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Patel MA, Daley M, Van Nynatten LR, Slessarev M, Cepinskas G, Fraser DD. A reduced proteomic signature in critically ill Covid-19 patients determined with plasma antibody micro-array and machine learning. Clin Proteomics 2024; 21:33. [PMID: 38760690 PMCID: PMC11100131 DOI: 10.1186/s12014-024-09488-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 05/06/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND COVID-19 is a complex, multi-system disease with varying severity and symptoms. Identifying changes in critically ill COVID-19 patients' proteomes enables a better understanding of markers associated with susceptibility, symptoms, and treatment. We performed plasma antibody microarray and machine learning analyses to identify novel proteins of COVID-19. METHODS A case-control study comparing the concentration of 2000 plasma proteins in age- and sex-matched COVID-19 inpatients, non-COVID-19 sepsis controls, and healthy control subjects. Machine learning was used to identify a unique proteome signature in COVID-19 patients. Protein expression was correlated with clinically relevant variables and analyzed for temporal changes over hospitalization days 1, 3, 7, and 10. Expert-curated protein expression information was analyzed with Natural language processing (NLP) to determine organ- and cell-specific expression. RESULTS Machine learning identified a 28-protein model that accurately differentiated COVID-19 patients from ICU non-COVID-19 patients (accuracy = 0.89, AUC = 1.00, F1 = 0.89) and healthy controls (accuracy = 0.89, AUC = 1.00, F1 = 0.88). An optimal nine-protein model (PF4V1, NUCB1, CrkL, SerpinD1, Fen1, GATA-4, ProSAAS, PARK7, and NET1) maintained high classification ability. Specific proteins correlated with hemoglobin, coagulation factors, hypertension, and high-flow nasal cannula intervention (P < 0.01). Time-course analysis of the 28 leading proteins demonstrated no significant temporal changes within the COVID-19 cohort. NLP analysis identified multi-system expression of the key proteins, with the digestive and nervous systems being the leading systems. CONCLUSIONS The plasma proteome of critically ill COVID-19 patients was distinguishable from that of non-COVID-19 sepsis controls and healthy control subjects. The leading 28 proteins and their subset of 9 proteins yielded accurate classification models and are expressed in multiple organ systems. The identified COVID-19 proteomic signature helps elucidate COVID-19 pathophysiology and may guide future COVID-19 treatment development.
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Affiliation(s)
- Maitray A Patel
- Epidemiology and Biostatistics, Western University, London, ON, N6A 3K7, Canada
| | - Mark Daley
- Epidemiology and Biostatistics, Western University, London, ON, N6A 3K7, Canada
- Computer Science, Western University, London, ON, N6A 3K7, Canada
| | | | - Marat Slessarev
- Medicine, Western University, London, ON, N6A 3K7, Canada
- Lawson Health Research Institute, London, ON, N6C 2R5, Canada
| | - Gediminas Cepinskas
- Lawson Health Research Institute, London, ON, N6C 2R5, Canada
- Medical Biophysics, Western University, London, ON, N6A 3K7, Canada
| | - Douglas D Fraser
- Lawson Health Research Institute, London, ON, N6C 2R5, Canada.
- Children's Health Research Institute, London, ON, N6C 4V3, Canada.
- Pediatrics, Western University, London, ON, N6A 3K7, Canada.
- Clinical Neurological Sciences, Western University, London, ON, N6A 3K7, Canada.
- Physiology & Pharmacology, Western University, London, ON, N6A 3K7, Canada.
- London Health Sciences Centre, 800 Commissioners Road East, London, ON, N6A 5W9, Canada.
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Majumder V, Choudhury C, Goswami B, Sengupta S, Bhattacharjee B. Severity of respiratory illness among Covid-19-vaccinated and non-vaccinated admitted patients-An observational study from a teaching hospital of Tripura. J Family Med Prim Care 2024; 13:2111-2115. [PMID: 38948609 PMCID: PMC11213422 DOI: 10.4103/jfmpc.jfmpc_1643_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 01/11/2024] [Accepted: 01/11/2024] [Indexed: 07/02/2024] Open
Abstract
Objective To determine the association between vaccination status and mortality among critically ill patients admitted in a dedicated Covid hospital of Tripura who required invasive mechanical ventilation. Material and Methods This study was conducted at a dedicated Covid hospital of Tripura for a period of six months, i.e., from June 2021 to November 2021. A total of 304 patients were enrolled for this study. Baseline epidemiological, radiological data along with other information like heart rate, pulse rate, oxygen saturation (SpO2), etc., were collected through patient record sheet in all cases during hospitalization. Statistical analysis was done by using SPSS 25 version. Results Admission and mortality rates in hospital and advanced oxygen support like bi-level positive airway pressure (BiPAP), high-flow nasal cannula (HFNOC), and ventilator use incidences were higher in non-vaccinated patients (17.1%) in comparison to double-dose-vaccinated (0.98%) and single-dose (2.3%)-vaccinated patients. Conclusion This retrospective data analysis of Covid-19 positive patients admitted in the dedicated Covid Hospital of Tripura suggests that severe infection, need for invasive and non-invasive ventilation, and death were significantly less in the vaccinated patients as compared to the vaccine-naive one.
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Affiliation(s)
- Vaskar Majumder
- Department of Anaesthesiology, AGMC and GBP Hospital, P. O. Kunjavan, Agartala, Tripura, India
| | - Chirasree Choudhury
- Department of Anaesthesiology, AGMC and GBP Hospital, P. O. Kunjavan, Agartala, Tripura, India
| | - Bidhan Goswami
- Department of Microbiology, Agartala Government Medical College, P. O. Kunjavan, Agartala, Tripura, India
| | - Shauli Sengupta
- Multidisciplinary Research Unit, Agartala Government Medical College, P. O. Kunjavan, Agartala, Tripura, India
| | - Bhaskar Bhattacharjee
- Multidisciplinary Research Unit, Agartala Government Medical College, P. O. Kunjavan, Agartala, Tripura, India
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Rebellón-Sánchez DE, Guzmán TM, Rodriguez S, Llanos-Torres J, Vinueza D, Tafurt E, Beltrán E, Martínez Á, Rosso F. Navigating the waves in Colombia: a cohort study of inpatient care during four COVID-19 waves. Braz J Infect Dis 2024; 28:103737. [PMID: 38484781 PMCID: PMC10955096 DOI: 10.1016/j.bjid.2024.103737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 02/14/2024] [Accepted: 02/22/2024] [Indexed: 03/17/2024] Open
Abstract
INTRODUCTION Understanding the intricate dynamics between different waves of the COVID-19 pandemic and the corresponding variations in clinical outcomes is essential for informed public health decision-making. Comprehensive insights into these fluctuations can guide resource allocation, healthcare policies, and the development of effective interventions. This study aimed to compare the characteristics and clinical outcomes of COVID-19 at peak transmission points by including all patients attended during the first four pandemic waves in a referral center in Colombia. MATERIAL AND METHODS In a prospective observational study of 2733 patients, clinical and demographic data were extracted from the Fundacion Valle de Lili's COVID-19 Registry, focusing on ICU admission, Invasive Mechanical Ventilation (IMV), length of hospital stay, and mortality. RESULTS Our analysis unveiled substantial shifts in patient care patterns. Notably, the proportion of patients receiving glucocorticoid therapy and experiencing secondary infections exhibited a pronounced decrease across waves (p < 0.001). Remarkably, there was a significant reduction in ICU admissions (62.83% vs. 51.23% vs. 58.23% vs. 46.70 %, p < 0.001), Invasive Mechanical Ventilation (IMV) usage (39.25% vs. 32.22% vs. 31.22% vs. 21.55 %, p < 0.001), and Length of Hospital Stay (LOS) (9 vs. 8 vs. 8 vs. 8 days, p < 0.001) over the successive waves. Surprisingly, hospital mortality remained stable at approximately 18‒20 % (p > 0.05). Notably, vaccination coverage with one or more doses surged from 0 % during the initial waves to 66.71 % in the fourth wave. CONCLUSIONS Our findings emphasize the critical importance of adapting healthcare strategies to the evolving dynamics of the pandemic. The reduction in ICU admissions, IMV utilization, and LOS, coupled with the rise in vaccination rates, underscores the adaptability of healthcare systems. Hospital mortality's persistence may warrant further exploration of treatment strategies. These insights can inform public health responses, helping policymakers allocate resources effectively and tailor interventions to specific phases of the pandemic.
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Affiliation(s)
| | - Tania M Guzmán
- Fundación Valle del Lili, Centro de Investigaciones Clínicas, Cali, Colombia
| | - Sarita Rodriguez
- Fundación Valle del Lili, Centro de Investigaciones Clínicas, Cali, Colombia
| | - Julio Llanos-Torres
- Fundación Valle del Lili, Centro de Investigaciones Clínicas, Cali, Colombia
| | - Daniela Vinueza
- Fundación Valle del Lili, Centro de Investigaciones Clínicas, Cali, Colombia
| | - Eric Tafurt
- Fundación Valle del Lili, Centro de Investigaciones Clínicas, Cali, Colombia; Universidad Icesi, Facultad de Ciencias de la Salud, Cali, Colombia
| | - Estefanía Beltrán
- Fundación Valle del Lili, Centro de Investigaciones Clínicas, Cali, Colombia
| | - Álvaro Martínez
- Fundación Valle del Lili, Centro de Investigaciones Clínicas, Cali, Colombia; Universidad Icesi, Facultad de Ciencias de la Salud, Cali, Colombia; Fundación Valle del Lili, Servicio de Enfermedades Infecciosas, Cali, Colombia
| | - Fernando Rosso
- Fundación Valle del Lili, Centro de Investigaciones Clínicas, Cali, Colombia; Universidad Icesi, Facultad de Ciencias de la Salud, Cali, Colombia; Fundación Valle del Lili, Servicio de Enfermedades Infecciosas, Cali, Colombia
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Elamin MY, Maslamani YA, Alsheikh FA, Sailah MA, Samm MA, Motanbk AM, Hejri YM, Alameer AA, Khalid OH, Dahlan AA, Gosadi IM. Impact of vaccination on morbidity and mortality in adults hospitalized with COVID-19 during the omicron wave in the Jazan Region, Saudi Arabia. Saudi Med J 2024; 45:179-187. [PMID: 38309738 PMCID: PMC11115406 DOI: 10.15537/smj.2024.45.2.20230530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 01/04/2024] [Indexed: 02/05/2024] Open
Abstract
OBJECTIVES To evaluate the impact of coronavirus disease-19 (COVID-19) vaccination on morbidity and mortality in adults hospitalized with COVID-19 during the omicron wave in the Jazan Region, Saudi Arabia. METHODS A 6-month record-based historical prospective study enrolled COVID-19 adult patients admitted between January and June 2022. Individuals were classified into 3 groups according to their immunity status (immunized, partially immunized, and not immunized). Death, intensive care unit (ICU) admission, and mechanical ventilation were identified as the primary outcomes, collectively referred to as "serious outcomes". On the other hand, the length of hospital stays longer than 5 days was categorized as a secondary outcome. Multiple logistic regression analysis was used to evaluate independent factors and the relationship between the outcomes and vaccination status. RESULTS Among the 634 COVID-19 patients admitted to Jazan hospitals, 46.4% were fully immunized, 19.7% were partially immunized, and 33.9% were not immunized. Not being immunized was significantly associated with ICU admission (odds ratio [OR]=1.91, 95% confidence interval [CI]: [1.17-3.11]; p=0.009), mechanical ventilation (OR=2.11, 95% CI: [1.25-3.56]; p=0.005), increased length of hospital stays (OR=1.79, 95% CI: [1.24-2.59]; p=0.002), and death (OR=3.03, 95% CI: [1.85-4.98]; p<0.001). CONCLUSION Our study underscores the importance of a comprehensive approach for managing COVID-19 patients that includes vaccination against the disease.
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Affiliation(s)
- Mohammed Y. Elamin
- From the Public Health Administration (Elamin, Maslamani, Alsheikh, Sailah, Hejri, Alameer, Khalid, Dahlan); from the Command and Control Center (Samm); from the Emergency Administration (Motanbk), Jazan Health Directorate, and from the Department of Family and Community Medicine (Gosadi), Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia.
| | - Yahya A. Maslamani
- From the Public Health Administration (Elamin, Maslamani, Alsheikh, Sailah, Hejri, Alameer, Khalid, Dahlan); from the Command and Control Center (Samm); from the Emergency Administration (Motanbk), Jazan Health Directorate, and from the Department of Family and Community Medicine (Gosadi), Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia.
| | - Feras A. Alsheikh
- From the Public Health Administration (Elamin, Maslamani, Alsheikh, Sailah, Hejri, Alameer, Khalid, Dahlan); from the Command and Control Center (Samm); from the Emergency Administration (Motanbk), Jazan Health Directorate, and from the Department of Family and Community Medicine (Gosadi), Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia.
| | - Mohsen A. Sailah
- From the Public Health Administration (Elamin, Maslamani, Alsheikh, Sailah, Hejri, Alameer, Khalid, Dahlan); from the Command and Control Center (Samm); from the Emergency Administration (Motanbk), Jazan Health Directorate, and from the Department of Family and Community Medicine (Gosadi), Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia.
| | - Mussab A. Samm
- From the Public Health Administration (Elamin, Maslamani, Alsheikh, Sailah, Hejri, Alameer, Khalid, Dahlan); from the Command and Control Center (Samm); from the Emergency Administration (Motanbk), Jazan Health Directorate, and from the Department of Family and Community Medicine (Gosadi), Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia.
| | - Ahmed M. Motanbk
- From the Public Health Administration (Elamin, Maslamani, Alsheikh, Sailah, Hejri, Alameer, Khalid, Dahlan); from the Command and Control Center (Samm); from the Emergency Administration (Motanbk), Jazan Health Directorate, and from the Department of Family and Community Medicine (Gosadi), Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia.
| | - Yehya M. Hejri
- From the Public Health Administration (Elamin, Maslamani, Alsheikh, Sailah, Hejri, Alameer, Khalid, Dahlan); from the Command and Control Center (Samm); from the Emergency Administration (Motanbk), Jazan Health Directorate, and from the Department of Family and Community Medicine (Gosadi), Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia.
| | - Anwar A. Alameer
- From the Public Health Administration (Elamin, Maslamani, Alsheikh, Sailah, Hejri, Alameer, Khalid, Dahlan); from the Command and Control Center (Samm); from the Emergency Administration (Motanbk), Jazan Health Directorate, and from the Department of Family and Community Medicine (Gosadi), Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia.
| | - Osama H. Khalid
- From the Public Health Administration (Elamin, Maslamani, Alsheikh, Sailah, Hejri, Alameer, Khalid, Dahlan); from the Command and Control Center (Samm); from the Emergency Administration (Motanbk), Jazan Health Directorate, and from the Department of Family and Community Medicine (Gosadi), Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia.
| | - Abdu A. Dahlan
- From the Public Health Administration (Elamin, Maslamani, Alsheikh, Sailah, Hejri, Alameer, Khalid, Dahlan); from the Command and Control Center (Samm); from the Emergency Administration (Motanbk), Jazan Health Directorate, and from the Department of Family and Community Medicine (Gosadi), Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia.
| | - Ibrahim M. Gosadi
- From the Public Health Administration (Elamin, Maslamani, Alsheikh, Sailah, Hejri, Alameer, Khalid, Dahlan); from the Command and Control Center (Samm); from the Emergency Administration (Motanbk), Jazan Health Directorate, and from the Department of Family and Community Medicine (Gosadi), Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia.
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Yıldırım S, Erkoyun E, Alpdoğan Ö, Yılmaz HO, Yılmaz B, Erdal Dönmez G, Sarıtaş A, Gökmen N, Ergan B, Bayrak V, Yakar MN, Kılıç Ö, Kılınç A, Saygılı S, Gaygısız Ü, Aydın K, Özel Yeşilyurt A, Cankar Dal H, Bayındır Dicle Ç, Turan S, Binay S, Yarıcı M, Yıldırım F, Hancı P, İnal MT, Akbaş T, Eyüpoğlu S, Albayrak T, Koçak G, Çakır T, Yüksel RC, Sarı A, Güneş M, Menteş O, Yamanel HL, Kirakli C. Vaccination status of COVID-19 patients followed up in the ICU in a country with heterologous vaccination policy: A multicenter national study in Turkey. J Infect Chemother 2023; 29:959-964. [PMID: 37343924 PMCID: PMC10278896 DOI: 10.1016/j.jiac.2023.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/07/2023] [Accepted: 06/18/2023] [Indexed: 06/23/2023]
Abstract
OBJECTIVE Vaccination against severe acute respiratory syndrome coronavirus-2 (SARS-2) prevents the development of serious diseases has been shown in many studies. However, the effect of vaccination on outcomes in COVID-19 patients requiring intensive care is not clear. METHODS This is a retrospective multicenter study conducted in 17 intensive care unit (ICU) in Turkey between January 1, 2021, and December 31, 2021. Patients aged 18 years and older who were diagnosed with COVID-19 and followed in ICU were included in the study. Patients who have never been vaccinated and patients who have been vaccinated with a single dose were considered unvaccinated. Logistic regression models were fit for the two outcomes (28-day mortality and in-hospital mortality). RESULTS A total of 2968 patients were included final analysis. The most of patients followed in the ICU during the study period were unvaccinated (58.5%). Vaccinated patients were older, had higher Charlson comorbidity index (CCI), and had higher APACHE-2 scores than unvaccinated patients. Risk for 28-day mortality and in-hospital mortality was similar in across the year both vaccinated and unvaccinated patients. However, risk for in-hospital mortality and 28-day mortality was higher in the unvaccinated patients in quarter 4 adjusted for gender and CCI (OR: 1.45, 95% CI: 1.06-1.99 and OR: 1.42, 95% CI: 1.03-1.96, respectively) compared to the vaccinated group. CONCLUSION Despite effective vaccination, fully vaccinated patients may be admitted to ICU because of disease severity. Unvaccinated patients were younger and had fewer comorbid conditions. Unvaccinated patients have an increased risk of 28-day mortality when adjusted for gender and CCI.
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Affiliation(s)
- Süleyman Yıldırım
- University of Health Sciences Turkey, Dr. Suat Seren Chest Disease and Surgery Training and Research Hospital, Intensive Care Unit, İzmir, Turkey.
| | | | - Özcan Alpdoğan
- University of Health Sciences, İzmir Tepecik Training and Research Hospital, Intensive Care Unit, İzmir, Turkey
| | | | - Barış Yılmaz
- University of Health Sciences, Istanbul Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Gül Erdal Dönmez
- University of Health Sciences, Istanbul Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey
| | - Aykut Sarıtaş
- University of Health Sciences, İzmir Tepecik Training and Research Hospital, Intensive Care Unit, İzmir, Turkey
| | - Necati Gökmen
- Dokuz Eylül University, Faculty of Medicine, Department of Anesthesiology and Reanimation, Division of Intensive Care, İzmir, Turkey
| | - Begüm Ergan
- Dokuz Eylül University, Faculty of Medicine, Department of Chest Disease, Division of Intensive Care, İzmir, Turkey
| | - Vecihe Bayrak
- Dokuz Eylül University, Faculty of Medicine, Department of Anesthesiology and Reanimation, Division of Intensive Care, İzmir, Turkey
| | - Mehmet Nuri Yakar
- Dokuz Eylül University, Faculty of Medicine, Department of Anesthesiology and Reanimation, Division of Intensive Care, İzmir, Turkey
| | - Özgür Kılıç
- On Dokuz Mayıs University, Faculty of Medicine, Department of Internal Medicine, Division of Intensive Care, Samsun, Turkey
| | - Ahmet Kılınç
- On Dokuz Mayıs University, Faculty of Medicine, Department of Internal Medicine, Division of Intensive Care, Samsun, Turkey
| | - Saba Saygılı
- University of Health Sciences Turkey, Dr. Suat Seren Chest Disease and Surgery Training and Research Hospital, Intensive Care Unit, İzmir, Turkey
| | - Ümmügülsüm Gaygısız
- Gazi University, Faculty of Medicine, Department of Anesthesiology and Reanimation, Division of Intensive Care, Ankara, Turkey
| | - Kaniye Aydın
- Çukurova University, Faculty of Medicine, Department of Internal Medicine, Division of Intensive Care Medicine, Adana, Turkey
| | - Aysun Özel Yeşilyurt
- Çukurova University, Faculty of Medicine, Department of Internal Medicine, Division of Intensive Care Medicine, Adana, Turkey
| | - Hayriye Cankar Dal
- University of Health Sciences, Ankara City Hospital, Intensive Care Unit, Ankara, Turkey
| | - Çilem Bayındır Dicle
- University of Health Sciences, Ankara City Hospital, Intensive Care Unit, Ankara, Turkey
| | - Sema Turan
- University of Health Sciences, Ankara City Hospital, Intensive Care Unit, Ankara, Turkey
| | - Songül Binay
- University of Health Sciences, Ankara Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital, Intensive Care Unit, Ankara, Turkey
| | - Metin Yarıcı
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of General Surgery, Intensive Care Unit, Ankara, Turkey
| | - Fatma Yıldırım
- University of Health Sciences, Dışkapı Yıldırım Beyazıt Research and Education Hospital, Department of Chest Diseases, Pulmonary Intensive Care Unit, Ankara, Turkey
| | - Pervin Hancı
- Trakya University Faculty of Medicine, Department of Pulmonology, Division of Intensive Care, Edirne, Turkey
| | - Mehmet Turan İnal
- Trakya University Faculty of Medicine, Department of Pulmonology, Division of Intensive Care, Edirne, Turkey
| | - Türkay Akbaş
- Düzce University, Faculty of Medicine, Department of Internal Medicine, Division of Intensive Care, Düzce, Turkey
| | - Selin Eyüpoğlu
- Giresun Training and Research Hospital, Intensive Care Unit, Giresun, Turkey
| | - Tuna Albayrak
- Giresun University, Giresun Training and Research Hospital, Department of Anesthesiology and Reanimation, Giresun, Turkey
| | - Gamze Koçak
- Mersin City Hospital, Intensive Care Unit, Mersin, Turkey
| | - Tümay Çakır
- Muğla Training and Research Hospital, Intensive Care Unit, Muğla, Turkey
| | - Recep Civan Yüksel
- Ministry of Health, Kayseri City Hospital, Intensive Care Unit, Kayseri, Turkey
| | - Ali Sarı
- Gaziantep Abdulkadir Yüksel State Hospital, Intensive Care Unit, Gaziantep, Turkey
| | - Murat Güneş
- Gümüşhane State Hospital, Intensive Care Unit, Gümüşhane, Turkey
| | - Oral Menteş
- Gülhane Training and Research Hospital, Intensive Care Unit, Ankara, Turkey
| | - H Levent Yamanel
- Gülhane Training and Research Hospital, Intensive Care Unit, Ankara, Turkey
| | - Cenk Kirakli
- University of Health Sciences Turkey, Dr. Suat Seren Chest Disease and Surgery Training and Research Hospital, Intensive Care Unit, İzmir, Turkey
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Chiumello D, Tavelli A, Serio L, De Benedittis S, Pozzi T, Maj R, Velati M, Brusatori S, D'Albo R, Zinnato C, Marchetti G, Camporota L, Coppola S, D'Arminio Monforte A. Differences in clinical characteristics and quantitative lung CT features between vaccinated and not vaccinated hospitalized COVID-19 patients in Italy. Ann Intensive Care 2023; 13:24. [PMID: 37010706 PMCID: PMC10068232 DOI: 10.1186/s13613-023-01103-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 01/27/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND To evaluate the differences in the clinical characteristics and severity of lung impairment, assessed by quantitative lung CT scan, between vaccinated and non-vaccinated hospitalized patients with COVID-19; and to identify the variables with best prognostic prediction according to SARS-CoV-2 vaccination status. We recorded clinical, laboratory and quantitative lung CT scan data in 684 consecutive patients [580 (84.8%) vaccinated, and 104 (15.2%) non-vaccinated], admitted between January and December 2021. RESULTS Vaccinated patients were significantly older 78 [69-84] vs 67 [53-79] years and with more comorbidities. Vaccinated and non-vaccinated patients had similar PaO2/FiO2 (300 [252-342] vs 307 [247-357] mmHg; respiratory rate 22 [8-26] vs 19 [18-26] bpm); total lung weight (918 [780-1069] vs 954 [802-1149] g), lung gas volume (2579 [1801-3628] vs 2370 [1675-3289] mL) and non-aerated tissue fraction (10 [7.3-16.0] vs 8.5 [6.0-14.1] %). The overall crude hospital mortality was similar between the vaccinated and non-vaccinated group (23.1% vs 21.2%). However, Cox regression analysis, adjusted for age, ethnicity, age unadjusted Charlson Comorbidity Index and calendar month of admission, showed a 40% reduction in hospital mortality in the vaccinated patients (HRadj = 0.60, 95%CI 0.38-0.95). CONCLUSIONS Hospitalized vaccinated patients with COVID-19, although older and with more comorbidities, presented a similar impairment in gas exchange and lung CT scan compared to non-vaccinated patients, but were at a lower risk of mortality.
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Affiliation(s)
- Davide Chiumello
- Department of Anesthesia and Intensive Care, ASST Santi Paolo e Carlo, San Paolo University Hospital, Via Di Rudini 9, Milan, Italy.
- Department of Health Sciences, University of Milan, Milan, Italy.
- Coordinated Research Center on Respiratory Failure, University of Milan, Milan, Italy.
| | - Alessandro Tavelli
- Infectious Diseases Unit, Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo University Hospital, Milan, Italy
| | - Lorenzo Serio
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Sara De Benedittis
- Infectious Diseases Unit, Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo University Hospital, Milan, Italy
| | - Tommaso Pozzi
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Roberta Maj
- Department of Anesthesiology, Medical University of Göttingen, University Medical Center Göttingen, Göttingen, Germany
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Mara Velati
- Department of Anesthesiology, Medical University of Göttingen, University Medical Center Göttingen, Göttingen, Germany
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Serena Brusatori
- Department of Anesthesiology, Medical University of Göttingen, University Medical Center Göttingen, Göttingen, Germany
| | - Rosanna D'Albo
- Department of Anesthesiology, Medical University of Göttingen, University Medical Center Göttingen, Göttingen, Germany
| | - Carmelo Zinnato
- Department of Anesthesiology, Medical University of Göttingen, University Medical Center Göttingen, Göttingen, Germany
| | - Giulia Marchetti
- Department of Health Sciences, University of Milan, Milan, Italy
- Infectious Diseases Unit, Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo University Hospital, Milan, Italy
| | - Luigi Camporota
- Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, London, SE1 7EH, UK
| | - Silvia Coppola
- Department of Anesthesia and Intensive Care, ASST Santi Paolo e Carlo, San Paolo University Hospital, Via Di Rudini 9, Milan, Italy
| | - Antonella D'Arminio Monforte
- Department of Health Sciences, University of Milan, Milan, Italy
- Infectious Diseases Unit, Department of Health Sciences, ASST Santi Paolo e Carlo, San Paolo University Hospital, Milan, Italy
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The COVID-19 Vaccination Coverage in ICU Patients with Severe COVID-19 Infection in a Country with Low Vaccination Coverage-A National Retrospective Analysis. J Clin Med 2023; 12:jcm12051749. [PMID: 36902535 PMCID: PMC10003614 DOI: 10.3390/jcm12051749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/18/2023] [Accepted: 02/20/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Romania is one of the European countries with low COVID-19 vaccination coverage. The main goal of this study was to describe the COVID-19 vaccination status in patients admitted to Romanian ICUs with a severe COVID-19 infection. The study describes the patients' characteristics according to their vaccination status and evaluates the association between vaccination status and ICU mortality. METHODS This retrospective, observational, multicenter study included patients with confirmed vaccination status admitted to Romanian ICUs from January 2021 to March 2022. RESULTS Two thousand, two hundred and twenty-two patients with confirmed vaccination status were included. Five point one three percent of patients were vaccinated with two vaccine doses and one point seventeen percent of patients were vaccinated with one vaccine dose. The vaccinated patients showed a higher rate of comorbidities but had similar clinical characteristics at ICU admission and lower mortality rates compared to non-vaccinated patients. Vaccinated status and higher Glasgow Coma Scale at ICU admission were independently associated with ICU survival. Ischemic heart disease, chronic kidney disease, higher SOFA score at ICU admission and the need for mechanical ventilation in ICU were independently associated with ICU mortality. CONCLUSION Lower rates of ICU admission were observed in fully vaccinated patients even in a country with low vaccination coverage. The ICU mortality was lower for fully vaccinated patients compared to non-vaccinated patients. The benefit of vaccination on ICU survival could be more important in patients with associated comorbidities.
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Parra-Bracamonte G, Lopez-Villalobos N, Velazquez M, Parra-Bracamonte F, Perales-Torres A, Juárez Rendón K. Comparative analysis of risk factors for COVID-19 mortality before, during and after the vaccination programme in Mexico. Public Health 2023; 215:94-99. [PMID: 36652788 PMCID: PMC9767886 DOI: 10.1016/j.puhe.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 11/18/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The purpose of this study was to compare case fatality rates (CFRs) and odds for mortality by risk factors of patients with COVID-19 in Mexico, before, during and after the implementation of the national COVID-19 vaccination programme. STUDY DESIGN A large database including COVID-19 monitoring cases was used to perform an observational retrospective study. METHODS The Chi-squared test and multivariate logistic regression analyses were applied to data from COVID-19-positive patients in Mexico. Data were analysed over 3 years, 2020, 2021 and 2022, corresponding with pre-, during and post-vaccination periods. The unadjusted odds ratios and 95% confidence interval were used to estimate the risk factors for COVID-19 mortality in each of the years. RESULTS Statistically significant differences in CFR and odds ratio were found in the studied years, favouring postvaccination period. Significant changes in CFR by age, sex and main comorbidities indicated changes in the epidemic dynamics after the implementation of the COVID-19 vaccination campaign. The likelihood of death increased for hospitalised cases and for patients who were middle-aged or older in 2021 and 2022, whereas the odds of death associated with sex and comorbidities remained similar or reduced over the 3 years. CONCLUSIONS Implementation of the COVID-19 vaccination programme during 2021 showed positive consequences on CFR. The increased odds of dying in hospitalised patients are likely to be due to the unvaccinated proportion of patients.
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Affiliation(s)
- G.M. Parra-Bracamonte
- Centro de Biotecnología Genómica-Instituto Politécnico Nacional, Reynosa, 87710, Mexico,Corresponding author. Centro de Biotecnología Genómica-IPN, Blvd. del Maestro SN, Esq. Elías Piña, Col. Narciso Mendoza, Reynosa, C.P. 88710, Tamaulipas, Mexico. Tel.: +52 8999243627x87709
| | - N. Lopez-Villalobos
- School of Agriculture and Environment, Massey University, Palmerston North, 4442, New Zealand
| | - M.A. Velazquez
- School of Natural & Environmental Sciences, Newcastle University, Newcastle Upon Tyne, NE1 7RU, United Kingdom
| | | | - A.L. Perales-Torres
- Unidad Académica Reynosa-Aztlán, Universidad Autónoma de Tamaulipas, Reynosa, 88710, Mexico
| | - K.J. Juárez Rendón
- Centro de Biotecnología Genómica-Instituto Politécnico Nacional, Reynosa, 87710, Mexico
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9
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Grasselli G, Zanella A, Carlesso E, Florio G, Canakoglu A, Bellani G, Bottino N, Cabrini L, Castelli GP, Catena E, Cecconi M, Cereda D, Chiumello D, Forastieri A, Foti G, Gemma M, Giudici R, Grazioli L, Lombardo A, Lorini FL, Madotto F, Mantovani A, Mistraletti G, Mojoli F, Mongodi S, Monti G, Muttini S, Piva S, Protti A, Rasulo F, Scandroglio AM, Severgnini P, Storti E, Fumagalli R, Pesenti A. Association of COVID-19 Vaccinations With Intensive Care Unit Admissions and Outcome of Critically Ill Patients With COVID-19 Pneumonia in Lombardy, Italy. JAMA Netw Open 2022; 5:e2238871. [PMID: 36301541 PMCID: PMC9614574 DOI: 10.1001/jamanetworkopen.2022.38871] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 09/08/2022] [Indexed: 11/14/2022] Open
Abstract
Importance Data on the association of COVID-19 vaccination with intensive care unit (ICU) admission and outcomes of patients with SARS-CoV-2-related pneumonia are scarce. Objective To evaluate whether COVID-19 vaccination is associated with preventing ICU admission for COVID-19 pneumonia and to compare baseline characteristics and outcomes of vaccinated and unvaccinated patients admitted to an ICU. Design, Setting, and Participants This retrospective cohort study on regional data sets reports: (1) daily number of administered vaccines and (2) data of all consecutive patients admitted to an ICU in Lombardy, Italy, from August 1 to December 15, 2021 (Delta variant predominant). Vaccinated patients received either mRNA vaccines (BNT162b2 or mRNA-1273) or adenoviral vector vaccines (ChAdOx1-S or Ad26.COV2). Incident rate ratios (IRRs) were computed from August 1, 2021, to January 31, 2022; ICU and baseline characteristics and outcomes of vaccinated and unvaccinated patients admitted to an ICU were analyzed from August 1 to December 15, 2021. Exposures COVID-19 vaccination status (no vaccination, mRNA vaccine, adenoviral vector vaccine). Main Outcomes and Measures The incidence IRR of ICU admission was evaluated, comparing vaccinated people with unvaccinated, adjusted for age and sex. The baseline characteristics at ICU admission of vaccinated and unvaccinated patients were investigated. The association between vaccination status at ICU admission and mortality at ICU and hospital discharge were also studied, adjusting for possible confounders. Results Among the 10 107 674 inhabitants of Lombardy, Italy, at the time of this study, the median [IQR] age was 48 [28-64] years and 5 154 914 (51.0%) were female. Of the 7 863 417 individuals who were vaccinated (median [IQR] age: 53 [33-68] years; 4 010 343 [51.4%] female), 6 251 417 (79.5%) received an mRNA vaccine, 550 439 (7.0%) received an adenoviral vector vaccine, and 1 061 561 (13.5%) received a mix of vaccines and 4 497 875 (57.2%) were boosted. Compared with unvaccinated people, IRR of individuals who received an mRNA vaccine within 120 days from the last dose was 0.03 (95% CI, 0.03-0.04; P < .001), whereas IRR of individuals who received an adenoviral vector vaccine after 120 days was 0.21 (95% CI, 0.19-0.24; P < .001). There were 553 patients admitted to an ICU for COVID-19 pneumonia during the study period: 139 patients (25.1%) were vaccinated and 414 (74.9%) were unvaccinated. Compared with unvaccinated patients, vaccinated patients were older (median [IQR]: 72 [66-76] vs 60 [51-69] years; P < .001), primarily male individuals (110 patients [79.1%] vs 252 patients [60.9%]; P < .001), with more comorbidities (median [IQR]: 2 [1-3] vs 0 [0-1] comorbidities; P < .001) and had higher ratio of arterial partial pressure of oxygen (Pao2) and fraction of inspiratory oxygen (FiO2) at ICU admission (median [IQR]: 138 [100-180] vs 120 [90-158] mm Hg; P = .007). Factors associated with ICU and hospital mortality were higher age, premorbid heart disease, lower Pao2/FiO2 at ICU admission, and female sex (this factor only for ICU mortality). ICU and hospital mortality were similar between vaccinated and unvaccinated patients. Conclusions and Relevance In this cohort study, mRNA and adenoviral vector vaccines were associated with significantly lower risk of ICU admission for COVID-19 pneumonia. ICU and hospital mortality were not associated with vaccinated status. These findings suggest a substantial reduction of the risk of developing COVID-19-related severe acute respiratory failure requiring ICU admission among vaccinated people.
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Affiliation(s)
- Giacomo Grasselli
- Dipartimento di Anestesia, Rianimazione ed Emergenza-Urgenza, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Alberto Zanella
- Dipartimento di Anestesia, Rianimazione ed Emergenza-Urgenza, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Eleonora Carlesso
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Gaetano Florio
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Arif Canakoglu
- Dipartimento di Anestesia, Rianimazione ed Emergenza-Urgenza, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giacomo Bellani
- Department of Anesthesia and Intensive Care Medicine, ASST Monza Ospedale San Gerardo, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Nicola Bottino
- Dipartimento di Anestesia, Rianimazione ed Emergenza-Urgenza, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Luca Cabrini
- Azienda Ospedaliera Ospedale di Circolo e Fondazione Macchi, Varese, Italy
- Università degli Studi dell'Insubria, Varese, Italy
| | - Gian Paolo Castelli
- Dipartimento di Anestesia e Rianimazione, ASST Mantova Ospedale Carlo Poma, Mantova Italy
| | - Emanuele Catena
- Department of Anesthesiology and Intensive Care, ASST Fatebenefratelli Sacco Luigi Sacco Hospital, Polo Universitario, Milan, Italy
| | - Maurizio Cecconi
- Department of Anaesthesia and Intensive Care Medicine, IRCCS Humanitas Clinical and Research Centre, Rozzano, Italy
- Humanitas University, Pieve Emanuele, Italy
| | - Danilo Cereda
- Directorate General for Health, Lombardy Region, Milano, Italy
| | - Davide Chiumello
- Department of Anesthesia and Intensive Care, San Paolo Hospital, Milano, Italy
- Department of Health Sciences, University of Milan, Milano, Italy
| | - Andrea Forastieri
- Dipartimento di Anestesia e Rianimazione ASST Lecco Ospedale di Lecco, Lecco, Italy
| | - Giuseppe Foti
- Department of Anesthesia and Intensive Care Medicine, ASST Monza Ospedale San Gerardo, Monza, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Marco Gemma
- Terapia Intensiva–Neuroanestesia e Rianimazione. Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Riccardo Giudici
- Dipartimento di Anestesia e Rianimazione, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Lorenzo Grazioli
- Department of Anaesthesia and Intensive Care, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Andrea Lombardo
- Dipartimento Di Emergenza, Rianimazione, Anestesia–UO Anestesia e Rianimazione 2–ASST Lariana Ospedale Sant'Anna, Como, Italy
| | | | - Fabiana Madotto
- Dipartimento di Anestesia, Rianimazione ed Emergenza-Urgenza, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Giovanni Mistraletti
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Department of Anesthesia and critical care, ASST Ovest Milanese Ospedale Nuovo di Legnano, Legnano, Italy
| | - Francesco Mojoli
- Anestesia e Rianimazione 1, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Dipartimento di Scienze Clinico-Chirurgiche Diagnostiche e Pediatriche, Università degli Studi di Pavia, Pavia, Italy
| | - Silvia Mongodi
- Anestesia e Rianimazione 1, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Gianpaola Monti
- Dipartimento di Anestesia e Rianimazione, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Stefano Muttini
- SC Anestesia e Rianimazione II, Ospedale San Carlo Borromeo, ASST Santi Paolo e Carlo–Polo Universitario, Milano, Italy
| | - Simone Piva
- Department of Anesthesia, Critical Care and Emergency, Spedali Civili University Hospital, Brescia, Italy
| | - Alessandro Protti
- Department of Anaesthesia and Intensive Care Medicine, IRCCS Humanitas Clinical and Research Centre, Rozzano, Italy
- Humanitas University, Pieve Emanuele, Italy
| | - Frank Rasulo
- Department of Anesthesia, Critical Care and Emergency, Spedali Civili University Hospital, Brescia, Italy
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Anna Mara Scandroglio
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milano, Italy
| | - Paolo Severgnini
- Azienda Ospedaliera Ospedale di Circolo e Fondazione Macchi, Varese, Italy
- Università degli Studi dell'Insubria, Varese, Italy
| | - Enrico Storti
- Dipartimento di Anestesia e Rianimazione ASST Cremona Ospedale di Cremona, Cremona, Italy
| | - Roberto Fumagalli
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Dipartimento di Anestesia e Rianimazione, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Antonio Pesenti
- Dipartimento di Anestesia, Rianimazione ed Emergenza-Urgenza, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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10
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AlKhafaji DM, Al Argan RJ, AlBahrani S, Alwaheed AJ, Alqatari SG, Al Elq AH, Albaker W, Alwazzeh M, AlSulaiman AS, AlSulaiman RS, Almadan HM, Alhammad AA, Almajid AN, Hakami FH, Alanazi WK. The Impact of Vaccination Against SARS-CoV-2 Virus on the Outcome of COVID-19 Disease. Infect Drug Resist 2022; 15:3477-3489. [PMID: 35813086 PMCID: PMC9259051 DOI: 10.2147/idr.s365179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 06/09/2022] [Indexed: 01/08/2023] Open
Affiliation(s)
- Dania M AlKhafaji
- Department of Internal Medicine, College of Medicine-Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Reem J Al Argan
- Department of Internal Medicine, College of Medicine-Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Salma AlBahrani
- Department of Internal Medicine, King Fahad Military Medical Complex, Dhahran, Eastern Province, Saudi Arabia
| | - Abrar J Alwaheed
- Department of Internal Medicine, College of Medicine-Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Safi G Alqatari
- Department of Internal Medicine, College of Medicine-Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Abdulmohsen H Al Elq
- Department of Internal Medicine, College of Medicine-Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Waleed Albaker
- Department of Internal Medicine, College of Medicine-Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Marwan Alwazzeh
- Department of Internal Medicine, College of Medicine-Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Amal S AlSulaiman
- Department of Internal Medicine, College of Medicine-Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Reem S AlSulaiman
- Department of Internal Medicine, College of Medicine-Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
- Correspondence: Reem S AlSulaiman, King Fahad University Hospital, Shura Street, Al Aqrabiyah, Al Khobar, 34445, Saudi Arabia, Tel +966 533229610, Email
| | - Hussain M Almadan
- Department of Internal Medicine, College of Medicine-Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Ali A Alhammad
- Department of Internal Medicine, College of Medicine-Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Ali N Almajid
- Department of Internal Medicine, College of Medicine-Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Fatimah H Hakami
- Department of Internal Medicine, King Fahad Military Medical Complex, Dhahran, Eastern Province, Saudi Arabia
| | - Wafa K Alanazi
- Department of Internal Medicine, King Fahad Military Medical Complex, Dhahran, Eastern Province, Saudi Arabia
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11
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Teran-Tinedo JR, Gonzalez-Rubio J, Najera A, Castany-Faro A, Contreras MDLN, Garcia IM, Lopez-Mellado L, Lorente-Gonzalez M, Perez-Garvin P, Sacristan-Crespo G, Suarez-Ortiz M, Navarro-Lopez JD, Jimenez-Diaz L, Landete P. Clinical characteristics and respiratory care in hospitalized vaccinated SARS-CoV-2 patients. EClinicalMedicine 2022; 48:101453. [PMID: 35611064 PMCID: PMC9121909 DOI: 10.1016/j.eclinm.2022.101453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The main objective of the present study was to analyze both clinical characteristics and evolution during hospitalization of a cohort of patients admitted for COVID-19 pneumonia who were not vaccinated, or with a complete or incomplete vaccination schedule. METHODS This COVID-19 specialized single-center cohort study of 1888 COVID-19 patients hospitalized at the "Enfermera Isabel Zendal" Emergencies Hospital (HEEIZ), Madrid (Spain) was performed between July 1 and September 30, 2021. It compared the results of 1327 hospitalized unvaccinated patients to 209 hospitalized fully vaccinated and 352 hospitalized partially vaccinated patients. The four different COVID-19 vaccines authorized in Spain during the time-period studied were: BNT162b2 (Pfizer); ChAdOx1 nCoV-19 (AstraZeneca), mRNA-1273 (Moderna); Ad26.COV2.S (Janssen). FINDINGS Hospitalized patients' median age was 41 years (IQR 33-50) for the unvaccinated and 61 years (IQR 53-67) for the fully vaccinated ones. The main comorbidities were obesity, hypertension and diabetes mellitus. 20% of unvaccinated patients (266) required noninvasive respiratory care, as did 14% (51) of partially and 14% (30) of fully vaccinated; 6% (78) of the unvaccinated patients also needed invasive respiratory care, as did 5% (16) of partially and 11 (5%) fully vaccinated. INTERPRETATION Fully vaccinated patients were 84% (95% CI: 82-86%) less likely to be admitted to hospital, and protection rose for those aged <50 years. Once hospitalized, vaccinated patients displayed more protection against requiring respiratory care than unvaccinated ones, despite being older and having more comorbidities. No differences appeared for the four studied COVID-19 vaccines and complying with vaccination recommendations proved relevant. FUNDING The research was funded by the "Plan Propio de Investigación" Program of the Castilla-La Mancha University /European Regional Development Fund (2021-GRIN-31,039).
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Affiliation(s)
- Jose Rafael Teran-Tinedo
- Respiratory intermediate Care Unit, “Enfermera Isabel Zendal” Emergency Hospital, Madrid, Spain
- Pneumology Service, General Universitary Hospital “Gregorio Marañón”, Madrid, Spain
- Universidad Complutense de Madrid, Madrid, Spain
| | - Jesus Gonzalez-Rubio
- University of Castilla-La Mancha, NeuroPhysiology & Behavior Lab, Centre for Regional Biomedical Reserch (CRIB), Faculty of Medicine of Albacete, Spain
| | - Alberto Najera
- University of Castilla-La Mancha, NeuroPhysiology & Behavior Lab, Centre for Regional Biomedical Reserch (CRIB), Faculty of Medicine of Albacete, Spain
- Corresponding author at: Department of Medical Sciences, Faculty of Medicine of Albacete, University of Castilla-La Mancha, Albacete, Spain.
| | - Andrea Castany-Faro
- Admission Service, “Enfermera Isabel Zendal” Emergency Hospital, Madrid, Spain
| | | | - Isabel Maria Garcia
- Nursering Management, “Enfermera Isabel Zendal” Emergency Hospital, Madrid, Spain
- Pneumology Service. Hospital Universitario "La Paz", Madrid, Spain
| | | | - Miguel Lorente-Gonzalez
- Respiratory intermediate Care Unit, “Enfermera Isabel Zendal” Emergency Hospital, Madrid, Spain
| | | | | | - Miguel Suarez-Ortiz
- Respiratory intermediate Care Unit, “Enfermera Isabel Zendal” Emergency Hospital, Madrid, Spain
| | - Juan D Navarro-Lopez
- University of Castilla-La Mancha, NeuroPhysiology & Behavior Lab, Centre for Regional Biomedical Reserch (CRIB), Faculty of Medicine of Ciudad Real, Spain
- Corresponding author at: Department of Medical Sciences, Faculty of Medicine of Ciudad Real, University of Castilla-La Mancha, Ciudad Real, Spain.
| | - Lydia Jimenez-Diaz
- University of Castilla-La Mancha, NeuroPhysiology & Behavior Lab, Centre for Regional Biomedical Reserch (CRIB), Faculty of Medicine of Ciudad Real, Spain
- Corresponding author at: Department of Medical Sciences, Faculty of Medicine of Ciudad Real, University of Castilla-La Mancha, Ciudad Real, Spain.
| | - Pedro Landete
- Respiratory intermediate Care Unit, “Enfermera Isabel Zendal” Emergency Hospital, Madrid, Spain
- Department of Pneumology, Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- Corresponding author at: Respiratory intermediate Care Unit, “Enfermera Isabel Zendal” Emergency Hospital, Madrid, Spain.
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12
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Bajpai J, Kant S, Verma A, Patwa AK, Atam V, Chaudhary SC, Pandey A. The Severity of COVID 19 Pneumonia in Vaccinated vs. Non-vaccinated Patients in the Second Wave: An Experience From a Tertiary Care Center in India. Cureus 2022; 14:e25378. [PMID: 35774652 PMCID: PMC9236633 DOI: 10.7759/cureus.25378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2022] [Indexed: 11/05/2022] Open
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13
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Perry J, Osman S, Wright J, Richard-Greenblatt M, Buchan SA, Sadarangani M, Bolotin S. Does a humoral correlate of protection exist for SARS-CoV-2? A systematic review. PLoS One 2022; 17:e0266852. [PMID: 35395052 PMCID: PMC8993021 DOI: 10.1371/journal.pone.0266852] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 03/28/2022] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND A correlate of protection (CoP) is an immunological marker associated with protection against infection. Despite an urgent need, a CoP for SARS-CoV-2 is currently undefined. OBJECTIVES Our objective was to review the evidence for a humoral correlate of protection for SARS-CoV-2, including variants of concern. METHODS We searched OVID MEDLINE, EMBASE, Global Health, Biosis Previews and Scopus to January 4, 2022 and pre-prints (using NIH iSearch COVID-19 portfolio) to December 31, 2021, for studies describing SARS-CoV-2 re-infection or breakthrough infection with associated antibody measures. Two reviewers independently extracted study data and performed quality assessment. RESULTS Twenty-five studies were included in our systematic review. Two studies examined the correlation of antibody levels to VE, and reported values from 48.5% to 94.2%. Similarly, several studies found an inverse relationship between antibody levels and infection incidence, risk, or viral load, suggesting that both humoral immunity and other immune components contribute to protection. However, individual level data suggest infection can still occur in the presence of high levels of antibodies. Two studies estimated a quantitative CoP: for Ancestral SARS-CoV-2, these included 154 (95% confidence interval (CI) 42, 559) anti-S binding antibody units/mL (BAU/mL), and 28.6% (95% CI 19.2, 29.2%) of the mean convalescent antibody level following infection. One study reported a CoP for the Alpha (B.1.1.7) variant of concern of 171 (95% CI 57, 519) BAU/mL. No studies have yet reported an Omicron-specific CoP. CONCLUSIONS Our review suggests that a SARS-CoV-2 CoP is likely relative, where higher antibody levels decrease the risk of infection, but do not eliminate it completely. More work is urgently needed in this area to establish a SARS-CoV-2 CoP and guide policy as the pandemic continues.
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Affiliation(s)
- Julie Perry
- Public Health Ontario, Toronto, Ontario, Canada
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Selma Osman
- Public Health Ontario, Toronto, Ontario, Canada
| | | | | | - Sarah A. Buchan
- Public Health Ontario, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, Ontario, Canada
| | - Manish Sadarangani
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
- Vaccine Evaluation Center, BC Children’s Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Shelly Bolotin
- Public Health Ontario, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Centre for Vaccine Preventable Diseases, University of Toronto, Toronto, Ontario, Canada
- Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
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