Alinia-2023-Safety, Txais, Thiab Hesitancy
Jun 05, 2023
TSAB NTAWV
Txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau kis tusid Ntau hom tshuaj tiv thaiv COVID-19 tau tsim thoob ntiaj teb rau cov neeg laus thiab cov menyuam yaus hnub nyoog qis dua 12 xyoos, thiab kev ua haujlwm ntawm cov tshuaj tiv thaiv hauv kev tiv thaiv cov tsos mob thiab kev mus pw hauv tsev kho mob tau kawm. Ib qho teeb meem loj rau kev txhaj tshuaj tiv thaiv COVID-19 uas tau tshwm sim nrog rau kev txhaj tshuaj tiv thaiv thoob ntiaj teb yog qhov tsis txaus siab lossis tsis pom zoo. Lub Koom Haum Saib Xyuas Kev Noj Qab Haus Huv Ntiaj Teb (WHO) tau tshaj tawm cov tshuaj tiv thaiv tsis txaus ntseeg yog ib qho ntawm 10 qhov kev hem thawj kev noj qab haus huv thoob ntiaj teb xyoo 2019. Qhov no kuj muaj feem cuam tshuam rau COVID-19.
Qhov kev tshuaj xyuas tam sim no tshawb txog cov pov thawj tam sim no ntawm COVID-19 cov tshuaj tiv thaiv kab mob thiab kev txhaj tshuaj tiv thaiv zoo, kev nyab xeeb, thiab cov kev cuam tshuam tsis zoo ntawm cov neeg muaj tswv yim, suav nrog cov neeg laus, cov neeg muaj kab mob ntev (mob ntshav qab zib, mob qog noj ntshav), cev xeeb tub thiab lactating poj niam, cov menyuam yaus, cov hluas, thiab kev txaus siab txhaj tshuaj tiv thaiv lossis tsis txaus siab ntawm cov pejxeem.
Muaj kev sib raug zoo ntawm ntshav qab zib thiab kev tiv thaiv kab mob. Cov neeg mob ntshav qab zib feem ntau muaj kev cuam tshuam lub cev tiv thaiv kab mob, ua rau lawv muaj kab mob thiab muaj teeb meem. Yog vim li cas yog tias ntshav qab zib siab tuaj yeem ua rau cov qe ntshav dawb hauv lub cev tiv thaiv kab mob uas muaj lub luag haujlwm tua cov kab mob thiab cov kab mob, ua rau lawv txoj haujlwm poob qis, yog li ua rau tus neeg mob tsis muaj zog tiv thaiv kab mob.
Tsis tas li ntawd, cov neeg mob ntshav qab zib feem ntau nrog cov teeb meem xws li rog rog, ntshav siab, thiab ntshav lipids. Cov teeb meem no tseem yuav cuam tshuam rau kev ua haujlwm ntawm lub cev tsis muaj zog thiab txo nws. Yog li ntawd, ua kom cov ntshav qab zib, ntshav siab, ntshav lipids, thiab lwm yam ntsuas nyob rau hauv ib txwm muaj, thiab tswj kev noj qab haus huv, xws li kev noj zaub mov kom zoo, qoj ib ce, thiab pw tsaug zog txaus, yuav pab txhim kho kev tiv thaiv ntawm cov neeg mob ntshav qab zib thiab txo qis. tshwm sim ntawm cov teeb meem. Txhawm rau kom tsis txhob muaj tej yam no tshwm sim, peb yuav tsum pib ua kom peb lub cev tiv thaiv kab mob. Cistanche muaj txiaj ntsig zoo rau kev txhim kho kev tiv thaiv. Cov polysaccharides hauv Cistanche tuaj yeem tswj hwm kev tiv thaiv kab mob ntawm tib neeg lub cev tiv thaiv kab mob thiab txhim kho kev ntxhov siab ntawm lub cev tiv thaiv kab mob, Txhim kho cov kab mob bactericidal ntawm lub cev tiv thaiv kab mob.
Nyem qhov txiaj ntsig kev noj qab haus huv ntawm cistanche
Taw qhia
Lub Ob Hlis 11, 2020, Lub Koom Haum Saib Xyuas Kev Noj Qab Haus Huv Ntiaj Teb (WHO) tau tshaj tawm lub xeev xwm txheej kub ntxhov ntawm tus kabmob tshiab, COVID-19. Tus kab mob no tau txheeb pom hauv Hubei Xeev, Wuhan City, Tuam Tshoj thaum lub Kaum Ob Hlis 2019 thiab kis mus rau 213 lub teb chaws thaum Lub Rau Hli 16, 2020, thiab tom qab ntawd thoob ntiaj teb [1, 2]. Thoob plaws ntiaj teb, txog rau thaum Lub Rau Hli 11, 2022, muaj 539,909,004 tus neeg mob uas tau lees paub los ntawm COVID-19, suav nrog 6,330,207 tus neeg tuag [3]. Vim muaj ntau yam zoo sib xws ntawm tus kab mob thiab tus kab mob hnyav ua pa nyuaj (SARS) tus kab mob, Lub Tuam Txhab International Committee on Taxonomy of Viruses (ICVT) hu nws SARS-CoV-2 [2, 4].
tswv yim
Peb tau tshawb nrhiav kev tshawb nrhiav ntawm pubmed, empas, web of science, thiab scopus los ntawm cov poj niam cev xeeb tub, cov poj niam cev xeeb tub, poj niam ua lactating, thiab cov neeg laus. Lub tswv yim tshawb fawb sib txuas cov ntsiab lus "( txhaj tshuaj tiv thaiv lossis tshuaj tiv thaiv) thiab (COVID-19 lossis COVID-19 kab mob lossis 2019-nCoV kab mob lossis kab mob coronavirus-19 lossis SARS coronavirus 2 kis los yog SARS-CoV-2 tus kab mob lossis COVID{10}} kis thoob qhov txhia chaw) thiab (me nyuam yaus lossis menyuam yaus lossis menyuam yaus lossis menyuam yaus lossis menyuam yaus hauv tsev kawm ntawv lossis menyuam yaus, menyuam kawm preschool lossis menyuam yaus preschool lossis menyuam mos lossis menyuam yaus lossis hluas lossis hluas lossis hluas lossis hluas lossis hluas lossis hluas los yog cov tub ntxhais hluas lossis cov poj niam cev xeeb tub lossis poj niam cev xeeb tub lossis poj niam cev xeeb tub lossis poj niam cev xeeb tub lossis cov neeg laus lossis cov neeg laus), "hauv lub npe thiab paub daws teeb meem, ua raws cov lus qhia tshawb fawb rau txhua qhov ntaub ntawv. Ob tus kws sau ntawv siv lub tswv yim tshawb nrhiav los txheeb xyuas cov kev tshawb fawb cuam tshuam thiab tshuaj xyuas tag nrho cov npe lossis cov ntsiab lus ntawm cov kev tshawb fawb pom. Cov ntawv sau tag nrho ntawm cov kev tshawb fawb cuam tshuam yuav raug tshuaj xyuas los ntawm ob tus neeg saib xyuas ywj pheej. Cov npe ntawm cov ntaub ntawv khaws cia tau tshawb nrhiav rau yav tom ntej.
Severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) virology
COVID-19 yog tus kab mob nyob rau hauv ib lub genome loj ntawm 26 thiab 32 kb. Nws yog ib qho ntawm cov kab mob loj tshaj plaws nrog ribonucleic acid (RNA) genome. Cov kab mob no zoo li lub kaus mom ntawm lub hnub, uas yog tus yam ntxwv ntawm tus mob coronaviruses [5]. Tus kab mob no muaj lub hnab ntawv nyuaj tshaj plaws thiab ruaj khov tshaj plaws hauv tsev neeg mob coronavirus thiab SARS-CoV-2 zoo li yuav tiv taus cov kua hauv lub cev thiab ib puag ncig ntau dua li SARS-CoV, thiab Middle East respiratory syndrome coronavirus (MERS-Cov) [ 6].
Lub genome ntawm tus kab mob no muaj plaub qhov qhib kev nyeem ntawv los encode cov kab mob proteins, suav nrog nucleocapsid proteins (NP), spike proteins (SP), hnab ntawv proteins (EP), nrog rau daim nyias nyias (MP) [7]. Nucleocapsid proteins (NP) (molecular hnyav 180 kDa) muaj ob lub npe thiab koom nrog cov kab mob rov ua dua. Cov protein no suav nrog ntau tus kab mob phosphoproteins tsim thaum kis kab mob thiab muab kev tiv thaiv kab mob siab. Kev kuaj ntshav thiab zis tuaj yeem kuaj pom thaum thawj ob lub lis piam ntawm tus kab mob uas ua rau kuaj pom tus kab mob [6]. Spike protein yog ib qho loj glycoprotein (molecular hnyav 180 kDa) uas muaj ob lub subunits hu ua S1 thiab S2. SP of SARS-CoV-2 penetrates the cells by the host cell surface angioten-sin-converting enzyme 2 (ACE2) receptor [8]. Spike antigen plays lub luag haujlwm tseem ceeb hauv kev tsim tshuaj tiv thaiv. Cov tshuaj tiv thaiv tiv thaiv no antigen, tshwj xeeb tshaj yog tus thib ob receptor, ua lub luag haujlwm tiv thaiv kab mob [5, 7]. Lub hnab ntawv protein (EP) yog lwm hom qauv protein uas muaj cov kab mob sib kis thiab tso tawm nrog rau cov kab mob kis kab mob [7]. Membrane proteins (MP) lossis anti-gene M muaj peb qhov chaw uas nyob nruab nrab ntawm daim nyias nyias thiab tsim cov kab mob thiab khi rau nucleocapsid [6].
COVID-19 platforms tshuaj tiv thaiv
Nws yog ib qho tseem ceeb kom nrhiav tau thiab txhaj tshuaj tiv thaiv zoo los tiv thaiv COVID-19 raws li kev kis tus kab mob sib kis tau yooj yim heev [1]. Txhawm rau tiv thaiv tus kabmob kis no, ntau dua 40 lub tebchaws tau sim tsim thiab tsim cov tshuaj tiv thaiv txij lub Kaum Ob Hlis 2020, thiab ntau dua 200 COVID-19 cov tshuaj tiv thaiv tau tsim [9- 11]. Raws li Lub Ib Hlis 5, 2022, 30 cov tshuaj tiv thaiv tau nyob rau theem 1 kev sim tshuaj (kom kuaj kev nyab xeeb thiab tshuaj lom) thiab 18 cov tshuaj tiv thaiv nyob rau theem 2 (kom sim nthuav dav kev sim kev nyab xeeb). 34 cov tshuaj tiv thaiv tau nyob rau theem 3 (los ntsuas kev ua tau zoo thiab kev ua tau zoo ntawm cov neeg coob), 19 cov tshuaj tiv thaiv tau pom zoo rau kev siv tsawg, 9 tshuaj tiv thaiv tau pom zoo los ntawm Food and Drug Administration (FDA) rau kev siv tag nrho, thiab 10 tshuaj tiv thaiv muaj ntau thiab tawm. kev tsim khoom thiab muab khoom (cov tshuaj tiv thaiv raug tso tseg tom qab sim) [12].
Cov tshuaj tiv thaiv yog nyob ntawm ntau lub platform, suav nrog cov kab mob nyob hauv, cov kab mob tsis muaj zog, cov kab mob zoo li cov kab mob (VLPs), protein subunits, DNA, RNA, thiab cov tshuaj tiv thaiv kab mob. Table 1 piav qhia qhov zoo thiab qhov tsis zoo ntawm txhua qhov tshuaj tiv thaiv kab mob [6-14]. Cov tshuaj tiv thaiv nyob rau ntawm cov koob tshuaj zoo sib xws tuaj yeem muab kev nyab xeeb thiab kev nyab xeeb mus ntev piv rau cov tshuaj tiv thaiv kab mob uas tsis muaj zog. Cov tshuaj tiv thaiv no txhawb nqa ob qho tib si humoral thiab cellular tiv thaiv kab mob [2, 6, 9-11]. Tam sim no, cov tshuaj tiv thaiv uas muaj protein ntau yog cov tshuaj tiv thaiv ntau tshaj plaws, suav txog 35 feem pua ntawm tag nrho cov tshuaj tiv thaiv SARS-CoV-2, tom qab los ntawm cov tshuaj tiv thaiv kab mob uas tsis yog rov ua dua (13.3 feem pua), tus xa xov ribonucleic acid (mRNA1) (12.1%), DNA (10.2%), replicating viral vector (9.8%), thiab inactivated vaccines (8.2%) [11]. Raws li kev txheeb xyuas meta, cov kev mob tshwm sim hauv zos thiab cov kab mob ntawm cov kab mob SARS-CoV-2 tshuaj tiv thaiv hauv cov tshuaj tiv thaiv protein subunit (33.0 feem pua vs 22.3 feem pua ), cov tshuaj tiv thaiv tsis muaj zog (23.7 feem pua Vs 21. 0 feem pua , thiab cov tshuaj tiv thaiv DNA (39.5 feem pua vs 29.3 feem pua ), yog qhov qis dua li cov tshuaj tiv thaiv kab mob uas tsis yog rov ua dua (55.9 feem pua vs 66.3 feem pua), tshuaj tiv thaiv RNA (89.4 feem pua vs 83.3 feem pua), thiab cov kab mob zoo li Cov tshuaj tiv thaiv kab mob (100.0 feem pua vs 78.9 feem pua) [14]. Table 2 nthuav qhia cov yam ntxwv ntawm cov tshuaj tiv thaiv tau pom zoo los ntawm FDA thiab kev tso cai siv thaum muaj xwm txheej ceev (EUA) [1, 9-11].
Kev txhaj tshuaj tiv thaiv ntawm cov sub-population
Vaccination is a step to end the epidemic and return to normal life. From the start of the pandemic to January 3, 2022, more than 9,195 billion doses have been administered worldwide. More than half of the world's population (about 60%) has been vaccinated with at least one dose of the COVID-19 vaccine, 51% have received two doses of the vaccine, and 6.8% have received an additional dose. The top 10 countries with the highest immunization rates are United Arab Emirates (>99 feem pua ), Brunei (93 feem pua), Teb chaws Cuba (92 feem pua), Chile (91 feem pua), Tuam Tshoj Mainland (90 feem pua), thiab Portugal (89 feem pua), Malta (88 feem pua), Cambodia (86 feem pua. ), Kaus Lim Qab Teb (86 feem pua), Argentina (85 feem pua).
Kev txhaj tshuaj tiv thaiv yog ib qho cuab yeej tseem ceeb rau txo kev mus pw hauv tsev kho mob thiab kev tuag [15]. Cov ntaub ntawv pov thawj qhia tias cov tshuaj tiv thaiv COVID-19 pom zoo muaj kev nyab xeeb thiab siv tau rau cov neeg laus [16-19]. Cov ntaub ntawv tsawg thiab tsis tshua muaj muaj nyob rau ntawm kev txhaj tshuaj tiv thaiv menyuam yaus, cev xeeb tub thiab lactating cov poj niam, cov neeg laus, thiab cov neeg uas muaj mob ua ntej thiab muaj mob [20]. Muaj kev txhawj xeeb txog kev ua tau zoo, kev nyab xeeb, thiab kev mob tshwm sim ntawm kev txhaj tshuaj tiv thaiv rau cov neeg muaj hnub nyoog qis dua 18 xyoo [21]. Cov kev tshawb fawb tseem niaj hnub soj ntsuam kev txhaj tshuaj tiv thaiv COVID-19 rau cov tib neeg hnub nyoog qis dua 18 xyoo, tab sis ob qho tib si FDA thiab EUA twb nrhiav kev pom zoo siv [20]. Vim tias cov poj niam cev xeeb tub thiab lactating poj niam tsis suav nrog hauv cov kev tshawb fawb tshuaj tiv thaiv thawj zaug, cov ntaub ntawv hais txog kev ua tau zoo thiab kev nyab xeeb ntawm cov tshuaj tiv thaiv ntawm pab pawg no raug txwv [22]. Immune senescence txo cov lus teb rau cov tshuaj tiv thaiv hauv cov neeg laus [15]
Cov tshuaj tiv thaiv COVID-19 hauv cov menyuam yaus thiab cov hluas
Lub Chaw Tiv Thaiv Kab Mob (CDC) thiab FDA-tso cai Pfizer-BioNTech hauv cov menyuam yaus hnub nyoog 5 xyoos thiab laus dua. Kev txhaj tshuaj loj rau pawg hnub nyoog no tau pib hauv ntau lub tebchaws [23]. Raws li WHO lub tswv yim tawm tswv yim pab pawg kws tshaj lij (SAGE), cov tshuaj tiv thaiv Pfizer / BioNTech yog qhov tsim nyog siv rau cov menyuam yaus hnub nyoog qis dua 12 xyoos. Raws li WHO, yuav tsum muaj pov thawj ntxiv ntawm kev siv lwm yam tshuaj tiv thaiv COVID-19 hauv cov menyuam yaus los ua cov lus pom zoo thoob ntiaj teb rau kev txhaj tshuaj tiv thaiv menyuam yaus [3].
Randomized theem 2-3 kev sim yog ua los ntsuas kev nyab xeeb thiab kev ua tau zoo ntawm ob koob tshuaj 10 mcg ntawm Pfizer's BioNTech cov tshuaj tiv thaiv rau cov menyuam yaus hnub nyoog 6 hli txog 11 xyoo uas tau muab rau ntawm 21-ib hnub. Cov ntawv soj ntsuam rau cov menyuam hnub nyoog 5 txog 11 xyoos tau raug tso tawm, tab sis cov txiaj ntsig rau cov menyuam yaus hnub nyoog qis dua 5 xyoos tseem tsis tau tso tawm. Txoj kev tshawb no tau pom tias Pfizer-BioNTech txhaj tshuaj tiv thaiv kab mob muaj kev nyab xeeb, tiv thaiv kab mob, thiab siv tau rau cov menyuam yaus hnub nyoog 5 txog 11 xyoo, thiab tsis muaj qhov tshwm sim tsis zoo [24].
Hauv kev sim tshuaj ntsuam xyuas randomized (RCT) ntawm Pfizer-BioNTech tshuaj tiv thaiv, qhov mob ntawm qhov chaw txhaj tshuaj yog qhov tshwm sim feem ntau thiab tsis muaj kev tuag. Lwm cov xwm txheej tshwm sim feem ntau yog kub taub hau, mob taub hau, thiab qaug zog [25, 27]. Hauv kev txhaj tshuaj Pfizer-BioNTech loj ntawm cov menyuam yaus hnub nyoog 12 txog 15 xyoo hauv Ixayees, tsis muaj qhov tshwm sim tsis zoo tshwm sim [27]. Cov tshuaj tiv thaiv tsis zoo cuam tshuam nrog mRNA-based COVID-19 cov tshuaj tiv thaiv xws li Pfizer-BioNTech tau tshaj tawm hauv Tebchaws Meskas. Kev soj ntsuam ntawm cov xwm txheej ntawm myocardial o yog tab tom ua [28]. Pfizer-BioNTech RCTs qhia tias kev siv tshuaj tiv thaiv tiv thaiv COVID-19 hauv cov menyuam yaus thiab cov tub ntxhais hluas yog 100 feem pua (95 feem pua CI: 75.{17}}). Qhov txiaj ntsig no txhawb kev siv koob tshuaj 3.0 µg hauv ob lub sijhawm txhaj tshuaj rau cov menyuam yaus thiab cov tub ntxhais hluas [25].
Ib theem 2 kev sim tshuaj ntsuam xyuas ntawm coronaVac muaj kev nyab xeeb thiab tau txais cov lus teb rau cov menyuam yaus thiab cov tub ntxhais hluas hnub nyoog 3 txog 17 xyoo. Cov txiaj ntsig ntawm txoj kev tshawb fawb no txhawb kev siv koob tshuaj 3.0 ug hauv ob txoj kev txhaj tshuaj [29]. Qhov kev sim tshuaj thib 3 ntawm CoronaVac tau ua rau cov neeg laus nkaus xwb thiab tsis muaj ntaub ntawv pom nyob rau theem kev sim tshuaj 3 CoronaVac hauv cov menyuam yaus thiab cov tub ntxhais hluas. Lwm yam CoronaVac RCTs tsis tau ntsuas qhov ua tau zoo ntawm cov tshuaj tiv thaiv. Tuam Tshoj tab tom npaj muab tshuaj tiv thaiv loj rau cov menyuam yaus hnub nyoog qis dua 12 xyoos [30].
ZyCoV-D yog lwm cov tshuaj tiv thaiv uas tau pom zoo los ntawm Indian Pharmaceutical Regulatory Authority rau kev siv xwm txheej ceev rau cov neeg laus dua 12 xyoos. Cov menyuam yaus hnub nyoog 2 txog 6 xyoo tau koom nrog kev sim tshuaj ntawm covaxin [31]. Ntxiv rau ZyCoV-D, lwm cov tshuaj tiv thaiv yog nyob rau hauv kev sim tshuaj, tab sis cov txiaj ntsig ntawm RCTs no tsis tau luam tawm.
AstraZeneca yog lwm yam tshuaj tiv thaiv COVID-19, thiab kev sim tshuaj tiv thaiv ntawm cov tshuaj tiv thaiv no thaum hluas tau raug txiav tawm vim qhov tsis tshua muaj tab sis muaj cov tshuaj tiv thaiv mob hnyav thiab thrombocytopenia syndrome hauv cov tub ntxhais hluas tom qab thawj koob tshuaj [32].
Cov tshuaj tiv thaiv COVID-19 thaum cev xeeb tub thiab pub niam mis
Cov pov thawj ntawm kev nyab xeeb thiab kev ua tau zoo ntawm kev txhaj tshuaj tiv thaiv COVID-19 thaum cev xeeb tub thiab lactation yog txwv, tab sis nce ntxiv. Tsis muaj pov thawj qhia tias qhov tshuaj tiv thaiv COVID-19 ua rau muaj teeb meem tsis muaj menyuam [33]. Txhawm rau ntsuas kev nyab xeeb ntawm cov tshuaj tiv thaiv Pfizer-BioNTech, Moderna, Jonssen & Jonssen hauv cov tsiaj, kev tshawb fawb tau ua los ntawm FDA uas tsis pom muaj kev phiv [22]. Hauv kev tshawb fawb hauv pawg, cov poj niam cev xeeb tub txhaj tshuaj tiv thaiv tau pom tias muaj cov tshuaj tiv thaiv kab mob muaj zog, tab sis cov poj niam cev xeeb tub uas tsis tau txhaj tshuaj tiv thaiv tsis zoo [34]. Lwm txoj kev tshawb fawb tau ua tiav ntawm 30 cev xeeb tub, 16 lactating, thiab 57 tsis cev xeeb tub lossis lactating cov poj niam uas tau txais mRNA-1273 (Moderna) lossis BioNTech (BNT)162b2 (Pfizer-BioNTech) COVID-19 tshuaj tiv thaiv. Nees nkaum ob tus poj niam cev xeeb tub nrog SARSCoV-2 tus kab mob thiab rau rau tus poj niam cev xeeb tub uas tsis tau txhaj tshuaj tiv thaiv tau pom tias cov tshuaj tiv thaiv COVID-19 mRNA yog cov tshuaj tiv thaiv kab mob hauv cov poj niam cev xeeb tub. Cov tshuaj txhaj tiv thaiv kab mob raug thauj mus rau hauv cov menyuam mos hauv plab qaum cov ntshav thiab cov kua mis. Cov poj niam cev xeeb tub thiab lactating kuj muaj kev nyab xeeb nrog rau COVID{19}} tshuaj tiv thaiv mRNA tiv thaiv SARSCoV-2 variants [35].
Ib qho kev tshawb fawb hla ntu ntawm cov neeg ua haujlwm kho mob tau soj ntsuam cov kev mob tshwm sim ntawm 38 tus poj niam cev xeeb tub (20 tus ntawm lawv tau txhaj tshuaj tiv thaiv PfizerBioNTech thiab 18 tus neeg ntxiv tau txhaj tshuaj tiv thaiv Moderna, ntawm 81.58 feem pua tau txais ob koob tshuaj tiv thaiv mRNA). Cov kev mob tshwm sim ntawm cov poj niam cev xeeb tub zoo ib yam li cov poj niam cev xeeb tub uas tsis yog cev xeeb tub tau txhaj tshuaj tiv thaiv mRNA tam sim lossis ntxov tom qab txhaj tshuaj tiv thaiv, thiab txhua tus muaj kev phom sij rau lub neej [36]. Lwm cov tshuaj tiv thaiv, xws li cov tshuaj tiv thaiv recombinant (Novavax), raug suav hais tias muaj kev nyab xeeb thaum cev xeeb tub vim lawv qhov tsis zoo. Txawm li cas los xij, tshwj xeeb saponin-based adjuvants siv hauv cov tshuaj tiv thaiv no yuav muaj teeb meem kev nyab xeeb thiab, tam sim no, tsis muaj ntaub ntawv muaj nyob rau cov poj niam cev xeeb tub [37]. Txoj kev tshawb nrhiav yav tom ntej tau tshawb xyuas qhov teeb meem ntawm cev xeeb tub ntawm PfizerBioNTech tshuaj tiv thaiv BNT162b2 thiab pom muaj qhov sib xws ntawm cov teeb meem ntawm cov poj niam cev xeeb tub thiab tsis tau txhaj tshuaj tiv thaiv. Nws kuj tseem siv tau los tiv thaiv tus kab mob COVID{14}} thiab tsis muaj qhov tshwm sim tsis zoo [38].
Lwm txoj kev tshawb fawb tau pom tias cov lus teb ntawm niam txiv muaj zog tau kis mus rau fetus [39]. Ib txoj kev tshawb fawb tau tshaj tawm tias cov poj niam cev xeeb tub tau txhaj tshuaj tiv thaiv BNT162b2 tsis muaj kev txhawj xeeb txog kev nyab xeeb thiab tsis muaj kev cuam tshuam rau cov poj niam cev xeeb tub thiab cov menyuam yaus hnub nyoog qis dua [40]. Txoj kev tshawb fawb yav tom ntej tau ua tiav ntawm 14 lactating thiab 10 tus poj niam uas tsis yog lactating txhaj tshuaj tiv thaiv BNT162b2 Pfizer-BioNTech. Tsis muaj qhov sib txawv ntawm qhov tshwm sim tom qab txhaj tshuaj tiv thaiv ntawm cov poj niam no. Qhov tshwm sim feem ntau yog myalgia. Ntxiv mus, txoj kev tshawb no tau tshaj tawm qhov zoo IgM, IgA, thiab IgG cov tshuaj tiv thaiv ntawm cov poj niam txhaj tshuaj. Cov tshuaj tiv thaiv qis, tshwj xeeb tshaj yog 42.9 feem pua IgG, tau pom nyob rau hauv cov kua mis ntawm cov poj niam lactating [41].
Hais txog qhov cuam tshuam ntawm kev txhaj tshuaj tiv thaiv kev pub niam mis, kev tshawb fawb hauv 4,445 leej niam pub niam mis nrog COVID-19 txhaj tshuaj tiv thaiv (BNT162b2 [Pfizer-BioNTech] thiab Moderna tshuaj tiv thaiv) tau tshaj tawm kev pub niam mis tsis tu ncua. Cov kev mob tshwm sim feem ntau ntawm leej niam yog mob ntawm qhov chaw txhaj tshuaj, malaise, thiab mob taub hau [42].
CDC tau tsim v-kev nyab xeeb COVID-19 cov npe tshuaj tiv thaiv cev xeeb tub los sau tag nrho cov xwm txheej tsis zoo ntawm cov tshuaj tiv thaiv lub sijhawm no [33]. Kev tshawb fawb ntawm BNT162b2 (Pfizer-BioNTech) thiab mRNA-1273 (Moderna) tshuaj tiv thaiv reactogenicity nyob rau hnub tom qab txhaj tshuaj tiv thaiv ntawm cov poj niam cev xeeb tub qhia tias 70 feem pua ntawm cov xwm txheej tsis zoo yog cev xeeb tub thiab 29.9 feem pua yog cuam tshuam nrog cev xeeb tub lossis cov menyuam yug tshiab [43 ].
Cov tshuaj tiv thaiv hauv cov neeg laus
Hauv ntau lub xeev cov tshuaj tiv thaiv tag nrho thiab ib nrab hauv Asmeskas cov tsev kho mob ntawm cov neeg laus dua 65 xyoo, PfizerBioNTech thiab Moderna cov tshuaj tiv thaiv tau zoo tiv thaiv COVID-19 pw hauv tsev kho mob hauv 94 feem pua (95 feem pua kev ntseeg siab [CI]=49 feem pua – 99 feem pua ) thiab 64 feem pua (95 feem pua ntawm kev ntseeg siab [CI]=28 feem pua – 82 feem pua , feem [44]. Ib txoj kev tshawb fawb sib txuas tau txuas rau cov npe kev noj qab haus huv hluav taws xob ntawm 1,409,831 Portuguese hnub nyoog 65-79 thiab 470,520 hnub nyoog 80 thiab tshaj saud los tshuaj xyuas qhov ua tau zoo ntawm cov tshuaj tiv thaiv mRNA tiv thaiv kev mus pw hauv tsev kho mob thiab tuag vim yog COVID{19}}. Cov tshuaj tiv thaiv zoo rau kev pw hauv tsev kho mob rau cov hnub nyoog 65-79 xyoo thiab laus dua 80 xyoo yog 94 feem pua thiab 82 feem pua , thiab kev tuag ntawm ob pawg hnub nyoog no yog 96 feem pua thiab 81 feem pua [45]. Qhov ua tau zoo ntawm cov tshuaj tiv thaiv mRNA rau kev pw hauv tsev kho mob cuam tshuam nrog COVID-19 hauv cov neeg laus tiv thaiv kab mob hnub nyoog 65 xyoo thiab laus dua uas tau txais ob koob tshuaj tau tshaj tawm tias yog 87 feem pua [46]. Tag nrho ntawm 7280 qhov chaw kuaj pom tus mob COVID-19 tau raug tshuaj xyuas hauv Tebchaws Meskas uas tau txhaj tshuaj tiv thaiv Pfizer BioNTech thiab Moderna thiab Janssen hnub nyoog 65-74 xyoo. Qhov ua tau zoo tiv thaiv COVID-19- ntsig txog kev mus pw hauv tsev kho mob yog 96 feem pua rau Pfizer BioNTech, 96 feem pua rau Moderna, thiab 84 feem pua rau cov khoom siv tshuaj tiv thaiv Janssen. Qhov tshwj xeeb hauv cov neeg laus hnub nyoog 75 xyoo yog 91 feem pua rau Pfizer-BioNTech, 96 feem pua rau Moderna, thiab 85 feem pua rau cov khoom siv tshuaj tiv thaiv Janssen [47].
Hauv randomized theem 2/3 kev sim tshuaj nyob rau hauv cov neeg laus hnub nyoog 55-69 thiab 70 xyoo thiab laus dua uas tau txais ib los yog ob koob tshuaj ChAdOx1 nCoV-19 tshuaj tiv thaiv (AstraZeneca), tag nrho cov kev mob tshwm sim me me thiab nruab nrab thiab tsis muaj kev phiv loj tshwm sim. Mob thiab rhiab ntawm qhov chaw txhaj tshuaj yog cov kev mob tshwm sim hauv zos feem ntau, thiab qaug zog, mob taub hau, ua npaws, thiab myalgia yog cov kev mob tshwm sim feem ntau. Tag nrho cov kev mob tshwm sim yog mob me rau cov neeg mob uas tau txais koob thib ob. Txoj kev tshawb no tau pom tias cov tshuaj tiv thaiv AstraZeneca muaj kev nyab xeeb thiab zam tau zoo, thiab cov neeg laus muaj qhov ntsuas qis dua li cov neeg hluas. Cov tshuaj tiv thaiv koob tshuaj tsawg tsawg yog tsawg reactogenic dua li cov tshuaj tiv thaiv kab mob hauv txhua tus neeg koom [48].
Ntau qhov kev tshawb fawb tau pom tias muaj kev cuam tshuam cov tshuaj tiv thaiv kab mob hauv cov neeg laus uas siv lwm cov tshuaj tiv thaiv kab mob, suav nrog ob hom tshuaj tiv thaiv mRNA (Moderna thiab PfizerBioNTech, USA), hom adenovirus -5 cov tshuaj tiv thaiv vectored (CanSino Biological/Beijing Institute of Biotechnology, Tuam Tshoj), thiab chimpanzee adenovirus-vectored vaccine (AstraZeneca, UK) [15]. Raws li kev tshawb fawb ntawm 45,965 tus neeg laus uas tsis tau kis tus kab mob yav dhau los nrog COVID-19 uas tau txais SARS-CoV-2 tshuaj tiv thaiv ChAdOx1 (AstraZeneca) lossis BNT162b2 (Pfizer-BioNTech), serum conversion rate thiab quantitative antibody. qib tom qab ib koob tshuaj ib zaug tau qis rau cov neeg laus, tshwj xeeb tshaj yog cov neeg laus dua 60 xyoo. Cov tshuaj tiv thaiv kab mob tau nce sai dua thiab mus txog qib siab dua nrog ib koob tshuaj PfizerBioNTech piv rau ib koob tshuaj AstraZeneca, tab sis txo qis tom qab ib koob tshuaj Pfizer- BioNTech hauv cov neeg laus. Tom qab ob koob tshuaj tiv thaiv, cov lus teb tau siab hauv txhua pawg hnub nyoog [49].
Raws li kev soj ntsuam kev tshawb fawb hauv Chile, kev kho cov txiaj ntsig ntawm CoronaVac hauv cov neeg muaj hnub nyoog 60 xyoo tsawg kawg yog 14 hnub tom qab koob thib ob yog 66.6 feem pua [50]. Cov txiaj ntsig ntawm kev sim tshuaj ntsuam xyuas tsis zoo ntawm cov tshuaj tiv thaiv CoronaVac hauv cov neeg laus dua 60 xyoo pom tias CoronaVac muaj kev nyab xeeb thiab zam tau zoo rau cov neeg laus. Cov koob tshuaj zoo tshaj plaws yog 3 ug [15]. Ib txoj kev tshawb fawb tswj tau ntsuas qhov ua tau zoo ntawm cov tshuaj tiv thaiv CoronaVac rau cov neeg laus hnub nyoog 70 xyoo thiab laus dua, nrog rau kev ua tau zoo ntawm 46.8 feem pua rau cov tsos mob COVID-19 tsawg kawg 14 hnub tom qab koob thib ob, thiab 55.5 feem pua rau kev tiv thaiv kev mus pw hauv tsev kho mob, thiab 61.2 feem pua rau cov neeg tuag [51].
Kev sim tshuaj ntsuam xyuas theem 3 randomized soj ntsuam kev nyab xeeb thiab kev ua tau zoo ntawm ob koob tshuaj NVX-CoV2373 (Novavax) rau cov neeg laus hnub nyoog 18-64 xyoo thiab 65 xyoo thiab laus dua. Cov txiaj ntsig ntawm txoj kev tshawb fawb no tau pom tias 5 ug koob tshuaj Novavax tau txais txiaj ntsig 89.7 feem pua. Cov kev mob tshwm sim hauv zos feem ntau yog rhiab lossis mob ntawm qhov chaw txhaj tshuaj, thiab cov kev mob tshwm sim feem ntau yog mob taub hau, mob leeg, thiab qaug zog tom qab noj thawj zaug thiab thib ob. Cov xwm txheej tsis zoo hauv cheeb tsam thiab hauv lub cev tau tshaj tawm ntau zaus hauv cov neeg hluas (18-64 xyoo) dua li cov neeg laus (65 xyoo thiab laus dua). Qhov tshwm sim ntawm cov xwm txheej tsis zoo yog tsawg, zoo ib yam li cov tshuaj tiv thaiv thiab cov placebo pawg [52].
Kev txhaj tshuaj tiv thaiv ntawm cov neeg uas muaj mob hauv qab
CDC thiab American Diabetes Association (ADA) txhawb nqa qhov tseem ceeb ntawm kev txhaj tshuaj tiv thaiv kab mob ntshav qab zib kom txo qis kev pheej hmoo kis mob rau cov neeg no [53].
Cov kev tshawb fawb tau pom tias ntshav qab zib yog ib yam kab mob ntev uas ua rau lub cev tsis muaj zog, tshwj xeeb tshaj yog nyob rau hauv cov neeg mob ntshav qab zib uas tsis muaj kev tswj hwm nrog HgbA (A1c) qis thiab lossis cov ntshav qabzib tsis tu ncua [54]. Hauv qhov sib piv, lwm txoj kev tshawb fawb pom tau tias ntshav qab zib thiab hyperglycemia tsis cuam tshuam rau kev noj qab haus huv thiab kev pheej hmoo ntawm cov tshuaj tiv thaiv tsis zoo rau cov tshuaj tiv thaiv COVID-19. Qhov txiaj ntsig no qhia tau tias kev txhaj tshuaj tiv thaiv yuav tsum tau ua ntej rau cov neeg mob ntshav qab zib [55].
Hauv cov neeg mob ntshav qab zib piv rau cov neeg mob uas tsis muaj ntshav qab zib, lub sijhawm tshuaj tiv thaiv kab mob thiab cov titers sib txawv me ntsis, yoog raws, thiab tsis cuam tshuam los ntawm cov piam thaj. Kev mob hnyav thiab kev tuag ntau ntxiv ntawm COVID-19 kab mob ua pa tshwm sim hauv cov neeg mob hyperglycemia tsis yog qhov tshwm sim ntawm kev tsis txaus ntseeg ntawm lub cev tiv thaiv kab mob rau COVID-19. Receptor-binding domain (RBD) immunoglobulin positivity yog txuam nrog kev tiv thaiv tseem ceeb, ua rau muaj kev ceev faj txog kev ua tau zoo ntawm cov tshuaj tiv thaiv yav tom ntej tiv thaiv COVID-19 hauv cov neeg mob ntshav qab zib [56].
Nws tseem tsis tau paub meej tias ntshav qab zib hloov pauv kev tiv thaiv kab mob rau cov tshuaj tiv thaiv. Ib txoj kev tshawb fawb Italian ntawm 150 cov neeg tuaj koom tau tshaj tawm tias qhov muaj ntshav qab zib thiab hyperglycemia tsis cuam tshuam rau kinetics, persistence, lossis tsim cov tshuaj tiv thaiv tsis zoo [55]. Kev tiv thaiv kev tiv thaiv tau kav ntev li ntawm 6 lub hlis thoob plaws hauv txoj kev tshawb no, ntawm tus nqi tib yam li cov neeg mob uas tsis muaj ntshav qab zib [56]. Txawm li cas los xij, lwm cov kev tshawb fawb ntawm BNT162b2 (Pfizer-BioNTech) tau qhia tias hom 2 mob ntshav qab zib mellitus txo qhov kev ua tau zoo ntawm cov tshuaj tiv thaiv los ntawm 0.73 piv rau cov neeg mob uas tsis yog ntshav qab zib [57]. Yog li ntawd, peb yuav tsum ua raws li cov qauv kev ceev faj uas tau pom zoo los ntawm WHO. Kev tswj hwm glycemic kom raug rau cov neeg mob ntshav qab zib thiab ua ntej txhaj tshuaj tiv thaiv kab mob ntshav qab zib yog ib qho ntawm cov lus pom zoo [58].
Cov neeg mob uas mob qog noj ntshav yog qhov muaj feem pheej hmoo ntawm tus mob coronavirus thiab muaj feem cuam tshuam loj, tshwj xeeb tshaj yog cov uas tau txais kev kho mob, cov neeg mob uas muaj ntau yam mob, thiab cov neeg laus [59]. Txawm hais tias cov ntaub ntawv tam sim no ntawm kev tiv thaiv thiab kev ua tau zoo ntawm cov tshuaj tiv thaiv tus mob coronavirus tau pom zoo hauv cov neeg mob qog noj ntshav, tshwj xeeb tshaj yog cov uas tau txais kev kho mob, muaj kev txwv, vim tias muaj kev pheej hmoo siab ntawm cov teeb meem thiab kev tuag, cov txiaj ntsig yuav ntau dua cov teeb meem thiab cov kev mob tshwm sim cuam tshuam nrog cov tshuaj tiv thaiv tus mob coronavirus [60] .
Cov neeg mob qog noj ntshav tuaj yeem txhaj tshuaj tiv thaiv, tab sis qee qhov kev tshawb fawb tau pom muaj kev zam. Cov neeg mob qog noj ntshav tau txais lossis tsis ntev los no tau txais kev kho hluav taws xob, tshuaj khomob, kev kho mob, kev hloov pauv ntawm cov qia, lossis kev siv tshuaj tiv thaiv kab mob yuav tsum tsis txhob txhaj tshuaj tiv thaiv COVID-19. Txawm li cas los xij, cov neeg mob uas rov zoo, tsis xav tau kev kho mob hauv lub sijhawm luv luv thiab tsis muaj mob qog noj ntshav yuav tsum tau txiav txim siab rau kev txhaj tshuaj nrog cov tshuaj tiv thaiv pom zoo [61].
Hauv kev tshawb fawb meta-analysis ntawm 281 cov neeg mob qog noj ntshav nrog cov qog nqaij hlav, tus nqi ntawm cov tshuaj tiv thaiv S antibody tom qab teem sijhawm ua tiav cov tshuaj tiv thaiv nrog cov tshuaj tiv thaiv tus kabmob coronavirus tau cog lus (Ntau dua lossis sib npaug li 90 feem pua). Cov tshuaj tiv thaiv kab mob rau cov tshuaj tiv thaiv tus kabmob coronavirus yog tsawg hauv 340 tus neeg mob uas muaj hematological malignancies. Txawm li cas los xij, qhov kev tshuaj ntsuam xyuas meta no tau pom tias cov tshuaj tiv thaiv tus kabmob coronavirus muaj txiaj ntsig zoo, nyab xeeb, thiab yuav tsum yog qhov tseem ceeb rau cov neeg mob qog noj ntshav. Txawm li cas los xij, cov neeg mob qog noj ntshav uas twb tau txhaj tshuaj tiv thaiv yuav tsum tau hnav lub ntsej muag txuas ntxiv kom nyob deb thiab huv ntawm tes [62].
Cov kev tshawb fawb tau pom tias cov tshuaj tiv thaiv kab mob coronavirus ua rau muaj kev nyab xeeb thiab tsawg kawg ua haujlwm tau zoo rau cov neeg mob qog noj ntshav. Qhov no yog ua raws li CDC cov lus pom zoo rau cov neeg tiv thaiv kab mob, thiab cov lus qhia tsis ntev los no thiab cov lus pom zoo los ntawm Cancer Immunotherapy Association, European kho mob oncology koom haum, American Association for Cancer Research (AACR) COVID-19, thiab pab pawg neeg ua haujlwm mob qog noj ntshav. Tsis ntev los no, pawg neeg pab tswv yim txog kev txhaj tshuaj tiv thaiv COVID-19 ntawm lub teb chaws thoob ntiaj teb kev mob qog noj ntshav. (NCCN) tau tshaj tawm cov lus pom zoo tshuaj tiv thaiv kab mob coronavirus [63].
Ob peb txoj kev tshawb fawb tau qhia cov kws kho mob kom txhaj tshuaj tiv thaiv cov neeg mob qog noj ntshav, txawm tias cov neeg muaj kab mob los yog tau txais kev kho mob los tiv thaiv mob qog noj ntshav [64]. Cov txiaj ntsig ntawm qee qhov kev tshawb fawb tau pom tias cov tshuaj tiv thaiv nano-based tuaj yeem txo cov tshuaj tiv thaiv kev mob tshwm sim thiab txhim kho kev ua tau zoo, nyob ntawm qhov muaj peev xwm ntawm nanomaterials los tsim cov haujlwm tseem ceeb ntawm cov tshuaj tiv thaiv kab mob. Qhov no yog qhov tseeb tshwj xeeb tshaj yog rau cov neeg uas hloov lub cev tiv thaiv kab mob, xws li cov neeg mob qog noj ntshav thiab lwm cov neeg mob immunocompromised [65].
Kev lees txais cov tshuaj tiv thaiv COVID-19
Kev tsis lees paub tshuaj tiv thaiv lossis tsis lees paub yog ib qho teeb meem nyuaj tshaj plaws ntsig txog COVID-19 txhaj tshuaj tiv thaiv uas tau hloov zuj zus nrog rau txoj haujlwm txhaj tshuaj tiv thaiv thoob ntiaj teb. Qhov no txhais tau tias "kev lees txais ncua lossis tsis kam txhaj tshuaj tiv thaiv txawm tias muaj cov kev pabcuam txhaj tshuaj" [66].
Tus nqi tau raug ntsuas hauv ntau qhov kev tshawb fawb los ntawm ntau lub teb chaws. Raws li cov txiaj ntsig ntawm kev txheeb xyuas qhov ntsuas, qhov tsis kam txhaj tshuaj tiv thaiv hauv ntau lub tebchaws yog 10 feem pua - 57 feem pua [67]. Lwm qhov kev tshuaj xyuas thiab ntsuas ntsuas ntsuas tau tshaj tawm 66 feem pua ntawm kev lees txais tshuaj tiv thaiv thoob ntiaj teb [68].
Cov kev txiav txim ntawm kev txais txhaj tshuaj tiv thaiv lossis ncua sij hawm kuj tau raug soj ntsuam hauv ntau qhov kev tshawb fawb. Yog li ntawd, nws yog cov yam ntxwv ntawm ntau yam uas suav nrog cov yam ntxwv ntawm cov tshuaj tiv thaiv (kev ua tau zoo thiab cov kev mob tshwm sim), cov ntaub ntawv xov xwm, kev noj qab haus huv thiab kev tsis sib xws, kev lag luam hauv zej zog, thiab kev ntseeg kev ntseeg. Cov txiaj ntsig tsis zoo sib xws hauv ntau lub tebchaws lossis haiv neeg. Feem ntau cov kev tshawb fawb tau pom tias qhov kev lees txais tshuaj tiv thaiv yog siab dua rau cov neeg muaj kev kawm siab dua, thaum nyob hauv Nyij Pooj, nws siab dua rau cov neeg tsis muaj kev kawm. Ib qho kev txiav txim siab tseem ceeb ntawm kev tsis txaus siab hauv kev txhaj tshuaj tiv thaiv COVID-19 yog lub sijhawm thiab sijhawm ntawm qhov kev pab cuam txhaj tshuaj. Cov kev tshawb fawb tau pom tias tus nqi siab nyob rau thawj ob peb lub hlis ntawm kev txhaj tshuaj tiv thaiv thiab txo qis raws sijhawm raws li txoj haujlwm txuas ntxiv mus. Kev loj hlob sai ntawm cov tshuaj tiv thaiv COVID-19 ntseeg tau tias yog vim li cas tseem ceeb ntawm kev tsis txaus siab hauv kev txhaj tshuaj [67, 69-71].
Tus nqi nkag saum toj no yog rau cov pej xeem. Tus nqi thiab nws cov kev txiav txim siab tsis zoo ib yam ntawm cov tib neeg hauv cov hnub nyoog sib txawv thiab cov kev noj qab haus huv sib txawv. Qee cov neeg muaj kev pheej hmoo siab, xws li menyuam yaus thiab cov tub ntxhais hluas, cov neeg laus, cov poj niam cev xeeb tub thiab lactating, thiab cov neeg mob qog noj ntshav thiab lwm yam hauv qab.
Kev lees txais txhaj tshuaj tiv thaiv tau raug tshaj tawm tias muaj ntau dua hauv cov neeg laus dua li cov neeg laus. Cov neeg laus zoo li muaj kev txhawj xeeb ntau dua thiab pom tias muaj kev hem thawj dua cov neeg hluas [72, 73].
Hauv cov tib neeg uas muaj kab mob hauv qab, cov txiaj ntsig tau tshaj tawm tsis zoo ib yam. Hauv qee cov neeg, qhov kev lees txais ntawm cov neeg mob hauv pawg pab pawg no tsawg [74]. Hauv qee qhov, xws li cov neeg mob Nyij Pooj, tus nqi siab [75]. Kev lees txais qis rau cov neeg mob rog rog nrog lub cev qhov ntsuas qhov ntsuas (BMI) tau tshaj tawm ntau dua 40 [74].
Ntau tshaj 50 feem pua ntawm cov neeg mob qog noj ntshav ntseeg tias kev txhaj tshuaj tiv thaiv tuaj yeem tiv thaiv tus kab mob COVID-19, tab sis kuj tseem txhawj xeeb txog cov kev mob tshwm sim ntawm kev txhaj tshuaj [76]. Raws li cov ntaub ntawv muaj, cov kws kho mob cov lus pom zoo yuav txhawb nqa lawv txoj kev paub txog kev npaj tshuaj tiv thaiv [77]. Kev tshawb fawb txog cov neeg mob qog noj ntshav hauv South Kauslim pom qhov feem pua ntawm 66 feem pua [77]. Kev tsis txaus siab rau cov mob qog noj ntshav, kab mob ntsws ntev, thiab kab mob autoimmune tau tshaj tawm tias yog 13.4 feem pua, 17.8 feem pua, thiab 19.4 feem pua, raws li [78].
Ib qho kev txiav txim siab tseem ceeb ntawm kev lees txais kev txhaj tshuaj rau cov neeg mob uas muaj kab mob hauv qab yog kev txhaj tshuaj tiv thaiv kab mob khaub thuas tsis tu ncua. Nws ua lub luag haujlwm zoo thiab kev kwv yees hauv kev lees txais COVID-19 txhaj tshuaj [78].
Hauv cov menyuam yaus thiab cov tub ntxhais hluas, qhov kev txiav txim siab tseem ceeb tshaj plaws uas tuaj yeem cuam tshuam txog kev txais txhaj tshuaj tiv thaiv yog niam txiv kev txhawb siab rau kev txhaj tshuaj [79, 80]. Cov niam txiv yuav tsis kam txhaj tshuaj tiv thaiv lawv cov menyuam, feem ntau yog vim muaj kev phiv mus ntev thiab kev txhawj xeeb txog kev nyab xeeb ntawm cov tshuaj tiv thaiv. Cov niam txiv tsis kam txhaj tshuaj tiv thaiv menyuam yaus dua li cov tub ntxhais hluas, thiab cov niam txiv tsis kam txhaj tshuaj tiv thaiv lawv cov menyuam dua li txiv [80, 81].
Qhov kev lees txais ntawm 30 feem pua (Romania thiab Qaib Cov Txwv)–89 feem pua (Tuam Tshoj) tau tshaj tawm nyob rau hauv ntau lub teb chaws Tus nqi kuj tseem siab rau cov menyuam yaus thiab cov tub ntxhais hluas los ntawm Latin America thiab Caribbean (92.2 feem pua) [82]. Cov txiaj ntsig ntawm kev tshuaj xyuas kev tshawb fawb tau qhia txog qhov kev lees paub ntawm 57 feem pua rau cov menyuam yaus [83].
Qhov kev lees txais yog los ntawm 30 feem pua (hauv Romania thiab Qaib Cov Txwv) mus rau 89 feem pua (hauv Suav teb) hauv ntau lub tebchaws [82-84]. Tus nqi no siab dua rau cov menyuam yaus thiab cov tub ntxhais hluas hauv Latin America thiab Caribbean (92.2 feem pua) [85]. Cov txiaj ntsig ntawm kev tshuaj xyuas kev tshawb fawb qhia txog qhov kev lees paub ntawm cov menyuam yaus ntawm 57 feem pua [86].
Cov poj niam cev xeeb tub thiab lactating poj niam yog lwm pab pawg neeg muaj kev pheej hmoo siab thiab nyuaj hauv cheeb tsam no. Kev soj ntsuam los ntawm 16 lub teb chaws pom tias qhov kev lees txais ntawm cov poj niam cev xeeb tub qis dua. Tus nqi no siab dua rau cov poj niam cev xeeb tub hauv Is Nrias teb thiab Philip-pines dua hauv Australia, Tebchaws Meskas, thiab Russia [84]. Hauv kev tshawb fawb hauv Tebchaws Meskas, kev txaus siab rau kev txhaj tshuaj tiv thaiv COVID-19 yog raws li hauv qab no, 76.2 feem pua ntawm cov poj niam cev xeeb tub, 55.2 feem pua ntawm cov poj niam lactating, thiab 44.3 feem pua ntawm cov poj niam cev xeeb tub [85].
Qhov kev lees txais txhaj tshuaj tiv thaiv zoo li tsawg hauv cov tebchaws tsim. Hauv Qaib Cov Txwv, tus nqi rau cov poj niam cev xeeb tub thiab lactating yog 37 feem pua thiab 33 feem pua [86, 87]. Cov txiaj ntsig ntawm lwm qhov kev tshuaj ntsuam xyuas pom tau tias Africa tau txais qhov tsawg tshaj plaws ntawm 19 feem pua [88].
Txij li qhov kev txhaj tshuaj tiv thaiv COVID-19 tsis zoo ib yam los ntawm lub teb chaws / cheeb tsam, kab mob, lossis pawg hnub nyoog, cov kev txiav txim siab ntawm kev tsis kam txhaj tshuaj kuj txawv hauv cheeb tsam thiab cov neeg nyob hauv cov neeg tau soj ntsuam. Ib yam li txhua pab pawg thiab cov pej xeem, qhov kev txiav txim siab tseem ceeb yog cov pej xeem muaj kev paub thiab kev ntseeg siab txog kev nyab xeeb, kev ua tau zoo, thiab cov teeb meem ntawm kev txhaj tshuaj tiv thaiv. Nws raug pom zoo kom txo qis cov ntaub ntawv tsis tseeb hauv qhov no los ntawm kev tsim cov kev qhia paub txog kev noj qab haus huv ntau dua uas siv cov chaw hauv tebchaws thiab thoob ntiaj teb.
Ua raws li kev coj ncaj ncees
Tsis muaj kev xav txog kev coj ncaj ncees los txiav txim siab hauv qhov kev tshawb fawb no.
Nyiaj txiag
Qhov kev tshawb fawb no tsis tau txais ib qho nyiaj pab los ntawm cov koom haum pab nyiaj txiag hauv pej xeem, kev lag luam, lossis cov tsis muaj txiaj ntsig.
Cov neeg sau ntawv pab txhawb
Txhua tus kws sau ntawv sib npaug sib npaug los npaj cov kab lus no.
Kev tsis sib haum xeeb
Cov kws sau ntawv tshaj tawm tias tsis muaj kev cuam tshuam ntawm kev txaus siab.
Cov ntaub ntawv
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