{"id":16773,"date":"2021-09-01T16:12:16","date_gmt":"2021-09-01T16:12:16","guid":{"rendered":"https:\/\/extraslovensko.sk\/spravy\/?p=16773"},"modified":"2021-09-01T16:12:16","modified_gmt":"2021-09-01T16:12:16","slug":"zvysene-riziko-myokarditidy-pri-pandemii","status":"publish","type":"post","link":"https:\/\/extraslovensko.sk\/spravy\/zvysene-riziko-myokarditidy-pri-pandemii\/","title":{"rendered":"Covid-19 a myokardit\u00edda, zv\u00fd\u0161en\u00e9 riziko v\u00fdskytu"},"content":{"rendered":"

Covid-19 a myokardit\u00edda. Bezpe\u010dnos\u0165 mRNA vakc\u00edny proti SARS-CoV-2. T\u00fato \u0161t\u00fadiu urobili Izraelsk\u00ed vedci. Sk\u00fa\u0161ky predbe\u017en\u00e9ho schv\u00e1lenia uk\u00e1zali, \u017ee vakc\u00edny na b\u00e1ze messenger RNA proti z\u00e1va\u017en\u00e9mu ak\u00fatnemu respira\u010dn\u00e9mu syndr\u00f3mu koronav\u00edrusu SARS-CoV-2 maj\u00fa dobr\u00fd bezpe\u010dnostn\u00fd profil, napriek tomu tieto \u0161t\u00fadie podliehali obmedzeniam ve\u013ekosti a mixu pacientov. <\/p>\n

Odhaduje sa, \u017ee infekcia SARS-CoV-2 nem\u00e1 v\u00fdznamn\u00fd vplyv na v\u00fdskyt lymfadenopatie, infekcie herpes zoster alebo apendicit\u00eddy, ale pod\u013ea odhadov m\u00e1 za n\u00e1sledok zna\u010dn\u00e9 zv\u00fd\u0161en\u00e9 riziko myokardit\u00eddy<\/em>. Je potrebn\u00e9 vyhodnoti\u0165 bezpe\u010dnos\u0165 vakc\u00edny mRNA BNT162b2 s oh\u013eadom na \u0161irok\u00fd rozsah potenci\u00e1lnych ne\u017eiaducich udalost\u00ed.<\/p>\n

SARS-CoV-2 myokardit\u00edda, zv\u00fd\u0161en\u00e9 riziko myokardit\u00eddy<\/h1>\n

Na vyhodnotenie bezpe\u010dnosti vakc\u00edny mRNA BNT162b2 mRNA pou\u017eili \u00fadaje z najv\u00e4\u010d\u0161ej zdravotn\u00edckej organiz\u00e1cie v Izraeli. Pre ka\u017ed\u00fa potenci\u00e1lnu ne\u017eiaducu udalos\u0165 sme v popul\u00e1cii os\u00f4b bez predch\u00e1dzaj\u00facej diagn\u00f3zy tejto udalosti individu\u00e1lne priradili o\u010dkovan\u00e9 osoby k neo\u010dkovan\u00fdm osob\u00e1m pod\u013ea sociodemografick\u00fdch a klinick\u00fdch premenn\u00fdch. Pomery rizika a rozdiely rizika 42 dn\u00ed po o\u010dkovan\u00ed boli odvoden\u00e9 pomocou Kaplan-Meierovho odhadu.<\/p>\n

Aby sme tieto v\u00fdsledky zaradili do kontextu, vykonali podobn\u00fa anal\u00fdzu zah\u0155\u0148aj\u00facu osoby infikovan\u00e9 SARS-CoV-2 priraden\u00e9 k neinfikovan\u00fdm osob\u00e1m. Rovnak\u00e9 ne\u017eiaduce udalosti boli \u0161tudovan\u00e9 pri anal\u00fdzach o\u010dkovania a infekcie SARS-CoV-2.
\n\"
\nPri anal\u00fdze o\u010dkovania ka\u017ed\u00e1 o\u010dkovan\u00e1 a kontroln\u00e1 skupina zah\u0155\u0148ala priemer 884 828 os\u00f4b. Analyzovali pozorovacie \u00fadaje od spolo\u010dnosti Clalit Health Services (CHS), aby sme napodobnili cie\u013eov\u00fa \u0161t\u00fadiu \u00fa\u010dinkov vakc\u00edny BNT162b2 na \u0161irok\u00fd rozsah potenci\u00e1lnych ne\u017eiaducich udalost\u00ed v popul\u00e1cii bez infekcie SARS-CoV-2. CHS je najv\u00e4\u010d\u0161ia zo \u0161tyroch organiz\u00e1ci\u00ed poskytuj\u00facich zdravotn\u00fa starostlivos\u0165, ktor\u00e9 pon\u00fakaj\u00fa povinn\u00e9 krytie zdravotnej starostlivosti v Izraeli.<\/p>\n

Na vyhodnotenie bezpe\u010dnostn\u00e9ho profilu vakc\u00edny BNT162b2 mRNA SARS-CoV-2 pou\u017eili s\u00fabor \u00fadajov zah\u0155\u0148aj\u00faci viac ako 2,4 mili\u00f3na o\u010dkovan\u00fdch os\u00f4b z integrovanej zdravotn\u00edckej organiz\u00e1cie. Medzi hlavn\u00e9 potenci\u00e1lne identifikovan\u00e9 ne\u017eiaduce udalosti patrilo nadmern\u00e9 riziko lymfadenopatie (78,4 pr\u00edpadov na 100 000 os\u00f4b), infekcie herpes zoster (15,8 udalost\u00ed), apendicit\u00edda (5,0 udalost\u00ed) a Myocarditis (2,7 udalost\u00ed).<\/p>\n

Aby sme tieto rizik\u00e1 zaradili do kontextu, sk\u00famali sme tie\u017e \u00fadaje o viac ako 240 000 infikovan\u00fdch osob\u00e1ch, aby sme odhadli \u00fa\u010dinky dokumentovanej infekcie SARS-CoV-2 na v\u00fdskyt rovnak\u00fdch ne\u017eiaducich udalost\u00ed. <\/p>\n

Odhaduje sa, \u017ee infekcia SARS-CoV-2 nem\u00e1 v\u00fdznamn\u00fd vplyv na v\u00fdskyt lymfadenopatie, infekcie herpes zoster alebo apendicit\u00eddy, ale pod\u013ea odhadov m\u00e1 za n\u00e1sledok zna\u010dn\u00e9 zv\u00fd\u0161en\u00e9 riziko myokardit\u00eddy (11,0 udalost\u00ed na 100 000 os\u00f4b).<\/p><\/blockquote>\n

V minulosti bola hl\u00e1sen\u00e1 asoci\u00e1cia medzi o\u010dkovan\u00edm proti SARS-CoV-2 a myokardit\u00eddou. 20 Napriek tomu, \u017ee v klinick\u00fdch sk\u00fa\u0161aniach BNT162b2 (Pfizer \u2013 BioNTech), 2 mRNA-1273 (Moderna), 3 alebo ChAdOx1 nCoV-19 (AstraZeneca) neboli hl\u00e1sen\u00e9 \u017eiadne pr\u00edpady myokardit\u00eddy, mnoho pr\u00edpadov myokardit\u00eddy po o\u010dkovan\u00ed proti Covid-19 malo ned\u00e1vno uveden\u00e9 v literat\u00fare a zd\u00e1 sa, \u017ee riziko je najvy\u0161\u0161ie u mlad\u00fdch mu\u017eov. <\/p>\n

Zistili sme, \u017ee riziko myokardit\u00eddy sa po o\u010dkovan\u00ed zv\u00fd\u0161ilo trojn\u00e1sobne, \u010do sa premietlo do pribli\u017ene 3 nadbyto\u010dn\u00fdch udalost\u00ed na 100 000 os\u00f4b; 95% interval spo\u013eahlivosti nazna\u010doval, \u017ee hodnoty medzi 1 a\u017e 5 nadbyto\u010dn\u00fdmi udalos\u0165ami na 100 000 os\u00f4b boli kompatibiln\u00e9 s na\u0161imi \u00fadajmi. Medzi 21 osobami s myokardit\u00eddou v o\u010dkovanej skupine bol priemern\u00fd vek 25 rokov a 90,9% boli mu\u017ei.<\/p>\n

Vo v\u00fdsledkoch tejto \u0161t\u00fadie boli pozorovan\u00e9 niektor\u00e9 p\u00f4vodne neo\u010dak\u00e1van\u00e9 \u00fa\u010dinky. Zd\u00e1 sa, \u017ee o\u010dkovacia l\u00e1tka BNT162b2 chr\u00e1ni pred ur\u010dit\u00fdmi stavmi, ako je an\u00e9mia a intrakrani\u00e1lne krv\u00e1canie. Rovnak\u00e9 ne\u017eiaduce udalosti s\u00fa v tejto \u0161t\u00fadii tie\u017e identifikovan\u00e9 ako komplik\u00e1cie infekcie SARS-CoV-2, tak\u017ee sa zd\u00e1 pravdepodobn\u00e9, \u017ee ochrann\u00fd \u00fa\u010dinok vakc\u00edny je sprostredkovan\u00fd jej ochranou pred nediagnostikovanou infekciou SARS-CoV-2, ktor\u00e1 m\u00f4\u017ee by\u0165 diagnostikovan\u00e1 bu\u010f z d\u00f4vodu nedostatku testovania alebo z d\u00f4vodu falo\u0161ne negat\u00edvnych v\u00fdsledkov PCR.<\/p>\n

V tejto \u0161t\u00fadii sme sa sna\u017eili zasadi\u0165 zv\u00fd\u0161en\u00e9 riziko ne\u017eiaducich udalost\u00ed sp\u00f4soben\u00fdch vakc\u00ednou BNT162b2 do kontextu t\u00fdm, \u017ee toto riziko porovn\u00e1te s rizikom rovnak\u00fdch ne\u017eiaducich udalost\u00ed po dokumentovanej infekcii SARS-CoV-2. Mysleli sme si, \u017ee je to nevyhnutn\u00e9, preto\u017ee o\u010dkovanie a jeho potenci\u00e1lne rizik\u00e1 sa nevyskytuj\u00fa pr\u00e1zdne, ale sk\u00f4r v kontexte prebiehaj\u00facej pand\u00e9mie<\/em>. Aj ke\u010f s\u00fa v\u0161eobecn\u00e9 rizik\u00e1 hospitaliz\u00e1cie, z\u00e1va\u017en\u00fdch chor\u00f4b a \u00famrt\u00ed na Covid-19 v\u0161eobecne uzn\u00e1van\u00e9, sekund\u00e1rne komplik\u00e1cie infekcie s\u00fa menej zn\u00e1me. <\/p>\n

Odhadli sme, \u017ee vakc\u00edna BNT162b2 viedla k zv\u00fd\u0161en\u00e9mu v\u00fdskytu nieko\u013ek\u00fdch ne\u017eiaducich udalost\u00ed po\u010das 42-d\u0148ov\u00e9ho obdobia sledovania. Aj ke\u010f v\u00e4\u010d\u0161ina t\u00fdchto udalost\u00ed bola mierna, niektor\u00e9 z nich, ako napr\u00edklad myokarditida, m\u00f4\u017eu by\u0165 potenci\u00e1lne z\u00e1va\u017en\u00e9. <\/p>\n

Na\u0161e v\u00fdsledky v\u0161ak nazna\u010duj\u00fa, \u017ee infekcia SARS-CoV-2 je sama o sebe ve\u013emi siln\u00fdm rizikov\u00fdm faktorom myokardit\u00eddy<\/p><\/blockquote>\n

a tie\u017e v\u00fdrazne zvy\u0161uje riziko mnoh\u00fdch \u010fal\u0161\u00edch z\u00e1va\u017en\u00fdch ne\u017eiaducich udalost\u00ed. Tieto zistenia pom\u00e1haj\u00fa objasni\u0165 kr\u00e1tkodob\u00e9 a strednodob\u00e9 rizik\u00e1 vakc\u00edny a zaradi\u0165 ich do klinick\u00e9ho kontextu. Na odhad potenci\u00e1lu dlhodob\u00fdch ne\u017eiaducich udalost\u00ed bud\u00fa potrebn\u00e9 \u010fal\u0161ie \u0161t\u00fadie.<\/p>\n

Origin\u00e1l textu: New England Journal of Medicine<\/a><\/p>\n

\n

Ako sa vrav\u00ed, rob v\u0161etko ako \u017eidia a ur\u010dite pre\u017eije\u0161. A \u017eidia sa na t\u00fato myokardit\u00eddu pozreli cez v\u00edrus a nie cez injekcie. Chud\u00e1ci antivaxeri a e\u0161te k tomu mRNA Pfizer vakc\u00edna \ud83d\ude42<\/p>\n

Support Your Local mRNA vaccine, Pfizer\/Biontech<\/h2>\n","protected":false},"excerpt":{"rendered":"

Covid-19 a myokardit\u00edda. Bezpe\u010dnos\u0165 mRNA vakc\u00edny proti SARS-CoV-2. T\u00fato \u0161t\u00fadiu urobili Izraelsk\u00ed vedci. Sk\u00fa\u0161ky predbe\u017en\u00e9ho schv\u00e1lenia uk\u00e1zali, \u017ee vakc\u00edny na b\u00e1ze messenger RNA proti z\u00e1va\u017en\u00e9mu ak\u00fatnemu respira\u010dn\u00e9mu syndr\u00f3mu koronav\u00edrusu SARS-CoV-2 maj\u00fa dobr\u00fd bezpe\u010dnostn\u00fd profil, napriek tomu tieto \u0161t\u00fadie podliehali obmedzeniam ve\u013ekosti a mixu pacientov. Odhaduje sa, \u017ee infekcia SARS-CoV-2 nem\u00e1 v\u00fdznamn\u00fd vplyv na v\u00fdskyt lymfadenopatie, […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-16773","post","type-post","status-publish","format-standard","hentry","category-biohazard"],"_links":{"self":[{"href":"https:\/\/extraslovensko.sk\/spravy\/wp-json\/wp\/v2\/posts\/16773","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/extraslovensko.sk\/spravy\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/extraslovensko.sk\/spravy\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/extraslovensko.sk\/spravy\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/extraslovensko.sk\/spravy\/wp-json\/wp\/v2\/comments?post=16773"}],"version-history":[{"count":0,"href":"https:\/\/extraslovensko.sk\/spravy\/wp-json\/wp\/v2\/posts\/16773\/revisions"}],"wp:attachment":[{"href":"https:\/\/extraslovensko.sk\/spravy\/wp-json\/wp\/v2\/media?parent=16773"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/extraslovensko.sk\/spravy\/wp-json\/wp\/v2\/categories?post=16773"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/extraslovensko.sk\/spravy\/wp-json\/wp\/v2\/tags?post=16773"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}