Effect of Influenza Vaccination on Risk of Stroke: A Systematic Review and Meta-Analysis

Lee, Kyu Rae; Bae, Jeong Hun; Hwang, In Cheol; Kim, Kyoung Kon; Suh, Heuy Sun; Ko, Ki Dong

doi:10.1159/000478017

Cited by 58 publications

(34 citation statements)

References 40 publications

(60 reference statements)

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“…They reported that respiratory viruses except parain uenza were signi cantly associated with ischemic stroke admission in the elderly (≥ 75 years). In particular, in uenza was widely discussed in the scienti c discourse because an in uenza vaccination is available and may possibly lead to a risk reduction [44]. However, the evidence is limited due to the lack of randomized controlled studies.…”

Section: Discussionmentioning

confidence: 99%

The Incidence of SARS-COV-2 Manifestations in the Central Nervous System: A Rapid Review and Meta-Analysis

Mayr

Glechner

Gartlehner

et al. 2020

Preprint

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Background: Coronavirus disease 2019 (COVID-19) is caused by SARS-CoV-2 and presents itself mainly as a respiratory tract infection. However, reports of associated central nervous system (CNS) manifestations are increasing.Methods: We conducted this rapid review to determine the frequency of CNS manifestations of COVID-19 (CNS symptoms, acute cerebrovascular disease, and infectious/inflammatory CNS diseases) and to summarize the current evidence for direct invasion of the CNS by SARS-CoV-2. An information specialist searched Ovid MEDLINE, the CDC: COVID-19 Research Articles Downloadable and WHO COVID-19 Databases, CENTRAL, and Epistemonikos.org on May 13, 2020. Two reviewers screened abstracts and potentially relevant full-text publications independently. The data extraction, assessment of risk of bias,and certainty of evidence using GRADE was done by one reviewer and double-checked by another. If possible and reasonable, a meta-analysis was carried out.Results: We identified 13 relevant studies (four cohort studies, nine case studies) with a total of 866 COVID-19 patients.In a Chinese cohort, dizziness (16.8%; 36 of 214) and headache (13.1%; 28 of 214) were the most common CNS symptoms reported. A meta-analysis of four cohort studies including 851 COVID-19 patients showed an incidence of 3.3% (95% CI: 2.2–4.9) for ischemic stroke (follow-up: one to five weeks). In 13 of 15 encephalitis case studies, PCR testing of the cerebrospinal fluid did not detect any virus components.Conclusion: CNS manifestations occur frequently in patients with COVID-19. It is important to integrate neurologists into the multiprofessional COVID-19 treatment team to detect neurological complications early and to treat them correctly.

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Section: Discussionmentioning

confidence: 99%

The Incidence of SARS-COV-2 Manifestations in the Central Nervous System: A Rapid Review and Meta-Analysis

Mayr

Glechner

Gartlehner

et al. 2020

Preprint

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“…Studies on the impact of influenza vaccination in older adults demonstrate reductions in the incidence of stroke and acute myocardial infarction of approximately 20% and studies in at-risk older patients with at least one co-morbidity show a clear dose-effect over multiple influenza seasons [43,44]. There are some indications that pneumococcal vaccination of older adults can also reduce the risk of cardiovascular disease, though the association is weaker than that reported for zoster or influenza [45,46]. Vaccination can markedly reduce demand for health services by older adults.…”

Section: The Full Burden Of Vaccine-preventable Diseasementioning

confidence: 99%

Adult vaccination as part of a healthy lifestyle: moving from medical intervention to health promotion

Doherty

Giudice²,

Maggi

2019

Annals of Medicine

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As the global population ages, there is concern about the effect of an increased proportion of older individuals on the economic sustainability of healthcare systems and the social effects of an older society. Health authorities and advocacy groups in countries at the forefront of this trend are now developing strategies to ameliorate the social and financial effects of an ageing population. There is broad agreement that for both society and for the individuals, it is important to ensure that increasing lifespans are matched with increased "healthspans"the number of years spent in good health. There is also growing consensus that vaccination is one of the tools that can play an important role in improving adult healththough currently vaccination coverage is often poor. This review focuses on two issues that consistently appear to be associated with under-vaccination: the low awareness of risk (and potential consequences) for vaccine-preventable diseases and a poor understanding of the value of improved vaccination coverage for adults. We suggest that understanding of vaccination as a health-promoting activity, rather than a medical intervention designed to prevent the spread of a specific pathogenis a crucial step to improve vaccination uptake among adults (see Supplementary video abstract). KEY MESSAGES As populations age globally, we are seeing an increasing burden of vaccine-preventable disease in adults. Adult vaccination against some common diseases has been shown to dramatically improve health and quality of life for older people. Despite the attested benefits, vaccination coverage is almost always poor in adults, even in countries where access is free at point of care. In this article, we discuss what appears to a neglected issue in adult vaccination, that of personal autonomy. We argue that adult vaccination will only be successful if it respects individual autonomy and that this requires treating the choice to vaccinate as a public health issue akin to smoking cessation, exercise and healthy diet.

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“…Lin et al 45 identificaram, em estudo de caso-controle, que idosos vacinados apresentavam menor risco de internação por AVC (OR = 0,76, IC95%: 0,60; 0,97) e que o risco diminuiu com o número crescente de vacinas (revacinação anual). Recentemente, uma revisão sistemática de estudos observacionais com metanálise também mostrou que a vacinação está associada a um risco menor de AVC, visto que indivíduos vacinados apresentaram menor risco em comparação aos indivíduos não vacinados (OR = 0,82, IC95%: 0,75; 0,91, p < 0,001) 48 .…”

Section: Sexo/faixa Etária (Anos)/períodosunclassified

Mortalidade por doenças cerebrovasculares em idosos e a vacinação contra a influenza: Estado de São Paulo, Brasil, 1980-2012

et al. 2019

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Este estudo descreve a tendência dos coeficientes de mortalidade por doenças cerebrovasculares (DCbV) em idosos no Estado de São Paulo, Brasil, entre 1980 e 2012, antes e depois das campanhas de vacinação contra a influenza, e identifica pontos de mudanças. Trata-se de um estudo ecológico de série temporal, realizado com dados de óbitos do Sistema de Informações sobre Mortalidade do Ministério da Saúde e dados populacionais do Instituto Brasileiro de Geografia e Estatística. Para análise dos dados, foram utilizados modelos de regressão linear, polinomial e joinpoint regression. Entre 1980 e 2012, foram registrados 480.955 óbitos por DCbV. Os coeficientes médios de mortalidade diminuíram em ambos os sexos para todas as faixas etárias analisadas, com maior redução nas idades mais longevas e no sexo masculino. Observou-se queda significativa na tendência de mortalidade em 1998 para o sexo masculino, na faixa de 60-69 anos (annual percent change - APC = -3%, IC95%: -4,3; -1,6) e para o total dos idosos (APC = -3,8%, IC95%: -4,4; -3,1). Considerando-se o período como um todo, não se observaram pontos de mudanças para a faixa de 70-79 (average annual percent change - AAPC = -3,3%, IC95%: -3,5; -3,1) e, no sexo masculino, para o grupo ≥ 80 anos (AAPC = -2,9%, IC95%: -3,1; -2,6). Para o total de idosos, a redução percentual média foi de 3,1% ao ano (AAPC = -3,1%, IC95%: -3,5; -2,7). Os resultados mostraram redução da mortalidade por DCbV no período estudado, com diferentes variações percentuais de queda dos coeficientes. Os achados deste estudo adicionam informações para o debate sobre o possível efeito das campanhas de vacinação na redução da mortalidade por DCbV na população idosa.

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Effect of Influenza Vaccination on Risk of Stroke: A Systematic Review and Meta-Analysis

Cited by 58 publications

References 40 publications

The Incidence of SARS-COV-2 Manifestations in the Central Nervous System: A Rapid Review and Meta-Analysis

The Incidence of SARS-COV-2 Manifestations in the Central Nervous System: A Rapid Review and Meta-Analysis

Adult vaccination as part of a healthy lifestyle: moving from medical intervention to health promotion

Mortalidade por doenças cerebrovasculares em idosos e a vacinação contra a influenza: Estado de São Paulo, Brasil, 1980-2012

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