观察研究
医学
荟萃分析
流感疫苗
糖尿病
肺炎
接种疫苗
人口
风险因素
随机对照试验
梅德林
内科学
重症监护医学
免疫学
环境卫生
内分泌学
政治学
法学
作者
Ilaria Dicembrini,Giovanni Antonio Silverii,Alessandra Clerico,R. Fornengo,Giovanni Gabutti,Valeria Sordi,Silvio Tafuri,Ottavia Peruzzi,Edoardo Mannucci
标识
DOI:10.1016/j.numecd.2023.03.016
摘要
Aims In order to better define the need for influenza vaccination in people with diabetes (DM), we collected all available evidence on the effect of DM as a risk factor for complications of both seasonal and pandemic influenza, and on the specific effectiveness of vaccines in patients with DM. Data synthesis Two distinct systematic searches on MEDLINE, Cochrane, ClinicalTrials.gov and Embase databases were performed, one for each metanalysis, collecting all observational studies and randomized clinical trials performed on humans up to May 31st, 2022. We retrieved 34 observational studies comparing risk for influenza complications in people with or without diabetes, and 13 observational studies assessing vaccine effectiveness on preventing such complications. Mortality for influenza and hospitalization for influenza and pneumonia resulted significantly higher in individuals with versus without DM, both when unadjusted and adjusted data are analyzed. In diabetic individuals vaccinated for influenza overall hospitalization, hospitalization for influenza or pneumonia and overall mortality are significantly lower in comparison with not vaccinated DM subjects, both when unadjusted and adjusted data were analyzed. Conclusion This systematic review and meta-analysis shows that: 1) influenza is associated with more severe complications in diabetic versus not diabetic individuals and 2) influenza vaccination is effective in preventing clinically relevant outcomes in adults with DM with a NNT (number needed to treat) of 60, 319, and 250 for all-cause hospitalization, specific hospitalization, and all-cause mortality, respectively. The identification of diabetic patients as the target of vaccination campaigns for influenza appears to be justified by available clinical evidence.
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