Vaccin phòng Covid-19 cho người bệnh đái tháo đường và rối loạn nội tiết

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Tác giả: Hải Thủy Nguyễn, Bá Thoại Trần

Ngôn ngữ: Vie

Ký hiệu phân loại: 615 Pharmacology and therapeutics

Thông tin xuất bản: Tạp chí Nội tiết và Đái tháo đường 2022

Mô tả vật lý: 28-36

Bộ sưu tập: Metadata

ID: 396416

Thêm vào giỏ Liên kết toàn văn

Bệnh Coronavirus 2019 (COVID-19) là một bệnh đa yếu tố ảnh hưởng đến hầu hết các hệ thống cơ quan trong cơ thể bệnh nhân. Nhiễm loại virus này sẽ thúc đẩy quá trình viêm mãn tính toàn thân do sự giải phóng các cytokine và sự hoạt hóa bất thường hệ thống miễn dịch sẵn có. Trong đại dịch COVID-19, việc triển khai tiêm chủng nhanh chóng và rộng rãi là biện pháp cơ bản để phòng bệnh và hạn chế lây lan. Việc phát triển loại vaccine hiệu quả ngừa COVID-19 sẽ được một bước tiến vượt bậc trong cuộc chiến chống lại đại dịch này. Theo WHO, cho đến tháng 7/2021 hiện có trên 330 loại vaccine phòng COVID-19 trong số đó có 102 đang trong nghiên cứu lâm sàng gồm 30 giai đoạn I, 30 trong giai đoạn I - II, 25 trong giai đoạn III và 8 trong giai đoạn phát triển IV. Một số vaccine Covid-19 đã được phê duyệt sử dụng khẩn cấpvà nhiều vaccine cònđang trong giai đoạn thử nghiệm lâm sàng cuối cùng và chỉ có 6 vaccine đã được WHO đưa vào danh sách sử dụng khẩn cấp hiện nay. Do việc tiêm chủng vaccine phòng COVID-19 ở một số bệnh nhân mắc các bệnh nội tiết như viêm tuyến giáp tự miễn có một số tác dụng không mong muốn. Hiệp hội Nội Tiết Châu Âu (ESE) đã đưa ra một số khuyến cáo đặc biệt. Trên thực tế, việc cấp quyền sử dụng khẩn cấp (Emergency Use Authorization, EUA) hai loại vaccine đầu tiên bởi cơ quan quản lý dược phẩm châu Âu (European Medicines Agency, EMA) và Cục quản lý thực phẩm và dược phẩm Hoa Kỳ (Food and Drug Administration, FDA) chấp thuận dựa trên các thử nghiệm lâm sàng. Theo phân tích chính của hai vaccine đầu tiên Pfizer/BioNTech và Moderna, được FDA báo cáo vào cuối năm 2020, những người có bệnh ác tính, bệnh phổi mãn tính, bệnh tim và các bệnh lý rối loạn miễn dịch, cũng như các rối loạn nội tiết như ĐTĐ và béo phì, đã được đưa vào các thử nghiệm này cho thấy, hiệu quả và độ an toàn ở trên các đối tượng này tương đương với người khỏe mạnh. Không thấy có báo cáo bất kỳ tác dụng phụ hoặc giảm hiệu quả nào khi tiêm vaccine COVID-19 cho những người bị đái tháo đường và rối loạn nội tiết. Do đó, một số hiệp hội lâm sàng đã đề nghị rằng người bệnh đái tháo đường và rối loạn nội tiết ổn định nên theo các khuyến nghị về chích phòng COVID 19 như mọi người bình thường. Tính an toàn về tiêm chủng vaccine phòng COVID-19 là vấn đề quan trọng với cả bác sĩ lâm sàng và bệnh nhân bị rối loạn nội tiết. Các rối loạn nội tiết và liệu pháp điều trị hormone được sử dụng có thể ảnh hưởng đến kết quả và tác dụng phụ của việc tiêm chủng vaccine. Do đó, trong chuyên đề này chúng tôi trình bày một số vấn đề an toàn và biện pháp phòng ngừa khi tiêm vaccine COVID-19 ở những bệnh nhân bị rối loạn nội tiết, bao gồm bệnh tuyến thượng thận, đái tháo đường, loãng xương, bệnh tuyến giáp, thiểu năng sinh dục và bệnh tuyến yên., Tóm tắt tiếng anh, Coronavirus disease 2019 (COVID-19) has completely changed our daily clinical practice as well as our social relations. Many organs and biological systems are involved in Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection and endocrine system is not only an exception. Vaccination is one of the most effective ways to protect patients against COVID-19. Evidence indicates that vaccines are very effective at preventing severe illness, hospitalization and death from COVID-19. Since the first outbreak of COVID-19, ongoing efforts have been made to discover an efficacious vaccine against COVID-19 to combat the pandemic. The clinical course of COVID-19 and the effects of vaccination against COVID-19 are both influenced by patients' health status and involve a systemic physiological response. In view of the systemic function of endocrine hormones, endocrine disorders themselves and the therapeutics used to treat them can influence the outcomes of vaccination for COVID-19. However, there are very limited data to support the development of clinical guidelines for patients with specific medical backgrounds based on large clinical trials. In the current severe circumstances of the COVID-19 pandemic, position statements made by clinical specialists are essential to provide appropriate recommendations based on both medical evidence and clinical experiences. As endocrinologists, we would like to present the medical background of COVID-19 vaccination, as well as precautions to prevent the side effects of COVID-19 vaccination in diabetic and endocrine patientsincluding autoimmune thyroid disease, osteoporosis, adrenal insufficiency, hypogonadism, and pituitary disorders. We should be aware of the priority and benefits of COVID-19 vaccines in Diabetic and Endocrine Patients and recommend prompt vaccination to patients.

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