant in kidney transplant recipients

目的分析肾移植受者感染奥密克戎变异株后的临床特点,初步探讨新冠灭活疫苗在预防该毒株感染中的临床价值。方法回顾性分析2022年12月1日至2023年1月31日广西壮族自治区人民医院移植随访中心290例肾移植奥密克戎变异株感染者的临床资料。依据新冠灭活疫苗接种史分为疫苗组(86例)和非疫苗组(204例),以世界卫生组织(WHO)临床进展量表分值评估患者病情等级,比较两组患者11种常见临床症状发生率、肺炎发生率、病情等级以及重症率。结果两组患者感染奥密克戎变异株后无症状和临床症状发生率差异无统计学意义(P>0.05),最常见症状为发热、咳嗽和肌痛。疫苗组患者肺炎发生率、病情等级以及重症率显著低于非疫苗组(P<0.05)。结论新冠灭活疫苗接种超6个月后对肾移植受者免疫保护效果有限,但仍能降低肾移植受者感染奥密克戎变异株后病情进展恶化风险。

Objective To analyze the clinical characteristics of kidney transplant recipients after infection caused by Omicron variant,and to preliminarily explore the clinical value of inactivated coronavirus disease 2019(COVID-19)vaccine in preventing infection caused by Omicron variant.Methods The clinical data of 290 kidney transplant recipients who were infected with Omicron variant were collected from the Transplantation Follow-up Center of the People′s Hospital of Guangxi Zhuang Autonomous Region during December 1,2022 and January 31,2023,and were retrospectively analyzed.According to the vaccination history of inactivated COVID-19 vaccine,the patients were divided into vaccine group(86 cases)and non-vaccine group(204 cases).The patients′disease grades were evaluated by World Health Organization(WHO)Clinical Progress Scale scores.The incidence rates of 11 common clinical symptoms,the incidence of pneumonia,the grade of disease and the rate of severe disease were compared between the two groups.Results There were no significant differences in the incidence rates of no symptoms and clinical symptoms after infection with Omicron variant between the patients in two groups(P>0.05).The most common symptoms were fever,cough and myalgia.The incidence of pneumonia,the grade of disease and the incidence of severe disease in the vaccine group were significantly lower than those in the non-vaccine group(P<0.05).Conclusion The immune protection effect of inactivated COVID-19 vaccine on kidney transplant recipients is limited after vaccination of more than 6 months,but the inactivated COVID-19 vaccine can still reduce the risk of the disease progression and deterioration of the kidney transplant recipients infected with Omicron variant.