1. Gabatarwa
Ka yi tunanin kai iyayen yaro ne a cikin shekaru 12-15 yana ƙoƙarin yanke shawara idan fa'idodin rigakafin COVID-19 ya zarce haɗarin. Kun ji labarin alakar COVID-19 kamuwa da cuta da myocarditis da kuma alakar COVID-19 alurar riga kafi da myocarditis. Kuna google "myocarditis da COVID-19 kamuwa da cuta". Nemanku ya dawo da wannan snippet mai zuwa:
Kuna iya yanke shawarar cewa "mafi kyawun kimiyya" yana nuna cewa yaronku yana cikin haɗarin haɓaka myocarditis bayan kamuwa da cutar COVID-19 fiye da bayan rigakafin COVID-19. Irin wannan ƙarshe ba zai zama daidai ba - manyan bincike guda biyu waɗanda aka buga binciken su a cikin manyan mujallu na likitanci suna ba da kwararan hujjoji cewa yaranku na cikin haɗarin myocarditis bayan rigakafin COVID-19 fiye da bayan kamuwa da COVID-19; haka kuma, "sabon binciken a Ingila" da ke ba da bayanan da Google ya nuna yana da gazawar kimiyya mai tsanani.
Jaridar American Medical Association Zuciya, Afrilu 20, 2022, an buga a bincike takarda da Karlstad et al. mai taken "Ayyukan SARS-CoV-2 da Myocarditis a cikin Nazarin Ƙungiya ta Nordic na Mazauna Miliyan 23." A shafi na 2 na eTable 7, mun lura cewa A cikin yawan binciken Karlstad et al, akwai lokuta 0 na myocarditis bayan kamuwa da SARS-CoV-2 ga maza da mata a cikin shekarun 12-15. (Yawancin binciken a cikin shekarun 12-15 ya kasance "a farkon farawa" 1,238,004, kuma a ƙarshen lokacin bin 750,253 ba a yi amfani da su ba.) Bugu da ƙari, ga yara maza 12-15, eTable 6 yana ba da rahoton abubuwan da suka faru na myocarditis da pericarditis hade, tare da abubuwan 5 da ke da alaƙa da kashi 1 na rigakafin mRNA da abubuwan 6, zuwa kashi 2.
Daga baya za mu bayyana bayanan myocarditis, na yara masu shekaru 13-17, daga wani babban binciken da ya yi daidai da na Karlstad et al. na yara masu shekaru 12-15. Don haka, lokacin da iyaye suka bincika Google don "myocarditis da COVID-19 kamuwa da cuta," kuma suka karanta a cikin babban sakamakon binciken cewa haɗarin myocarditis gabaɗaya "ya fi girma sosai nan da nan bayan kamuwa da cutar ta COVID-19 fiye da yadda yake a cikin makonnin da ke biyo bayan allurar rigakafin cutar ta coronavirus," ana sanar da iyayen kuskure.
Haka kuma, duk wanda ke yin la’akari da haɗarin rigakafin COVD-19 da waɗanda ke da alaƙa da kamuwa da cuta ya kamata ya sani cewa bambancin da aka zana a cikin snippet Google-search a sama tsakanin “nan da nan bayan kamuwa da cuta” da “a cikin makonnin da ke biyo bayan rigakafin” yana da matuƙar yaudara. "Sabon binciken a Ingila" ba ya bayar da rahoto game da myocarditis yana tasowa "nan da nan bayan kamuwa da cuta"; maimakon haka, yana ba da rahoto game da myocarditis yana haɓaka kwanaki 1-28 bayan ingantaccen gwajin COVID-19, kamar yadda yake ba da rahoto game da myocarditis yana haɓaka kwanaki 1-28 bayan rigakafin COVID-19. A wasu kalmomi, don binciken, babu bambanci a cikin haɗin gwiwa na wucin gadi na myocarditis tare da kamuwa da cuta vs. cewa tare da alurar riga kafi. Don haka, dawowar neman yana yada bayanan da ba daidai ba.
Ko da mafi muni, "sabon binciken a Ingila" wanda Google ya nuna yana da gazawa mai tsanani.
2. Sabon Nazari a Ingila: Bambance-bambancen Magana
Ma'anar kamuwa da cuta ta COVID-19 a bayyane take - idan mutum yana da nauyin COVID-19 mara nauyi kuma yana iya nuna alamun kamuwa da cutar COVID-19, to mutumin ya kamu da cutar. Duk da haka, wannan ba shine ma'anar "kamuwa da cuta" da aka yi amfani da shi a cikin "sabon binciken a Ingila". Bari mu tono cikin cikakkun bayanai.
An kwatanta "sabon binciken a Ingila" a cikin bincike takarda "Hadarin Myocarditis Bayan Kayayyakin Magungunan COVID-19 da Cutar Cutar SARS-CoV-2 ta Zamani da Jima'i," an buga 22 ga Agusta 2022 a cikin mujallar American Heart Association. Circulation. Takardar tana da mawallafa 14 tare da marubucin jagora M. Patone; Takaitaccen bayaninsa na "sakamako" ya fara, "A cikin mutane 42,842,345 da ke karɓar aƙalla kashi 1 na rigakafin [COVID-19], 21,242,629 sun karɓi allurai 3, kuma 5,934,153 sun kamu da cutar SARS-CoV-2 kafin ko bayan alurar riga kafi." Yawan binciken Patone et al. ya ƙunshi mazauna Ingila 42,842,345, masu shekaru 13 zuwa sama, suna karɓar aƙalla kashi ɗaya na maganin COVID-19 a lokacin binciken 1 Disamba 2020 har zuwa 15 Disamba 2021. Patone at al. rahoton 5,934,153 cututtukan SARS-CoV-2 sun faru a cikin yawan binciken su a tsawon lokacin 1 Disamba 2020 har zuwa 15 ga Disamba 2021.
A cewar wani labarin fasaha Ofishin Kididdigar Kasa na Ingila wanda "yana gabatar da ƙididdiga na adadin mutanen da suka kamu da cutar aƙalla guda ɗaya na coronavirus (COVID-19)," kusan kashi 8.3% na mutanen Ingilishi sun kamu da cutar a farkon lokacin binciken Patone et al kuma kusan 43.2% sun kamu da cutar a ƙarshensa. Don haka, aƙalla, muna iya tsammanin kusan 34.9%, (43.2 - 8.3)%, na yawan mutanen binciken sun sami kamuwa da cutar COVID-19 na farko yayin lokacin binciken: 0.349 × 42,842,345 ≈ 14,951,978 cututtukan farko, ba 5,934,153 ba.
Menene ya bayyana ban mamaki rashin kima na cututtuka a cikin yawan binciken? Ma'anar kamuwa da cuta mai zuwa wanda Patone et al., "... SARS-CoV-2 kamuwa da cuta, wanda aka ayyana azaman gwaji na farko na SARS-CoV-2-tabbatacce a cikin lokacin binciken". A cikin mahallin wannan binciken, ma'anar kamuwa da cuta da ta gabata ba ta dace ba. Yawancin cututtuka ba su da alaƙa da (an ruwaito) ingantattun gwaje-gwajen COVID-19. Misali, da Ƙididdiga na CDC na Amurka cewa ainihin adadin cututtukan shine sau 4 adadin adadin da aka ruwaito, aƙalla na tsawon lokacin Fabrairu 2020-Satumba 2021 a Amurka.
Ta yaya rashin kididdigar cututtuka ke shafar ƙididdigar ƙididdiga na abin da ya faru na myocarditis mai alaƙa da kamuwa da cutar COVID-19? Zan yi amfani da bayanai daga binciken Patone et al. don nunawa.
Kamar yadda na riga na lura, yawan mutanen binciken ya ƙunshi mazauna Ingila 42,842,345, masu shekaru 13 zuwa sama, suna karɓar aƙalla kashi ɗaya na rigakafin COVID-19 a lokacin binciken. A tsawon lokacin binciken, 5,934,153 (13.9%) na yawan mutanen binciken sun gwada ingancin SARS-CoV-2, gami da 2,958,026 (49.8%) kafin rigakafin su na farko.
Don binciken Patone et al., shari'ar myocarditis shine wanda ke haifar da mutuwa ko kuma a shigar da asibiti na myocarditis-wasu daga cikin waɗannan shigar sun faru ne a cikin kusancin ɗan lokaci (kwanaki 1-28) zuwa rigakafin COVID-19, wasu a kusancin ɗan lokaci (1-28 kwanaki) zuwa tabbataccen ƙungiyar COVID-19, wasu kuma ba su da tushe.
Akwai shari'o'in myocarditis guda 114 a cikin membobin-yawan binciken yayin da ba a yi musu allurar rigakafi ba wanda ke da alaƙa na ɗan lokaci tare da ingantaccen gwajin-COVID-19. Dangane da wannan danyen bayanan, shari'o'i 114 da suka fito daga 2,958,026 sun ba da rahoton ingantattun gwaje-gwaje a tsakanin membobin-yawan binciken yayin da ba a yi musu allurar rigakafi ba, muna samun abubuwan da suka faru na myocarditis mai alaƙa da gwaji a tsakanin membobin binciken yayin da ba a yi musu allurar ba:
Don samun abin da ya faru na myocarditis bayan COVID-19 kamuwa da cuta dole ne mu ƙara ƙima a cikin abin da ya gabata domin ya nuna adadin cututtukan SARS-CoV-2 da suka faru a cikin membobin yawan binciken yayin da ba a yi musu allurar ba. Adadin wadanda ba a yi musu allurar ba wadanda a karshe suka shiga yawan binciken ya fara ne a 42,842,345 kuma sannu a hankali ya ragu - don kimanta adadin wadanda suka kamu da cutar kafin a yi musu allurar, dole ne mu ci gaba da lura da raguwar adadin wadanda ba a yi wa alurar riga kafi ba na yawan mutanen binciken da kuma yawan kamuwa da cuta. Wannan matsala ce mai ban sha'awa ta lissafi, kuma, da sa'a, ni masanin lissafi ne.
A takarda wanda na rubuta tare da Spiro Pantazatos ya kwatanta lissafin da ke samar da 4,685,095 azaman ƙaramin iyaka akan adadin cututtukan SARS-CoV-2 da ke faruwa a lokacin binciken a cikin membobin yawan binciken yayin da ba a yi musu allurar ba. Don haka, kimanta abubuwan da suka faru na myocarditis bayan COVID-19 ikamuwa da cuta tsakanin masu karatu-yawan jama'a yayin da ba a yi musu allurar ba
kuma abin da ya gabata na iya zama abin kima saboda hanyar da ake amfani da ita don ƙididdige cututtuka, tana haifar da ƙarancin ƙima akan adadin cututtukan bisa ga bayanai daga Ofishin Kididdiga na Ƙasa ta Ingila (ONS) da Ma'aikatar Kiwon Lafiya ta Kasa (NHS).
Don fahimtar abubuwan da ke tattare da yin amfani da ƙarin ingantacciyar ƙididdiga ta cututtukan SARS-CoV-2 da ke faruwa a tsakanin membobin yawan binciken kafin su karɓi kashi na farko na rigakafin COVID-19, za mu ɗauka cewa rabon kamuwa da cuta zuwa ingantattun gwaje-gwaje, 1.58 ≈ 4,685,095 / 2,958,026, yayi kama da manyan mazaje 40, waɗanda aka yi la’akari da su a ƙarƙashin manyan mazaje 40. 40 zuwa sama, mata 40 zuwa sama.
Lokacin da aka yi la'akari da wannan factor na 1.58, a cikin, misali, adadin abubuwan da suka faru (IRRs) na Patone et al.'s Table 3, mun gano cewa, ga maza a karkashin shekaru 40, hadarin myocarditis bayan kashi 2 na Pfizer's BNT162b2 (IRR 3.08) ya fi girma fiye da post-kamuwa da cuta (IRR 2.75). ba a yi masa allurar rigakafi ba, yayin da Table 4.35 ke nuna akasin haka:
Mun gyara Teburin 3 daga labarin Patone et al, tare da kawar da layuka masu dacewa da sauran rukunin alƙaluma da daidaita bayanin abubuwan da ke cikin tebur tare da matakan da suka dace.
Mun lura cewa wasu sun lura da binciken Patone et al yana haɓaka haɗarin myocarditis bayan kamuwa da cutar SARS-CoV-2. Misali, Dr. Vinay Prasad ya tada wannan batu 28 Disamba 2021 (a cikin yin sharhi game da littafin da ya gabata yana tattauna bayanan binciken daga lokacin 1 Disamba 2020 zuwa 24 ga Agusta 2021):
Yayin da aka san adadin allurar rigakafi da daidaito, ba a san ainihin adadin cututtuka ba. Mutane da yawa ba sa neman gwaji ko kulawar likita. Don haka jan sandar da ke sama [mai nuna alamun gwajin da ke da alaƙa da wuce gona da iri na myocarditis] zai zama ya fi guntu idan kun yi amfani da ma'aunin ƙwayar cuta (aka daidai).
Patone et al Circulation takarda tana da wasu munanan gazawar sadarwa, misali, gazawarta wajen cancantar wannan magana mai zuwa daga sashin “Tattaunawa”:
A cikin mutane sama da miliyan 42 da aka yiwa alurar riga kafi, mun ba da rahoton sabbin bincike da yawa waɗanda zasu iya tasiri manufofin lafiyar jama'a akan rigakafin COVID-19. Na farko, haɗarin myocarditis ya fi girma sosai bayan kamuwa da cutar ta SARS-CoV-2 a cikin mutanen da ba a yi musu allurar ba fiye da haɓakar haɗarin da aka samu bayan allurar farko na ChAdOx1nCoV-19, da kashi na farko, na biyu, ko ƙara ƙarfi na rigakafin BNT162b2.
Na riga na tattauna hanyoyi biyu da Patone et al. yakamata ya cancanci bayanin da ya gabata: “kamuwa da cuta” baya nufin “kamuwa da cuta” kuma bayanin shine, tare da kusan tabbas, ƙarya ga maza da mata a cikin shekaru 12-15. Ana ba da wasu cancantar da suka shafi haɗarin myocarditis a cikin yara azaman iyakancewar karatu:
[A] ko da yake mun sami damar haɗawa da yara 2,230,058 masu shekaru 13 zuwa 17 a cikin wannan bincike, adadin abubuwan da suka faru na myocarditis sun kasance ƙanana (al'amuran 56 a cikin kowane lokaci da abubuwan 16 a cikin 1 zuwa 28 kwanakin bayan alurar riga kafi) a cikin wannan yawan jama'a kuma sun hana wani kimantawa daban na haɗarin.
Don haka, akwai abubuwan da suka faru na myocarditis guda 16 da ke da alaƙa da alluran rigakafi a cikin rukunin shekaru 13-17, kuma, a fili, babu wani shari'ar da ke da alaƙa da ingantattun gwaje-gwajen COVID-19, waɗanda za su yi daidai da binciken Karlstad et al. binciken na shekarun 12-15, da aka ambata a baya. Lura cewa na cika alƙawarin da na yi na "daga baya kwatanta bayanan ciwon zuciya, na yara masu shekaru 13-17, daga wani babban binciken da ya yi daidai da na Karlstad et al.'s na yara masu shekaru 12-15." Abin ban mamaki, sauran babban binciken da ke ba da shaidar cewa yara suna cikin haɗarin myocarditis bayan rigakafin COVID-19 fiye da bayan kamuwa da cuta shine "sabon binciken a Ingila," wanda Google ya haskaka, don isar da cewa "gaba ɗaya" haɗarin myocarditis bayan kamuwa da cuta ya kasance "mafi girma sosai" fiye da na bayan allurar.
Ga wata muhimmiyar cancantar da Patone et al. sun kasa yarda da batun binciken su na "sabbin binciken da zai iya tasiri manufofin kiwon lafiyar jama'a game da rigakafin COVID-19": Ka tuna cewa lokacin binciken Patone et al shine 1 Disamba 2020 har zuwa 15 Disamba 2021. Kamar yadda Pantazatos da kuma I nuna a cikin sashin "Ƙarin Iyakoki na Patone et al.'s Nazarin", aƙalla 0.18% na shari'ar SARS-CoV-2 waɗanda suka ba da gudummawa ga binciken binciken sune shari'o'in bambancin Omicron. Don haka, ƙididdigar binciken na haɗarin myocarditis bayan kamuwa da cuta ba ya magana game da haɗarin kamuwa da cutar Omicron, wanda aka gane ya fi na bambance-bambancen da suka gabata..
A gaskiya, a kwanan nan da aka buga ingarmay ta Lewnard et al. yana ba da shawarar rage haɗarin haɗari don sakamako mai tsanani na asibiti a duk faɗin hukumar don Omicron da Delta, tare da raguwar haɗari "mafi girman gaske a tsakanin mutanen da ba a yi musu allurar rigakafin COVID-19 a baya ba"; misali, daidaitaccen rabon haɗari don mace-mace shine 0.14 (0.07, 0.28) ga waɗanda ba a yi musu allurar ba.
Don haka, dangane da Omicron, muna sa ran cewa yawan abin da ya faru na myocarditis bayan kamuwa da cuta zai kasance ƙasa ko da fiye da daidaitattun ƙimar daidai gwargwadon bayanan Patone et al. Ta “madaidaitan adadin”, Ina nufin waɗanda aka lissafta ta amfani da ƙididdiga masu ƙima da adadin masu kamuwa da cuta maimakon ƙaramin adadin da aka ruwaito tabbataccen gwaje-gwaje.
Komawa ga tattaunawa ta a cikin sakin layi na farko na wannan maƙala da ke da alaƙa da binciken Google da aka zayyana akan “myocarditis da COVID-19 kamuwa da cuta,” na ba da shawarar cewa binciken da aka ambata a cikin snippet ɗin Google ba ya wakiltar “mafi kyawun kimiyya.” Tsayayyace kuma madaidaiciyar sadarwa tare da cancantar maganganun maganganun da za a iya yin amfani da su ta hanyar da ba ta dace ba ko kuma a fassara su ba shakka alama ce ta kyakkyawan rubutun kimiyya. Takardar binciken Patone et al.s tabbas ta kasa cika wannan ma'auni. Me game da tushen kimiyyar binciken Patone et al.?
3. Sabon Nazari a Ingila: Kimiya mara kyau
Mafi bayyane aibi a cikin "sabon binciken a Ingila" an gabatar da shi ta hanyar canji na ƙarshe a ƙirar binciken, da alama an yi shi yayin da Patone et al. Circulation. A fahimtata cewa canza ƙirar binciken bayan kusan duk bayanan binciken da aka tattara kuma an tantance su na iya zama alamar nuna son kai ga marubuci.
Haka kuma, marigayi canje-canje na iya gabatar da kurakuran ƙira waɗanda marubuta ba su da isasshen lokacin ganowa. Na bayyana a ƙasa wani babban kuskure a cikin binciken Patone et al. wanda aka gabatar bayan marubutan sun buga a preprint version daga cikinsu Circulation labarin akan 25 Disamba 2021.
Karatun preprint ya nuna cewa, kamar yadda aka tsara tun farko, binciken Patone et al. binciken bai haɗa da nazarin abubuwan da suka faru na myocarditis mai alaƙa da gwaji ba a cikin waɗanda ba a yi musu allurar ba. Maimakon haka, abubuwan da suka shafi myocarditis mai inganci-gwaji, pre-farko-kashi da bayan-farko, an haɗa su don ƙididdige abin da ya faru na myocarditis bayan ingantaccen gwaji mai zaman kansa ba tare da matsayin rigakafin ba. Don haka, ƙirar binciken asali bai haɗa da kuskuren da aka tattauna a ƙasa ba.
Hadarin myocarditis da ke da alaƙa da COVID-19 tsakanin waɗanda ba a yi musu allurar ba, ba shakka, ba shi da alaƙa da rigakafin. Duk da haka, yawan binciken Patone et al. ya ƙunshi mutanen da aka yi wa alurar riga kafi kawai. Wannan ya haifar da rashin ma'ana na Patone et al.'s lissafin abubuwan da suka faru na m-gwaji-haɗin myocarditis a cikin waɗanda ba a yi musu alurar riga kafi ba a kan yanke shawarar yin rigakafi daga baya ko kuma ba a yi ta wasu ƙananan mutane ba a Ingila-waɗancan mutane, masu shekaru 13 da sama, an kwantar da su a asibiti tare da myocarditis mai alaƙa da gwajin gwaji yayin lokacin binciken. Bayanan bincike sun nuna 114 daga cikin waɗancan mutanen daga baya sun zaɓi yin allurar, amma ba mu san nawa ne suka zaɓi ba. Idan babu wanda ya zaɓi yin allurar fa? Sa'an nan, mai lamba 114 a cikin Patone et al. babban bincike na abubuwan da suka faru na gwajin myocarditis na baya-bayan nan a cikin marasa lafiya zai zama 0 kuma binciken ba zai nuna hadarin kamuwa da kamuwa da cutar myocarditis a cikin marasa lafiya ba..
Pantatzatos da kuma I nuna cewa Patone et al.'s da'awar faruwar m-gwaji-da alaka da myocarditis a cikin marasa lafiya yana da inganci idan kuma kawai idan marasa lafiya (shekaru 13 da sama) sun kwantar da su a asibiti a lokacin binciken tare da myocarditis mai alaƙa da gwajin-gwaji daga baya sun zaɓi yin allurar rigakafi tare da yuwuwar waɗanda ba a yi musu allurar ba kuma sun riga sun kamu da cutar SARS. Mun gabatar da hujjar bayyanawa wanda ke nuna yiwuwar ƙarin ƙari game da haɗarin myocarditis bayan kamuwa da cuta ta hanyar 13. Ka tuna cewa Patone et al. sun riga sun wuce gona da iri bayan kamuwa da cutar myocarditis ta hanyar rage yawan cututtukan cututtuka a cikin yawan binciken su. Ƙarin wuce gona da iri na haɗarin myocarditis bayan kamuwa da cuta ta hanyar 2 (saboda aibi na zane-zane da aka tattauna a sama) zai, misali, rage ƙimar IRR da aka lissafta a baya na myocarditis sakamakon kamuwa da COVID-1.5 ga maza a ƙasa da 1.5 zuwa 19 / 40 ≈ 1.83. wanda, bisa ga Tebu 3 daga Patone et al.'s Labarin Zagayawa (sashe mai dacewa da aka sake bugawa a Sashe na 2 na sama), ya faɗi ƙasa da IRR don duk alluran rigakafin COVID-19 (ciki har da mai ƙara Pfizer) sai ga kashi na farko na AstraZeneca ChAdOx1.
Ba zan ba da wani hasashe ba game da dalilin da yasa Patone et al. sun yi chanjin marigayi ga tsarin karatun su. Maimakon haka, ina gayyatar masu karatu su zana nasu ra'ayin dangane da kwatancen da aka bayar a ƙasa na bayanan haɗarin myocarditis ga maza a ƙarƙashin 40 waɗanda aka gabatar a cikin juzu'in da aka buga akan wanda aka gabatar a cikin sigar da aka buga Circulation. Da farko la'akari da wadannan daga preprint:
Shafin Farko, Sakin layi Mai Biyan Tebur 1: A cikin maza da ke ƙasa da shekaru 40, mun lura da haɗarin myocarditis a cikin kwanakin 1-28 bayan kashi na farko na BNT162b2 (IRR 1.66, 95% CI 1.14, 2.41) da mRNA-1273 (IRR 2.34, 95% CI 1.03); bayan kashi na biyu na ChAdOx5.34 (1, 2.57% CI 95, 1.52), BNT4.35b162 (IRR 2, 3.41% CI 95, 2.44) da mRNA-4.78 (IRR 1273, 16.52%CI 95); bayan kashi na uku na BNT9.10b30.00 (IRR 162, 2% CI 7.60, 95); da bin gwajin tabbataccen SARS-CoV-2.44 (IRR 4.78, 2% CI 2.02, 95).
Babu wani kwatankwacin sakin layi a cikin sigar da aka buga- wacce a ciki, ga maza a ƙarƙashin 40, myocarditis mai alaƙa da alurar riga kafi ana kwatanta shi da myocarditis mai alaƙa da tabbatacce. Koyaya, ɓangaren Patone et al.'s Table 3 a cikin su Circulation labarin da ke bayyana a Sashe na 2 a sama, yayi kwatanta. Sakin da ke ƙasa ya taƙaita bayanin da ke cikin Tebur 3 da ya shafi maza a ƙasa da 40:
Sigar Bugawa, Tebur 3: A cikin maza da ke ƙasa da shekaru 40, an sami ƙarin haɗarin myocarditis a cikin kwanaki 1-28 bayan kashi na farko na BNT162b2 (IRR 1.85, 95% CI 1.30, 2.62) da mRNA-1273 (IRR 3.08, 95% CI 1.33); bayan kashi na biyu na ChAdOx7.03 (1, 2.73% CI 95, 1.62), BNT4.60b162 (IRR 2, 3.08% CI 95, 2.24) da mRNA-4.24 (IRR 1273, 16.83%CI 95, 9.11); bayan kashi na uku na BNT31.11b162 (IRR 2, 2.28% CI 95, 0.77); da bin gwajin tabbataccen SARS-CoV-6.80: (IRR 2, 4.35% CI 95, 2.31) kafin alurar riga kafi; (IRR 0.39, 95% CI 0.09, 1.60) bayan alurar riga kafi.
Lura: tuna cewa daga tattaunawar Sashe na 2 a sama, da na wannan sashe, IRR don kamuwa da cuta-haɗe da myocarditis kafin alurar riga kafi yana da yuwuwar zama ƙasa da 2.75 kuma mai yuwuwa ƙasa da 1.83.
4. Sabon Nazari a Ingila: Bace ko Rarraba Bayanan Mutuwar Myocarditis
Yanzu muna ba da kwatanci mai ban mamaki game da rashin daidaituwa na tsarin binciken Patone et al. tare da kimantawa game da abin da ya faru na myocarditis mai alaƙa da gwajin gwaji ga marasa lafiya (a cikin yawan binciken da ya ƙunshi mutanen da aka yi wa alurar riga kafi kawai). Muna mai da hankali kan ɓacewa ko ɓarna bayanai akan ingantacciyar alaƙa da alaƙa da mutuwar myocarditis a cikin yawan binciken Patone et al.
Ofaya daga cikin abubuwan da Myocarditis da aka bincika a cikin binciken mutuwa ne tare da "mutuwa da aka rubuta akan takardar shaidar ƙasa da cuta ta ƙasa (Table S1 da ke da alaƙa da Myocarditis."
Don mutuwa ta myocarditis, ranar taron shine ranar mutuwa. Mutum ya shiga cikin yawan binciken ne kawai bayan alurar riga kafi, kuma dole ne mutum ya kasance da rai don yin rigakafi; don haka, duk mutumin da ke da rikodin tabbataccen gwajin-COVID-19 kafin alluran farko wanda ya shiga cikin jama'a ta hanyar rigakafin ba zai sami mutuwar myocarditis mai alaƙa da gwajin tabbatacce na pre-jab ba.
Don haka, idan memba na nazarin ya mutu daga myocarditis, mutuwar za a danganta shi da alurar riga kafi (idan a cikin kwanaki 28 na jab), gwajin gwaji (idan a cikin kwanaki 28 na gwajin) wanda ke faruwa bayan alurar riga kafi, ko kuma kawai ya zama mutuwar myocarditis na asali. Don haka, kawai mutuwar myocarditis mai alaƙa da tabbataccen gwaji a cikin yawan binciken yana faruwa bayan kamuwa da cuta..
Bari mu bincika bayanan myocarditis-mutuwar da ke bayyana a cikin Table 2 a cikin labarin Patone et al da aka buga a Circulation. Bayanin abin da ke cikin tebur yana nuna teburin ya haɗa da bayanan da suka shafi "Cutar SARS-CoV-2":
Idan teburin da ya gabata ya ba da bayanai kan "Mutuwar da myocarditis" da ke da alaƙa da "SARS-CoV-2 Infection" (kamar yadda taken tebur ya nuna), a ina ake rubuta irin waɗannan mutuwar? Wata yuwuwar ita ce waɗannan mutuwar suna cikin ginshiƙi na asali (lissafin wasu daga cikin mutuwar tushen 245), amma hakan zai zama ɓarna, daidai da, wani kuskure na gaskiya.
Ina tsammanin an bar bayanan kawai. Me yasa? Idan an haɗa bayanan mutuwar myocarditis da ke da alaƙa da kamuwa da cuta, to zai zama a bayyane cewa Patone et al.'s daban-daban bincike na tabbatacce-gwajin alaƙa abubuwan da suka faru na farko-farko vs. bayan-farko-kashi bai dace da babban ma'auni na haɗawa ga yawan binciken su-karɓan allurai ɗaya ko fiye na lokacin binciken COVID-19.
Yi la'akari da abin da ke gaba daga Ƙarin Tebu 2 na preprint version Patone et al Circulation labarin.
Mun ga cewa an sami mace-mace masu alaƙar gwaji guda 12 a cikin yawan binciken a cikin lokacin 1 Disamba 2020-15 Nuwamba 2021, don haka dole ne a sami ≥ 12 masu alaƙa da alaƙar gwaji a cikin yawan binciken yayin cikakken binciken-lokacin 1 Disamba 2020 – 15 na labarin al'ada. Kamar yadda aka tattauna a sama, tsarin binciken Patone et al. ya kasance irin wannan cewa duk wani tabbataccen gwajin da ke da alaƙa da mutuwar myocarditis dole ne ya faru bayan alurar riga kafi.
Don haka, an ba da hanyar Patone et al. sun zaɓi yin nazarin myocarditis mai alaƙa da tabbatacce don binciken da aka buga kuma suna ɗaukar cewa mutuwar myocarditis mai inganci-gwaji ba a haɗa su cikin mutuwar asali ba, tebur da ke ba da cikakken rahoton sakamakon binciken mutuwa-ta-myocarditis zai haɗa da jerin-mutuwar-mutuwa da ke da fom ɗin da aka kwatanta a ƙasa:
Teburin da ya gabata ya kwatanta dalilin da ya sa ba a haɗa cikakken rahoton sakamakon binciken mutuwa-by-myocarditis a cikin littafin Patone et al. Circulation labarin-irin wannan rahoto ya nuna a fili yadda tsarin binciken Patone et al. ya kasance tare da ƙoƙari na nazarin abubuwan da suka faru na myocarditis mai dangantaka da gwaji ga marasa lafiya (a cikin binciken-yawan jama'a wanda ya ƙunshi kawai mutanen da aka yi wa alurar riga kafi). Me ya sa Patone et al. yanke shawarar canza ƙirar binciken su don haɗa irin wannan bincike, kuma a fili yayin da suke Circulation An ƙaddamar da ƙaddamarwa don bugawa?
5. Kammalawa
Mu koma ga fitaccen martanin da Google ya bayar game da bukatar neman “myocarditis da COVID-19”:
Feature-snippet amsa: Babban haɗarin myocarditis - kumburin tsokar zuciya - ya fi girma sosai nan da nan bayan kamuwa da cutar ta COVID-19 fiye da yadda yake a cikin makonnin da ke biyo bayan allurar rigakafin cutar sankara, wani babban sabon bincike a Ingila ya nuna.
Saboda "binciken a Ingila" (na Patone et al.) yana amfani da ma'anar "kamuwa da cuta" (duba Sashe na 2 a sama), yana da mummunar ƙira da aka gabatar bayan kusan dukkanin bayanan binciken da aka tattara kuma an bincika su (duba Sashe na 3 a sama), kuma kusan dukkanin cututtuka da ke faruwa a cikin yawan binciken ba su da cututtuka na Omicron (duba Sashe na 2 a sama), yana yiwuwa a ce gaba ɗaya bayanan karya ne. Hadarin alurar riga kafi na iya zama mafi girma fiye da haɗarin kamuwa da cutar Omicron ga kowane rukuni na shekaru, maza da mata. A cikin wannan maƙala, na tabbatar da snippet ƙwaƙƙwaran ita ce, tare da kusan tabbas, ƙarya ga yara masu shekaru 12-15 kuma suna iya zama ƙarya ga, a ce, namiji a ƙarƙashin 40 yana tunanin karɓar kashi na biyu na Pfizer's BNT162b2.
Me ya sa Patone et al. yi amfani da ma'anar "kamuwa da cuta" mai ɓatarwa? Me yasa suka canza tsarin binciken su bayan an tattara kusan dukkanin bayanan binciken da aka bincika? Me ya sa suka kasa jaddada cewa binciken su na snippet bai shafi yara masu shekaru 13-17 ba? Me yasa suka kasa fahimtar cewa binciken su na snippet na sama bazai iya kasancewa mai inganci dangane da kamuwa da Omicron?
Ga wata tambaya mai mahimmanci: Me yasa cibiyar kiwon lafiya ke rashin sanar da jama'a game da haɗarin myocarditis bayan alurar riga kafi da kamuwa da cuta bayan kamuwa da cuta.?
Zan ƙare da wasu abubuwan lura gabaɗaya game da kwatanta haɗarin rigakafin COVID-19 da irin haɗarin kamuwa da COVID-19. Alurar riga kafi tare da mRNA COVID-19 rigakafin ya haɗa da haɗari masu alaƙa da allurai biyu, da yuwuwar ƙarar allurai. Don haka, misali, haɗarin myocarditis bayan kamuwa da cuta ya kamata a kwatanta shi da haɗarin haɗarin aƙalla allurai 1 da 2 na maganin mRNA.
Kwatankwacin haɗarin da ke da alaƙa da kamuwa da COVID-19 zuwa haɗarin guda ɗaya da ke da alaƙa da rigakafin COVID-19 bai kamata a iyakance shi ga kwanaki 28 kawai bayan kamuwa da cuta ko rigakafin ba. Idan rigakafin ya hana kamuwa da cuta kuma ba a buƙatar maimaita alurar riga kafi ba, to, iyakance kimanta haɗarin da ke da alaƙa da kamuwa da cuta tare da haɗarin guda ɗaya da ke da alaƙa da allurar rigakafi zuwa gajeriyar taga lokacin da sakamako mara kyau yakan faru kamar ma'ana.
Koyaya, a cikin dogon lokaci, rigakafin COVID-19 yana ba da kariya kaɗan ko babu kariya daga kamuwa da cuta. (Misali, duba Tebu na 4 na sa ido kan rigakafin COVID-19 na Hukumar Tsaro ta Lafiya ta Burtaniya Rahoton na 3 Nuwamba 2022.) Saboda haka, wani bincike na kasada tare da fa'idodin alurar riga kafi dole ne tantance har zuwa abin da alurar riga kafi zai rage yawan cututtuka da wani alurar riga kafi zai fuskanci da kuma yadda har, idan wani, allurar zai rage aukuwa da / ko tsanani m sakamakon da ke hade da cututtuka.
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Paul Bourdon shi ne Farfesa na Lissafi, Janar Faculty, Jami'ar Virginia (Mai Ritaya); Tsohon, Cincinnati Farfesa na Lissafi, Jami'ar Washington & Lee
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