關於 journal of infection disease ，我們在網路上蒐集到這些相關的討論、資訊與評價

這陣子許多網友私訊我，詢問13價肺炎鏈球菌是否能夠預防新冠肺炎？這個問題要分很多個層面來回答，但是首先有一個觀念要先釐清：

#重要_十三價肺炎鏈球菌不能直接預防新冠肺炎_他是預防肺炎鏈球菌造成的細菌感染

#重要_十三價肺炎鏈球菌不能直接預防新冠肺炎_他是預防肺炎鏈球菌造成的細菌感染

#重要_十三價肺炎鏈球菌不能直接預防新冠肺炎_他是預防肺炎鏈球菌造成的細菌感染


在還沒有打到新冠疫苗的狀況之下，世界衛生組織在2020年曾建議有三支疫苗可以考慮先施打，其中一支是13價肺炎鏈球菌結合型疫苗。另外兩支分別是：百日咳、流感疫苗。世界衛生組織的建議連結：https://apps.who.int/iris/rest/bitstreams/1275303/retrieve

主要原因是盡量避免呼吸道感染，也讓醫療資源不要被消耗掉。

今天先講主角：13價肺炎鏈球菌疫苗

其實從去年疫情剛爆發開始，國外一直陸續有報導研究說，新冠肺炎的重症病患裡面，有不少的比例會合併肺炎鏈球菌，會增加死亡率。

這件事情其實並不意外，因為流感、十幾年前的S A R S，都有不少的比例會合併肺炎鏈球菌，加重重症的發生率。

前陣子也有一篇美國柏克萊大學發表在journal of infectious disease 的研究顯示, 施打肺炎鏈球菌結合型疫苗，對於降低新冠病毒住院的死亡率有相關性。https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiab128/6164926

台大黃立民教授也提到這個觀點：
https://www.ettoday.net/amp/amp_news.php7?news_id=1985894&from=m.facebook.com

https://m.commonhealth.com.tw/article/82865

https://health.udn.com/health/story/7739/5470452

肺炎鏈球菌容易引起續發性細菌感染secondary bacterial infection , 如果萬一同時要面對兩個對手(SARS CoV-2 /鏈球菌)，疫苗至少先可以預防一個對手（肺炎鏈球菌）趁著機會入侵來攪局。當然有打新冠疫苗就更好。

所以如果短期間也沒辦法施打新冠疫苗，可以參照W H O的建議考慮去施打這一支疫苗。可以考慮請家中免疫力比較不足的長輩、或者自己若是有免疫力低下、氣喘、慢性肺部等疾病（您的醫師也評估過有需要的話），考慮施打。

#重申一次肺炎鏈球菌和新冠肺炎是不一樣的東西_施打肺炎鏈球菌無法預防新冠肺炎

大家都在引頸期盼剛到台灣的AZ 、moderna 、J&J疫苗，不要灰心，看到一點希望了。

徐嘉賢診所-黑眼圈奶爸Dr.徐嘉賢醫師
07 361 3338
https://goo.gl/maps/GvphRtRkpbMsbffg8

跟徐嘉賢醫師預約視訊看診：🎥
https://forms.gle/vvcunBPrN7Z37thW8

#左手打疫苗_右手按追蹤偶的instagram📸 ：http://www.instagram.com/drblackeye

#加入奶爸的line: https://line.me/R/ti/p/%40drblackeye

參考資料：

https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiab128/6164926

https://link.springer.com/article/10.1007/s10096-021-04166-w

https://www.elsevier.es/es-revista-medicina-clinica-2-avance-resumen-pneumococcal-superinfection-in-covid-19-patients-S0025775320303493

https://www.frontiersin.org/articles/10.3389/fimmu.2020.586984/full

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7521348/

https://www.biorxiv.org/content/10.1101/2021.05.03.441323v1

https://www.sciencedirect.com/science/article/pii/S2213716520301806

https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html

➥ 新冠肺炎全球大流行，重創全球經濟，隨著一些歐美國家和美國各州逐漸解封之際，第二波疫情有隨之升溫的趨勢；在決策當局權衡得失的同時須考慮以下四點...
More：http://forum.nhri.org.tw/covid19/virus/j_translate/j1417/

📋 (The New England Journal of Medicine - 2020-06-05) Waiting for Certainty on Covid-19 Antibody Tests — At What Cost?


➥ SARS-CoV-2感染肺部造成肺部發炎是COVID-19患者呼吸困難最常被提到的致病機轉，芬蘭赫爾辛基研究團隊在此文中提出另外的致病機轉，亦即SARS-CoV-2從鼻咽處經嗅神經及三叉神經路徑進入中樞神經造成神經病變，導致中樞自主神經系統失調，進而影響自主呼吸。支持此假說的觀察如下...
More：http://forum.nhri.org.tw/covid19/virus/j_translate/j1407/

📋( Taylor & Francis - Acta Oto-Laryngologica - 2020-06-28) Pathophysiology of the COVID-19 - Entry to the CNS Through the Nose


➥ 對腎臟移植接受者來說，COVID-19大流行無疑將帶來極大的風險，不僅因為這些患者長期處於免疫抑制的狀況，以致感染後出現發炎反應可能會造成器官受損，另外也由於過去多年的慢性腎臟疾病容易引起心血管的併發症而導致死亡率升高。本文是葡萄牙波多市Centro Hospitalar e Universitário的醫師報告5例在當地...
More：http://forum.nhri.org.tw/covid19/virus/j_translate/j1405/

📋( Wiley In Research - Transplant Infectious Disease - 2020-06-29) SARS-CoV-2 Infection in Kidney Transplant Recipients


〈 國家衛生研究院-論壇 〉
➥ COVID-19學術資源-轉譯文章 - 2020/07/30
衛生福利部
疾病管制署 - 1922防疫達人
疾病管制署

一同響應陳建仁副總統與中研院院士前輩們為中華民國、為台灣、為學術良知發聲：

陳副臉書全文連結：https://tinyurl.com/y5vmj8y3

林煜軒醫師整理的好讀易懂「圖文懶人包」 ：https://tinyurl.com/y3u5x5lp

這個議題，值得臺灣醫療界、科學界的你我，一起來關心！

━━━━

要求《The Lancet》立即更正錯誤，共同捍衛台灣主權與學術尊嚴

世界頂尖學術期刊《The Lancet》（刺胳針）於6月25日刊登一篇中國的醫學研究，由於該研究將台灣納為中國的一省，嚴重矮化台灣的國際地位，除引發數千網友在其臉書上留言抗議並要求更正外，衛福部也將正式行文給《The Lancet》抗議，說明「台灣是台灣、中國是中國」。

雖然《The Lancet》回應表示，這是根據聯合國（UN）和世界衛生組織（WHO）的方針，才將台灣列為中國一省，和其它的國際衛生分析沒有不同。但必須嚴正指出的是，除了政治上的錯誤之外，正因為台灣和中國為各自獨立的兩個不同國家，有各自獨立不同的行政、健保體系，在健保相關資料的完整性與正確性上，台灣與中國更是有許多差異，因此，這篇研究將不同方法所蒐集的健康資料放在同一個層級的模型來作研究，不但產生許多方法學上與研究結果的偏差，更已犯了學術研究的大忌，我們認為頂尖的《The Lancet》期刊不應該犯這樣的錯誤才對。

因此，我和中央研究院陳定信院士、廖運範院士、楊泮池院士等人，特別聯名致函《The Lancet》編輯部，要求該期刊立即更正錯誤，因為，這不只關係到台灣的主權尊嚴，更關係著國際學術研究的專業與倫理。

我也要在此呼籲所有關心這個事件的國人同胞，踴躍到 《The Lancet》的臉書粉絲專業表答您的意見，
https://www.facebook.com/374651963469/posts/10157661625328470/?substory_index=0

以下是致函《The Lancet》編輯部全文：

To the Editor:

We read the recent article by Zhou et al. comparing mortality, morbidity and risk factors in China and its provinces, 1990-2017. The authors used data from Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 to analyse health patterns in 34 province-level administrative units in China. This is a misleading and biased report due to the inclusion of Taiwan in the analyses.

The authors made an obvious flaw by including Taiwan in the study. The national health system, government system and administrative system are independent in Taiwan. The completeness and accuracy of national databases of health insurance, cancer registry, death certification, cancer screening and health surveillance in Taiwan is totally different from those of China. The health outcomes measured by different methods should not be included in the same hierarchical models. Taiwan has its own cancer and death registration system, and the information were not collected by the Chinese Center for Disease Control and Prevention as described wrongly in the article. The data source from the Global Health Data Exchange (http://ghdx.healthdata.org/countries) that the authors used in this paper also clearly showed Taiwan and China are two distinguished countries under the category of Eastern Asia.

Taiwan has an independent National Health Insurance system which covers more than 95% of 23 million people since 1995. Taiwan has also implemented a series of public health programs to reduce mortality and morbidity which are not implemented in China. For example, Taiwan is the first country in the world to implement universal newborn hepatitis B vaccination program since 1984 whereas China started in 1992. We reimbursed antiviral treatment for chronic viral hepatitis since 2003 and decreased liver disease burdens continuously. Taiwan started to reimburse direct antiviral agents for chronic hepatitis C patients with advance fibrosis since 2017 and for all chronic hepatitis C patients since 2019, and has committed to eliminating hepatitis C infection in 2025, 5 years earlier than the 2030 deadline set by WHO.

The inclusion of Taiwan in the analysis leads definitely to a significant bias of the findings of Zhou et al. In their similar publication in 2016 (Lancet 387:251-272), Taiwan was not included in the analyses. We would like to urge the authors to re-run the analyses and remove Taiwan from their analyses in order to yield unbiased estimates of mortality, morbidity and risk factors in China. Lancet, as an esteemed medical journal, has the reputation to publish accurate and precise research findings. Such a major categorization mistake in the methods section by Zhou et al. should be rectified.

Maggie Dai-Hua TSAI RIEDIKER
Mei-Hsuan LEE
Ding-Sing CHEN
Yun-Fan LIAW
Pan-Chyr YANG
Yi-Hao HUANG
Chien-Jen CHEN