1
|
Oncu S, Korkmaz D. Evaluation of the relationship of treatment and vaccination with prognosis in patients with a diagnosis of COVID-19. Inflammopharmacology 2024; 32:1817-1826. [PMID: 38493271 PMCID: PMC11136715 DOI: 10.1007/s10787-024-01457-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 03/01/2024] [Indexed: 03/18/2024]
Abstract
PURPOSE Coronavirus disease 2019 (COVID-19) has affected millions of people worldwide and caused mortality. Many factors have been reported to affect the prognosis of COVID-19. In this study, we aimed to investigate the effects of drug therapy and vaccination on prognosis in patients hospitalized with a COVID-19 diagnosis. METHODS In this single-center, cross-sectional study, data were retrospectively collected from patients receiving inpatient treatment at a university hospital with a diagnosis of COVID-19 between January 1, 2020, and April 30, 2022. The patients' demographic and clinical characteristics were recorded. The Chi-square, Cox and logistic regression was performed, P < 0.05 was considered statistically significant. RESULTS Total 1723 patients (50.1% were men, mean age: 60.6 ± 16.90) who had not been vaccinated rate was 27.0% (> 3 doses: 45.7%). Mortality rate was 17.0%. Increasing age, male, a high Charlson Comorbidity Index (CCI), and no vaccination significantly increased mortality (P < 0.05). The mortality rate was significantly lower in the chloroquine treatment group than in the other treatment groups. Increasing age, male, and a high CCI were determined to be factors that significantly increased the length of hospital stay (LOHS). LOHS found to be significantly lower in the favipiravir or chloroquine groups compared to the remaining treatment groups (P < 0.001). Both mortality and the LOHS significantly differed according to AST, d-dimer, ferritin, and GFR. CONCLUSION This study primarily investigated the effect of treatment and vaccination on the prognosis of COVID-19. This was determined to be prepared for another potential pandemic that may arise due to COVID-19.
Collapse
Affiliation(s)
- Seyma Oncu
- Department of Pharmacology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, 03030, Turkey.
| | - Derya Korkmaz
- Department of Infectious Disease, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| |
Collapse
|
2
|
Chen D, Cowling BJ, Ainslie KEC, Lin Y, Wong JY, Lau EHY, Wu P, Nealon J. Association of COVID-19 vaccination with duration of hospitalization in older adults in Hong Kong. Vaccine 2024; 42:2385-2393. [PMID: 38448323 DOI: 10.1016/j.vaccine.2024.02.074] [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: 10/16/2023] [Revised: 02/21/2024] [Accepted: 02/24/2024] [Indexed: 03/08/2024]
Abstract
INTRODUCTION The association between COVID-19 vaccination and length of hospital stay may provide further insight into vaccination benefits, but few studies have investigated such associations in detail. We aimed to investigate the association between COVID-19 vaccination and length of hospital stay in COVID-19 patients during Omicron waves in Hong Kong, and explore potential predictors. METHODS This retrospective cohort study was conducted on local patients aged ≥60 years who were admitted due to COVID-19 infection in Hong Kong in 2022, from 1 February to 22 November, and with 28 days of follow-up since admission. The exposure was either not vaccinated; or having received 2/3/4 doses of CoronaVac (Sinovac); or 2/3/4 doses of BNT162b2 (BioNTech/Fosun Pharma/Pfizer). Length of stay in hospital was the main outcome. Accelerated failure time models were used to quantify variation in hospital stay for vaccinated compared with unvaccinated patients, accounting for age, sex, comorbidity, type of vaccine and number of doses received, care home residence and admission timing; stratified by age groups and epidemic waves. RESULTS This study included 32,398 patients aged 60 years and above for main analysis, their median (IQR) age was 79 (71-87) years, 53% were men, and 40% were unvaccinated. The patients were stratified by confirmation prior to or since 23 May 2022, resulting in a sample size of 15,803 and 16,595 in those two waves respectively. Vaccinated patients were found to have 13-39% shorter hospital stay compared to unvaccinated patients. More vaccine doses received were associated with shorter hospital stay, and BNT162b2 recipients had slightly shorter hospital stays than CoronaVac recipients. CONCLUSION Vaccination was associated with reduced hospital stay in breakthrough infections. Increased vaccination uptake in older adults may improve hospital bed turnover and public health outcomes especially during large community epidemics.
Collapse
Affiliation(s)
- Dongxuan Chen
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region; Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, New Territories, Hong Kong Special Administrative Region
| | - Benjamin J Cowling
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region; Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, New Territories, Hong Kong Special Administrative Region.
| | - Kylie E C Ainslie
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region; Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Yun Lin
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Jessica Y Wong
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Eric H Y Lau
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region; Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, New Territories, Hong Kong Special Administrative Region
| | - Peng Wu
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region; Laboratory of Data Discovery for Health Limited, Hong Kong Science and Technology Park, New Territories, Hong Kong Special Administrative Region
| | - Joshua Nealon
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region
| |
Collapse
|
3
|
Donato F, Pilotto A, Focà E, Tresoldi M, Tonoli A, Perani C, Minisci D, Salvetti M, Filippini M, Bezzi M, Em Boari G, Gipponi S, Stegher C, Nardin M, Caruso A, Metra M, Padovani A, Rossi C, Castelli F. The impact of time since SARS-Cov-2 vaccination, age, sex and comorbidities on COVID-19 outcome in hospitalized patients with SARS-CoV-2 infection. Vaccine 2024; 42:1863-1867. [PMID: 38355322 DOI: 10.1016/j.vaccine.2024.02.003] [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: 11/20/2023] [Revised: 01/22/2024] [Accepted: 02/01/2024] [Indexed: 02/16/2024]
Abstract
We evaluated the impact of COVID-19 vaccination on disease outcome in hospitalized patients with SARS-CoV-2 infection with a prospective study. 745 vaccinated and 451 unvaccinated patients consecutively admitted to a COVID-19 Hospital from 1st September 2021 to 1st September 2022 were included. Compared with unvaccinated cases, vaccinated patients were older, had more comorbidities, but had a lower risk of O2 need (odds ratio, OR, 0.46; 95 % CI 0.32-0.65) by logistic regression analysis adjusted for age, sex, comorbidity and WHO COVID-19 Clinical Progression Scale at admission. The ORs for O2 need were 0.38 (0.24-0.61), 0.50 (0.30-0.83) and 0.57 (0.34-0.96) in patients vaccinated 14-120, 121-180 and > 180 days prior to hospitalization, respectively. An anti-spike Ig titer higher than 5000 U/ml was associated with a reduced risk of O2 need (OR 0.52; 95 % CI 0.30-0.92). This study shows that COVID-19 vaccination has a significant impact on COVID-19 outcomes in hospitalized patients.
Collapse
Affiliation(s)
- Francesco Donato
- University Unit of Hygiene, Epidemiology and Public Health, University of Brescia, 25123 Brescia, Italy.
| | - Andrea Pilotto
- Neurology Unit, Department of Continuity of Care and Frailty, ASST Spedali Civili Hospital, Brescia, Italy; Department of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, Italy
| | - Emanuele Focà
- University Division of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy
| | - Marco Tresoldi
- University Unit of Hygiene, Epidemiology and Public Health, University of Brescia, 25123 Brescia, Italy
| | - Alessio Tonoli
- Emergency Department and Bed Management, ASST Spedali Civili Hospital, Brescia, Italy
| | - Cristiano Perani
- Emergency Department and Bed Management, ASST Spedali Civili Hospital, Brescia, Italy
| | - Davide Minisci
- University Division of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy
| | - Massimo Salvetti
- Emergency Medicine Unit, Department of Clinical & Experimental Sciences, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy
| | - Matteo Filippini
- Department of Anesthesia, Intensive Care and Emergency, ASST Spedali Civili Hospital, Brescia, Italy
| | - Michela Bezzi
- Division of Pneumology, ASST Spedali Civili Hospital, Brescia, Italy
| | - Gianluca Em Boari
- COVID_19 Medicine, Internal Medicine Unit, Montichiari Hospital, Montichiari, Italy
| | - Stefano Gipponi
- Neurology Unit, Department of Continuity of Care and Frailty, ASST Spedali Civili Hospital, Brescia, Italy
| | - Claudia Stegher
- Department of Obstetrics and Gynecology, ASST Spedali Civili Hospital, Brescia, Italy
| | - Matteo Nardin
- Medicine III, ASST Spedali Civili Hospital, Brescia, Italy
| | - Arnaldo Caruso
- Department of Molecular and Translational Medicine, Institute of Microbiology, ASST Spedali Civili Hospital, Brescia, Italy
| | - Marco Metra
- Cardiology Unit, Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Alessandro Padovani
- Neurology Unit, Department of Continuity of Care and Frailty, ASST Spedali Civili Hospital, Brescia, Italy; Department of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, Italy
| | - Camillo Rossi
- Chief Medical Officer of ASST Spedali Civili Hospital Health Directorate, Brescia, Italy
| | - Francesco Castelli
- University Division of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy
| |
Collapse
|
4
|
Lorenzon A, Palandri L, Uguzzoni F, Cristofor CD, Lozza F, Poluzzi R, Rizzi C, Bertoli P, Zerzer F, Righi E. Effectiveness of the SARS-CoV-2 Vaccination in Preventing Severe Disease-Related Outcomes: A Population-Based Study in the Italian Province of Bolzano (South Tyrol). Int J Public Health 2024; 69:1606792. [PMID: 38550269 PMCID: PMC10976940 DOI: 10.3389/ijph.2024.1606792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/26/2024] [Indexed: 04/02/2024] Open
Abstract
Objective: To investigate the effectiveness of SARS-CoV2 vaccination in preventing ordinary or intensive care unit (ICU) admissions and deaths among cases registered during a variant transitional pandemic phase in the geographically and culturally unique territory of the Province of Bolzano (South Tyrol), an Italian region with low vaccination coverage. Methods: We collected data from 93,643 patients registered as positive for SARS-CoV-2 by health authorities during the winter of 2021-22. The data were analyzed retrospectively using descriptive statistics and multiple logistic regression. Results: 925 patients were hospitalized (0.99%), 89 (0.10%) were in intensive care, and 194 (0.21%) died. Vaccinated patients had a significantly lower risk of being hospitalized: adjusted Odds Ratio (aOR): 0.39; 95% CI: 0.33-0.46, ICU admission: aOR: 0.16; 95% CI: 0.09-0.29 and death: aOR: 0.41; 95% CI: 0.29-0.58. Similar risk reductions were also observed in booster-vaccinated patients, independent of sex, age, and predominant variant. Furthermore, the median length of stay (LoS) in the ICU was significantly longer for unvaccinated individuals compared to vaccinated subjects (9 vs. 6 days; p < 0.003). Conclusion: Primary series vaccination and ongoing campaign booster doses were effective in preventing all severe disease-related outcomes and in reducing ICU Length of Stay, even during a transitional pandemic phase and in a unique territorial context.
Collapse
Affiliation(s)
- Antonio Lorenzon
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Epidemiological Surveillance Unit, South Tyrolean Health Care Agency, Bolzano, Italy
| | - Lucia Palandri
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Francesco Uguzzoni
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Filippo Lozza
- Epidemiological Surveillance Unit, South Tyrolean Health Care Agency, Bolzano, Italy
| | - Riccardo Poluzzi
- Epidemiological Surveillance Unit, South Tyrolean Health Care Agency, Bolzano, Italy
| | - Cristiana Rizzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Pierpaolo Bertoli
- Epidemiological Surveillance Unit, South Tyrolean Health Care Agency, Bolzano, Italy
| | - Florian Zerzer
- Epidemiological Surveillance Unit, South Tyrolean Health Care Agency, Bolzano, Italy
| | - Elena Righi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| |
Collapse
|
5
|
Fang X, Tao G, Zhou H, Zhou Y. Vaccines reduced hospital length of stay and fraction of inspired oxygen of COVID-19 patients: A retrospective cohort study. Prev Med Rep 2024; 39:102632. [PMID: 38348219 PMCID: PMC10859302 DOI: 10.1016/j.pmedr.2024.102632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 02/15/2024] Open
Abstract
Few studies have focused on the evaluation of vaccine effectiveness (VE) in mainland China. This study was to characterize the VE including the frequent symptoms, laboratory indices, along with endotracheal intubation, hospital length of stay (LoS), and survival status. This retrospective cohort study included patients with COVID-19 admitted to our hospital. Statistical comparisons of continuous variables were carried out with an independent Student's t-test or Mann-Whitney U test. For categorical variables, the Chi-square test and Fisher exact test were used. Multivariable regression analysis was performed to adjust the confounding factors such as age, gender, body mass index (BMI), residential area, smoking status, the Charlson comorbidity index (CCI) score, followed by investigating the effects of vaccination on critical ill prevention, reduced mortality and endotracheal intubation, LoS and inspired oxygen. This study included 549 hospitalized patients with COVID-19, including 222 (40.43 %) vaccinated participants and 327 (59.57 %) unvaccinated counterparts. There was no obvious difference between the two groups in typical clinical symptoms of COVID-19, clinical laboratory results and mortality. Multivariable analysis showed that COVID-19 vaccine obviously reduced LoS by 1.2 days (lnLoS = -0.14, 95 %CI[-0.24,-0.04]; P = 0.005) and decreased fraction of inspired oxygen by 40 % (OR: 0.60; 95 %CI[0.40,0.90]; P = 0.013) after adjusting age, gender, BMI, residential area, smoking status and CCI score. In contrast, vaccination induced reduction in the critically ill, mortality, and endotracheal intubation compared with the unvaccinated counterparts, but with no statistical differences. Vaccinated patients hospitalized with COVID-19 have a reduced LoS and fraction of inspired oxygen compared to unvaccinated cases in China.
Collapse
Affiliation(s)
- Xiaomei Fang
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, P. R. China
| | - Guofang Tao
- Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, P. R. China
| | - Hua Zhou
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, P. R. China
| | - Yuxia Zhou
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, P. R. China
| |
Collapse
|
6
|
Lombardi A, Villa S, Colaneri M, Scaglione G, Bai F, Varisco B, Bono V, Vena A, Dentone C, Russo C, Tettamanti M, Renisi G, Viero G, Azzarà C, Mantero M, Peyvandi F, Bassetti M, Marchetti G, Muscatello A, Nobili A, Gori A, Bandera A. Clinical characteristics and outcomes of vaccinated patients hospitalised with SARS-CoV-2 breakthrough infection: Multi-IPV, a multicentre study in Northern Italy. J Infect Public Health 2024; 17:467-473. [PMID: 38262085 DOI: 10.1016/j.jiph.2023.12.026] [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: 06/06/2023] [Revised: 12/29/2023] [Accepted: 12/31/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Despite the well-known efficacy of anti-COVID-19 vaccines in preventing morbidity and mortality, several vaccinated individuals are diagnosed with SARS-CoV-2 breakthrough infection, which might require hospitalisation. This multicentre, observational, and retrospective study aimed to investigate the clinical characteristics and outcomes of vaccinated vs. non-vaccinated patients, both hospitalised with SARS-CoV-2 infection in 3 major hospitals in Northern Italy. METHODS Data collection was retrospective, and paper and electronic medical records of adult patients with a diagnosed SARS-CoV-2 infection were pseudo-anonymised and analysed. Vaccinated and non-vaccinated individuals were manually paired, using a predetermined matching criterion (similar age, gender, and date of hospitalisation). Demographic, clinical, treatment, and outcome data were compared between groups differing by vaccination status using Pearson's Chi-square and Mann-Whitney tests. Moreover, multiple logistic regression analyses were performed to assess the impact of vaccination status on ICU admission or intra-hospital mortality. RESULTS Data from 360 patients were collected. Vaccinated patients presented with a higher prevalence of relevant comorbidities, like kidney replacement therapy or haematological malignancy, despite a milder clinical presentation at the first evaluation. Non-vaccinated patients required intensive care more often than their vaccinated counterparts (8.8% vs. 1.7%, p = 0.002). Contrariwise, no difference in intra-hospital mortality was observed between the two groups (19% vs. 20%, p = 0.853). These results were confirmed by multivariable logistic regressions, which showed that vaccination was significantly associated with decreased risk of ICU admission (aOR=0.172, 95%CI: 0.039-0.542, p = 0.007), but not of intra-hospital mortality (aOR=0.996, 95%CI: 0.582-1.703, p = 0.987). CONCLUSIONS This study provides real-world data on vaccinated patients hospitalised with COVID-19 in Northern Italy. Our results suggest that COVID-19 vaccination has a protective role in individuals with higher risk profiles, especially regarding the need for ICU admission. These findings contribute to our understanding of SARS-CoV-2 infection outcomes among vaccinated individuals and emphasise the importance of vaccination in preventing severe disease, particularly in those countries with lower first-booster uptake rates.
Collapse
Affiliation(s)
- Andrea Lombardi
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Infectious Diseases Unit, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy.
| | - Simone Villa
- Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy
| | - Marta Colaneri
- Department of Infectious Diseases, Ospedale Luigi Sacco, Milan, Italy
| | | | - Francesca Bai
- Department of Health Sciences, Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, Milan, Italy
| | - Benedetta Varisco
- Department of Health Sciences, Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, Milan, Italy
| | - Valeria Bono
- Department of Health Sciences, Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, Milan, Italy
| | - Antonio Vena
- Department of Health Sciences, University of Genoa, Genoa, Italy; Infectious Diseases Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Chiara Dentone
- Department of Health Sciences, University of Genoa, Genoa, Italy; Infectious Diseases Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Chiara Russo
- Department of Health Sciences, University of Genoa, Genoa, Italy; Infectious Diseases Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Mauro Tettamanti
- Department of Health Policy, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Giulia Renisi
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Infectious Diseases Unit, Milan, Italy
| | - Giulia Viero
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Infectious Diseases Unit, Milan, Italy
| | - Cecilia Azzarà
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Infectious Diseases Unit, Milan, Italy
| | - Marco Mantero
- Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy; Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Respiratory Unit and Cystic Fibrosis Center, Milan, Italy
| | - Flora Peyvandi
- Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy; Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy
| | - Matteo Bassetti
- Department of Health Sciences, University of Genoa, Genoa, Italy; Infectious Diseases Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giulia Marchetti
- Department of Health Sciences, Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, Milan, Italy
| | - Antonio Muscatello
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Infectious Diseases Unit, Milan, Italy
| | - Alessandro Nobili
- Department of Health Policy, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Andrea Gori
- Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy; Department of Infectious Diseases, Ospedale Luigi Sacco, Milan, Italy
| | - Alessandra Bandera
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Infectious Diseases Unit, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy
| |
Collapse
|
7
|
Gonçalves BP, Jassat W, Baruch J, Hashmi M, Rojek A, Dasgupta A, Martin-Loeches I, Reyes LF, Piubelli C, Citarella BW, Kartsonaki C, Lefèvre B, López Revilla JW, Lunn M, Harrison EM, Kraemer MUG, Shrapnel S, Horby P, Bisoffi Z, Olliaro PL, Merson L. A multi-country analysis of COVID-19 hospitalizations by vaccination status. MED 2023; 4:797-812.e2. [PMID: 37738979 PMCID: PMC10935543 DOI: 10.1016/j.medj.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/18/2023] [Accepted: 08/25/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND Individuals vaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), when infected, can still develop disease that requires hospitalization. It remains unclear whether these patients differ from hospitalized unvaccinated patients with regard to presentation, coexisting comorbidities, and outcomes. METHODS Here, we use data from an international consortium to study this question and assess whether differences between these groups are context specific. Data from 83,163 hospitalized COVID-19 patients (34,843 vaccinated, 48,320 unvaccinated) from 38 countries were analyzed. FINDINGS While typical symptoms were more often reported in unvaccinated patients, comorbidities, including some associated with worse prognosis in previous studies, were more common in vaccinated patients. Considerable between-country variation in both in-hospital fatality risk and vaccinated-versus-unvaccinated difference in this outcome was observed. CONCLUSIONS These findings will inform allocation of healthcare resources in future surges as well as design of longer-term international studies to characterize changes in clinical profile of hospitalized COVID-19 patients related to vaccination history. FUNDING This work was made possible by the UK Foreign, Commonwealth and Development Office and Wellcome (215091/Z/18/Z, 222410/Z/21/Z, 225288/Z/22/Z, and 220757/Z/20/Z); the Bill & Melinda Gates Foundation (OPP1209135); and the philanthropic support of the donors to the University of Oxford's COVID-19 Research Response Fund (0009109). Additional funders are listed in the "acknowledgments" section.
Collapse
Affiliation(s)
| | - Waasila Jassat
- National Institute for Communicable Diseases, Johannesburg, South Africa; Right to Care, Pretoria, South Africa
| | - Joaquín Baruch
- ISARIC, Pandemic Sciences Institute, University of Oxford, Oxford, UK
| | - Madiha Hashmi
- Critical Care Asia and Ziauddin University, Karachi, Pakistan
| | - Amanda Rojek
- ISARIC, Pandemic Sciences Institute, University of Oxford, Oxford, UK
| | - Abhishek Dasgupta
- Doctoral Training Centre, University of Oxford, Oxford, UK; Department of Biology, University of Oxford, Oxford, UK
| | - Ignacio Martin-Loeches
- Department of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization (MICRO), St James's Hospital, Leinster, Dublin, Ireland; Pulmonary Intensive Care Unit, Respiratory Institute, Hospital Clinic of Barcelona, IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), University of Barcelona, CIBERes, Barcelona, Spain
| | - Luis Felipe Reyes
- Unisabana Center for Translational Science, School of Medicine, Universidad de La Sabana, Chía, Colombia
| | - Chiara Piubelli
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | | | - Christiana Kartsonaki
- MRC Population Health Research Unit, Clinical Trials Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Benjamin Lefèvre
- Université de Lorraine, CHRU-Nancy, Service des Maladies Infectieuses et Tropicales, Nancy, France; Université de Lorraine, APEMAC, Nancy, France
| | - José W López Revilla
- Instituto Nacional del Niño San Borja and Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Peru
| | - Miles Lunn
- ISARIC, Pandemic Sciences Institute, University of Oxford, Oxford, UK
| | - Ewen M Harrison
- Centre for Medical Informatics, The University of Edinburgh, Usher Institute of Population Health Sciences and Informatics, Edinburgh, UK
| | - Moritz U G Kraemer
- Department of Biology, University of Oxford, Oxford, UK; Pandemic Sciences Institute, University of Oxford, Oxford, UK
| | - Sally Shrapnel
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Herston, Brisbane, Australia; School of Mathematics and Physics, Faculty of Science, The University of Queensland, St Lucia, Brisbane, Australia
| | - Peter Horby
- ISARIC, Pandemic Sciences Institute, University of Oxford, Oxford, UK
| | - Zeno Bisoffi
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Piero L Olliaro
- ISARIC, Pandemic Sciences Institute, University of Oxford, Oxford, UK
| | - Laura Merson
- ISARIC, Pandemic Sciences Institute, University of Oxford, Oxford, UK
| |
Collapse
|
8
|
Vigna M, Ceriana P, Santomassimo M, Vitacca M, Maniscalco M, Ambrosino N. Effects of pulmonary rehabilitation in survivors of severe acute respiratory syndrome coronavirus 2. Role of vaccination. Monaldi Arch Chest Dis 2023. [PMID: 37732337 DOI: 10.4081/monaldi.2023.2738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 09/11/2023] [Indexed: 09/22/2023] Open
Abstract
Survivors of severe COVID-19 requiring hospital admission may suffer from short- and long-term sequelae, including disability and reduced physical performance. Vaccination and pulmonary rehabilitation (PR) are effective tools against COVID-19 effects. While the beneficial effect of each of these treatments is known, there are no data about their combined effect. In people admitted to PR hospitals after severe COVID-19 disease, we retrospectively analyzed whether PR outcome might be influenced by vaccination status. Ninety-six individuals were studied (46 vaccinated, 50 unvaccinated). Unvaccinated individuals were younger and less comorbid than vaccinated ones and had needed more intensive care support during the previous hospitalization. Measures of disability and physical performance did not differ between groups at the beginning and at the end of the PR program. However, each group showed a statistically significant improvement in all outcome measures (6-minute walking test, short physical performance battery, Barthel Index). We conclude that vaccination status does not influence the outcome of in-patient PR programs for survivors of severe COVID-19.
Collapse
Affiliation(s)
- Matteo Vigna
- Respiratory Rehabilitation Unit, ICS Maugeri IRCCS, Institute of Pavia.
| | - Piero Ceriana
- Respiratory Rehabilitation Unit, ICS Maugeri IRCCS, Institute of Pavia.
| | - Mara Santomassimo
- Respiratory Rehabilitation Unit, ICS Maugeri IRCCS, Institute of Pavia.
| | - Michele Vitacca
- Respiratory Rehabilitation Unit, ICS Maugeri IRCCS, Institute of Lumezzane (BS).
| | - Mauro Maniscalco
- Respiratory Rehabilitation Unit, ICS Maugeri IRCCS, Institute of Telese (BN).
| | - Nicolino Ambrosino
- Respiratory Rehabilitation Unit, ICS Maugeri IRCCS, Institute of Montescano (PV).
| |
Collapse
|
9
|
Linquest L, Ackerman K, Dewan K. Implications of COVID-19 in Airway and Swallowing Function. OTO Open 2023; 7:e74. [PMID: 37693827 PMCID: PMC10487325 DOI: 10.1002/oto2.74] [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: 04/20/2023] [Revised: 07/18/2023] [Accepted: 08/09/2023] [Indexed: 09/12/2023] Open
Abstract
Objective The acute treatment and complications of the novel COVID-19 virus have been well studied, but the implications of this novel virus for swallowing function continue to be investigated. The goal of this study is to retrospectively assess airway and swallowing outcomes for those patients who required intensive care unit(ICU)-level care for COVID-19 infection. Study Design Comparison of swallowing outcomes through diet change in COVID-19 patients in the Ochsner-Louisiana State University (LSU) Hospital ICU. Setting Ochsner-LSU Hospital (Shreveport, Louisiana). Methods A retrospective chart review was performed from March 2020 to May 2022 to identify patients with a primary diagnosis of COVID-19. Variables analyzed include age, gender, length of intubation, length of ventilation, airway interventions, use of extracorporeal membrane oxygenation, and diet prior to, during, and after hospitalization for COVID-19 infection. Results Two hundred and seven patients fit the inclusion criteria. There was a significant difference in discharge diet between those patients who were intubated and those who were not (P = .007). Thirty percent of patients were discharged on a different diet than their baseline with patients on a nonregular diet significantly more likely to discharge to a facility (P = .043). Negative vaccine status was associated with prolonged ICU stay, prolonged duration of intubation, and prolonged duration of ventilation. Conclusion COVID-19 continues to present novel challenges with new implications and outcomes being discovered in the third year of the pandemic. Further research is necessary to determine the most effective treatment approaches with respect to optimized speech and swallow outcomes.
Collapse
Affiliation(s)
- Lauren Linquest
- Department of Otolaryngology–Head and Neck SurgeryLSU‐Health Sciences CenterShreveportLouisianaUSA
| | - Kayla Ackerman
- Department of Otolaryngology–Head and Neck SurgeryLSU‐Health Sciences CenterShreveportLouisianaUSA
| | - Karuna Dewan
- Department of Otolaryngology–Head and Neck SurgeryLSU‐Health Sciences CenterShreveportLouisianaUSA
| |
Collapse
|
10
|
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.
Collapse
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
| |
Collapse
|
11
|
Su N, Donders MCHCM, Ho JPTF, Vespasiano V, de Lange J, Loos BG. Development and external validation of prediction models for critical outcomes of unvaccinated COVID-19 patients based on demographics, medical conditions and dental status. Heliyon 2023; 9:e15283. [PMID: 37064437 PMCID: PMC10084632 DOI: 10.1016/j.heliyon.2023.e15283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 03/18/2023] [Accepted: 03/31/2023] [Indexed: 04/18/2023] Open
Abstract
Background Multiple prediction models were developed for critical outcomes of COVID-19. However, prediction models using predictors which can be easily obtained in clinical practice and on dental status are scarce. Aim The study aimed to develop and externally validate prediction models for critical outcomes of COVID-19 for unvaccinated adult patients in hospital settings based on demographics, medical conditions, and dental status. Methods A total of 285 and 352 patients from two hospitals in the Netherlands were retrospectively included as derivation and validation cohorts. Demographics, medical conditions, and dental status were considered potential predictors. The critical outcomes (death and ICU admission) were considered endpoints. Logistic regression analyses were used to develop two models: for death alone and for critical outcomes. The performance and clinical values of the models were determined in both cohorts. Results Age, number of teeth, chronic kidney disease, hypertension, diabetes, and chronic obstructive pulmonary diseases were the significant independent predictors. The models showed good to excellent calibration with observed: expected (O:E) ratios of 0.98 (95%CI: 0.76 to 1.25) and 1.00 (95%CI: 0.80 to 1.24), and discrimination with shrunken area under the curve (AUC) values of 0.85 and 0.79, based on the derivation cohort. In the validation cohort, the models showed good to excellent discrimination with AUC values of 0.85 (95%CI: 0.80 to 0.90) and 0.78 (95%CI: 0.73 to 0.83), but an overestimation in calibration with O:E ratios of 0.65 (95%CI: 0.49 to 0.85) and 0.67 (95%CI: 0.52 to 0.84). Conclusion The performance of the models was acceptable in both derivation and validation cohorts. Number of teeth was an additive important predictor of critical outcomes of COVID-19. It is an easy-to-apply tool in hospitals for risk stratification of COVID-19 prognosis.
Collapse
Affiliation(s)
- Naichuan Su
- Department of Oral Public Health, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Marie-Chris H C M Donders
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, the Netherlands
- Department of Oral and Maxillofacial Surgery, Isala Zwolle, Zwolle, the Netherlands
| | - Jean-Pierre T F Ho
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, the Netherlands
- Department of Oral and Maxillofacial Surgery, Northwest Clinics, Alkmaar, the Netherlands
| | - Valeria Vespasiano
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, the Netherlands
| | - Jan de Lange
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, the Netherlands
- Department of Oral and Maxillofacial Surgery, Isala Zwolle, Zwolle, the Netherlands
| | - Bruno G Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| |
Collapse
|
12
|
Paggi R, Barbiero A, Manciulli T, Miftode A, Tilli M, Lagi F, Mencarini J, Borchi B, Pozzi M, Bartalesi F, Spinicci M, Martini L, Coppola A, Nozzoli C, Peris A, Bonizzoli M, Pieralli F, Bartoloni A, Zammarchi L. Characteristics of COVID-19 vaccinated and unvaccinated patients admitted to Careggi University Hospital, Florence, Italy. Intern Emerg Med 2023; 18:821-830. [PMID: 36853393 PMCID: PMC9972322 DOI: 10.1007/s11739-023-03231-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 02/14/2023] [Indexed: 03/01/2023]
Abstract
More than 11.5 billion COVID-19 vaccine doses have been administered around the world. Although vaccine effectiveness for severe infections is reported to be 89.0%, breakthrough infections are common and may lead to severe outcome in fragile population. We conducted a real-world observational study on 420 COVID-19 admitted patients from July 2021 to January 2022 in a tertiary level Italian hospital. We collected patient's vaccination and SARS-CoV-2 serological status, SARS-CoV-2 treatments, oxygen supports, intensive (ICU) and subintensive (sub-ICU) care unit admissions, length of staying (LoS) and in-hospital mortality. One-hundred-seventy-two vaccinated and 248 unvaccinated patients were admitted during the study period. Vaccinated group (Vg) had a significantly more elevated Charlson Comorbidity Index than Unvaccinated group (UVg), and no statistical differences were found in terms of in-hospital mortality, LoS or ICU and sub-ICU admissions. Among Vg, anti-S antibodies were detected in 86.18% of patients (seropositives). Vaccinated seronegative patients' in-hospital mortality was significantly higher than vaccinated seropositive patients (33.33% vs 10.69%, p = 0.0055): in particular, mortality rate in 45-69 years old population was higher in vaccinated seronegative group, and comparable in patients ≥ 70 years old. No differences in terms of outcome were registered between Vg and UVg, taking into account that Vg was considerably older and with more comorbidities. In line with other recent observations, higher mortality rate was evidenced for seronegative vaccinated patients. Primary prophylaxis and early treatments result to be necessary, especially for older and immunosuppressed populations.
Collapse
Affiliation(s)
- Riccardo Paggi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Anna Barbiero
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Tommaso Manciulli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Andreea Miftode
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Marta Tilli
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Filippo Lagi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Jessica Mencarini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Beatrice Borchi
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Marco Pozzi
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Filippo Bartalesi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Michele Spinicci
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Lorenzo Martini
- Internal Medicine Unit 2, Careggi University Hospital, Florence, Italy
| | | | - Carlo Nozzoli
- Internal Medicine Unit 1, Careggi University Hospital, Florence, Italy
| | - Adriano Peris
- Intensive Care Unit and Regional ECMO Referral Centre, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Manuela Bonizzoli
- Intensive Care Unit and Regional ECMO Referral Centre, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Filippo Pieralli
- High-Intensity Internal Medicine Unit, Careggi University Hospital, Florence, Italy
| | - Alessandro Bartoloni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Lorenzo Zammarchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy.
| |
Collapse
|
13
|
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.
Collapse
|
14
|
Promlek T, Hansirisathit T, Kunno J, Thanunchai M. The Effects of CoronaVac and ChAdOx1 nCoV-19 in Reducing Severe Illness in Thailand: A Retrospective Cohort Study. Trop Med Infect Dis 2023; 8:tropicalmed8020095. [PMID: 36828511 PMCID: PMC9960383 DOI: 10.3390/tropicalmed8020095] [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: 12/20/2022] [Revised: 01/16/2023] [Accepted: 01/29/2023] [Indexed: 02/05/2023] Open
Abstract
Two primary vaccines for coronavirus disease 2019 (COVID-19) have been rolled out in the mass vaccination campaign that started simultaneously with the spread of the delta variant. To explore the vaccines' effect on reducing viral load and disease severity, we conducted a retrospective cohort study in Thai patients aged ≥18 years who were confirmed COVID-19 positive by RT-PCR. Compared to unvaccinated patients, Ct values and the number of severe cases among vaccine regimens were analyzed. Ct values of vaccinated patients were not significantly different from unvaccinated patients, despite an increase of Ct values in a booster dose. The adjusted odd ratio for prevention of delta-related severe diseases was 0.47, 95% CI: 0.30-0.76 and 0.06, 95% CI: 0.01-0.45 after receiving one dose and two doses, respectively. No severe illness was found in booster-vaccinated individuals. Focusing on the vaccine types, one dose of ChAdOx1 nCoV-19 gave significant protection, whereas one dose of CoronaVac did not (0.49, 95% CI: 0.30-0.79, p = 0.003 vs. 0.28, 95% CI: 0.04-2.16, p = 0.223). Two-dose vaccination showed robust protective effects in all subpopulations regardless of vaccine type. Vaccinations with two primary vaccines could not reduce viral load in patients with COVID-19, but could prevent severe illness.
Collapse
Affiliation(s)
- Thanyarat Promlek
- Department of Clinical Pathology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok 10300, Thailand
| | - Tonsan Hansirisathit
- Department of Central Laboratory, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok 10300, Thailand
| | - Jadsada Kunno
- Department of Research and Medical Innovation, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok 10300, Thailand
| | - Maytawan Thanunchai
- Department of Clinical Pathology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok 10300, Thailand
- Division of Clinical Microbiology, Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai 50200, Thailand
- Correspondence: ; Tel.: +66-89264-8729
| |
Collapse
|
15
|
Wu JS. Measuring efficiency of the global fight against the COVID-19 pandemic. Digit Health 2023; 9:20552076231197528. [PMID: 37654724 PMCID: PMC10467301 DOI: 10.1177/20552076231197528] [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: 04/14/2023] [Accepted: 08/10/2023] [Indexed: 09/02/2023] Open
Abstract
Objectives The ongoing COVID-19 pandemic has led to an unprecedented loss of life and a severe economic downturn across the globe. Countries have adopted various social distancing and vaccination policies to reduce the spread of the disease and lessen the impact on healthcare systems. The world should work together to confront the disaster and challenge of COVID-19. Methods This study uses stochastic frontier analysis to measure the efficiency and influencing factors of the global response to COVID-19 epidemics and to provide follow-up strategies and reference guidelines. Results The results of this study show that (1) the average efficiency of the global response to COVID-19 is not good, with significant space for improvement of up to 60%; (2) adequate medical supplies and equipment can reduce mortality; (3) the initial implementation of social distancing policies and wearing masks can effectively reduce the infection rate; and (4) as infection rates and vaccination rates increase so that most people have basic immunity to COVID-19, the epidemic will gradually be reduced. Conclusions As the world becomes more aware of the COVID-19 disease, humans will gradually return to normal social interaction and lifestyles. The results of this study are expected to provide a reference for the future direction of the global fight against epidemics and the improvement of public health policies.
Collapse
Affiliation(s)
- Jih-Shong Wu
- College of General Education, Chihlee University of Technology, New Taipei City, Taiwan
| |
Collapse
|
16
|
Wang C, Liu B, Zhang S, Huang N, Zhao T, Lu Q, Cui F. Differences in incidence and fatality of COVID-19 by SARS-CoV-2 Omicron variant versus Delta variant in relation to vaccine coverage: A world-wide review. J Med Virol 2022; 95:e28118. [PMID: 36056540 PMCID: PMC9537802 DOI: 10.1002/jmv.28118] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/13/2022] [Accepted: 08/31/2022] [Indexed: 01/11/2023]
Abstract
We aim to evaluate the evolution differences in the incidence and case fatality rate (CFR) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta and Omicron variants. The average incidence and CFRs were described between different countries. A gamma generalized linear mixed model (GLMM) was used to compare the CFRs of Delta and Omicron variants based on vaccination coverage. Totally, 50 countries were included for analyses. The incidence of coronavirus disease 2019 (COVID-19) ranged from 0.16/100,000 to 82.95/100,000 during the Delta period and 0.03/100,000 to 440.88/100,000 during the Omicron period. The median CFRs were 8.56 (interquartile range [IQR]: 4.76-18.39) during the Delta period and 3.04 (IQR: 1.87-7.48) during the Omicron period, respectively. A total of 47 out of 50 countries showed decreased CFRs of the Omicron variant with the rate ratio ranging from 0.02 (95% confidence interval [CI]: 0.01-0.03) (in Cambodia) to 0.97 (95% CI: 0.87-1.08) (in Ireland). Gamma GLMM analysis showed that the decreased CFR was largely a result of the decreased pathogenicity of Omicron besides the increased vaccination coverage. The Omicron variant shows a higher incidence but a lower CFR around the world as a whole, which is mainly a result of the decreased pathogenicity by SARS-CoV-2's mutation, while the vaccination against SARS-CoV-2 still acts as a valuable measure in preventing people from death.
Collapse
Affiliation(s)
- Chao Wang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public HealthPeking UniversityBeijingPeople's Republic of China,Department of Epidemiology and Biostatistics, School of Public HealthPeking UniversityBeijingPeople's Republic of China
| | - Bei Liu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public HealthPeking UniversityBeijingPeople's Republic of China,Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases GroupPeking UniversityBeijingPeople's Republic of China
| | - Sihui Zhang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public HealthPeking UniversityBeijingPeople's Republic of China,Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases GroupPeking UniversityBeijingPeople's Republic of China
| | - Ninghua Huang
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public HealthPeking UniversityBeijingPeople's Republic of China
| | - Tianshuo Zhao
- Department of Epidemiology and Biostatistics, School of Public HealthPeking UniversityBeijingPeople's Republic of China,Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases GroupPeking UniversityBeijingPeople's Republic of China
| | - Qing‐Bin Lu
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public HealthPeking UniversityBeijingPeople's Republic of China,Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases GroupPeking UniversityBeijingPeople's Republic of China
| | - Fuqiang Cui
- Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public HealthPeking UniversityBeijingPeople's Republic of China,Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases GroupPeking UniversityBeijingPeople's Republic of China
| |
Collapse
|
17
|
Starrfelt J, Danielsen AS, Buanes EA, Juvet LK, Lyngstad TM, Rø GØI, Veneti L, Watle SV, Meijerink H. Age and product dependent vaccine effectiveness against SARS-CoV-2 infection and hospitalisation among adults in Norway: a national cohort study, July-November 2021. BMC Med 2022; 20:278. [PMID: 36050718 PMCID: PMC9436448 DOI: 10.1186/s12916-022-02480-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 07/14/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND COVID-19 vaccines have been crucial in the pandemic response and understanding changes in vaccines effectiveness is essential to guide vaccine policies. Although the Delta variant is no longer dominant, understanding vaccine effectiveness properties will provide essential knowledge to comprehend the development of the pandemic and estimate potential changes over time. METHODS In this population-based cohort study, we estimated the vaccine effectiveness of Comirnaty (Pfizer/BioNTech; BNT162b2), Spikevax (Moderna; mRNA-1273), Vaxzevria (AstraZeneca; ChAdOx nCoV-19; AZD1222), or a combination against SARS-CoV-2 infections, hospitalisations, intensive care admissions, and death using Cox proportional hazard models, across different vaccine product regimens and age groups, between 15 July and 31 November 2021 (Delta variant period). Vaccine status is included as a time-varying covariate and all models were adjusted for age, sex, comorbidities, county of residence, country of birth, and living conditions. Data from the entire adult Norwegian population were collated from the National Preparedness Register for COVID-19 (Beredt C19). RESULTS The overall adjusted vaccine effectiveness against infection decreased from 81.3% (confidence interval (CI): 80.7 to 81.9) in the first 2 to 9 weeks after receiving a second dose to 8.6% (CI: 4.0 to 13.1) after more than 33 weeks, compared to 98.6% (CI: 97.5 to 99.2) and 66.6% (CI: 57.9 to 73.6) against hospitalisation respectively. After the third dose (booster), the effectiveness was 75.9% (CI: 73.4 to 78.1) against infection and 95.0% (CI: 92.6 to 96.6) against hospitalisation. Spikevax or a combination of mRNA products provided the highest protection, but the vaccine effectiveness decreased with time since vaccination for all vaccine regimens. CONCLUSIONS Even though the vaccine effectiveness against infection waned over time, all vaccine regimens remained effective against hospitalisation after the second vaccine dose. For all vaccine regimens, a booster facilitated recovery of effectiveness. The results from this support the use of heterologous schedules, increasing flexibility in vaccination policy.
Collapse
Affiliation(s)
- Jostein Starrfelt
- Department of Infection Control and Preparedness, Norwegian Institute of Public Health, Postboks 222 Skøyen, 0213, Oslo, Norway.
| | - Anders Skyrud Danielsen
- Department of Infection Control and Preparedness, Norwegian Institute of Public Health, Postboks 222 Skøyen, 0213, Oslo, Norway.,Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - Eirik Alnes Buanes
- Norwegian Intensive Care and Pandemic Registry (NIPaR), Helse Bergen Health Trust, Bergen, Norway.,Department of Anaesthesiology and Intensive Care Haukeland University Hospital, Bergen, Norway
| | - Lene Kristine Juvet
- Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
| | - Trude Marie Lyngstad
- Department of Infection Control and Preparedness, Norwegian Institute of Public Health, Postboks 222 Skøyen, 0213, Oslo, Norway
| | | | - Lamprini Veneti
- Department of Infection Control and Preparedness, Norwegian Institute of Public Health, Postboks 222 Skøyen, 0213, Oslo, Norway
| | - Sara Viksmoen Watle
- Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
| | - Hinta Meijerink
- Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
| |
Collapse
|
18
|
Assessment of Clinical Profile and Treatment Outcome in Vaccinated and Unvaccinated SARS-CoV-2 Infected Patients. Vaccines (Basel) 2022; 10:vaccines10071125. [PMID: 35891289 PMCID: PMC9321523 DOI: 10.3390/vaccines10071125] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 07/07/2022] [Accepted: 07/13/2022] [Indexed: 12/10/2022] Open
Abstract
Vaccines against severe acute respiratory syndrome-corona virus-2 (SARS-CoV-2) infection, which causes coronavirus disease–19 (COVID-19) in humans, have been developed and are being tested for safety and efficacy. We conducted the cross-sectional prospective cohort study on 820 patients who were positive for SARS-CoV-2 and were admitted to Princess Krishnajammanni trauma care centre (PKTCC), Mysore, which was converted to a designated COVID hospital between April 2021 to July 2021. After obtaining the informed consent, RT-PCR report, vaccination certificate and patient history, patients were classified according to their vaccination status. Results from the study showed decreases in serum ferritin levels, clinical symptoms, improvement in oxygen saturation, early recovery in patients having diabetes and hypertension, and a substantial reduction in the overall duration of hospital stay in vaccinated patients compared to unvaccinated patients. Further, fully vaccinated patients showed better outcomes compared to single dose vaccinated and nonvaccinated patients. Taken together, our findings reaffirm the vaccine’s effectiveness in reducing case fatality and promoting faster recovery compared to nonvaccinated patients. Efforts to increase the number of immunized subjects in the community help to achieve herd immunity and offer protection against the severity of COVID-19 and associated complications while minimizing the public health and economic burden.
Collapse
|
19
|
Salman A, Elsaddik G, El Mawla Z, Masri R, Hamadeh M, Khatoon A, Saliba MW, Michel Minari A, Hassoun M, Abi Hanna P. The Effectiveness of COVID-19 Vaccines in Preventing Hospitalizations During the Delta Wave: A Patient-Population Study at a Major Referral Center. Cureus 2022; 14:e26030. [PMID: 35859980 PMCID: PMC9288660 DOI: 10.7759/cureus.26030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2022] [Indexed: 11/05/2022] Open
Abstract
Background and objective Coronavirus disease 2019 (COVID-19) has turned into a deadly global pandemic since its first discovery in Wuhan, China in December 2019. Safe and effective vaccines against COVID-19 have been introduced to the public and have been shown to reduce the severity of the disease and related mortality rates. COVID-19 vaccination was first introduced in Lebanon in mid-February 2021. In this study, we analyzed the effectiveness of vaccination against COVID-19-related hospitalization during the Delta wave at a major referral center in Lebanon. Methods This patient-population study was conducted on patients hospitalized with COVID-19 between July 1, 2021, and September 30, 2021, at the Rafik Hariri University Hospital (RHUH) in Beirut, Lebanon. Data were collected directly from the patients or from digitized records and included demographic characteristics (age, sex, and comorbidities), vaccination status, oxygen requirement, and outcomes. National vaccination data were collected from the daily bulletin provided by the Lebanese Ministry of Public Health. The data collected were analyzed using SPSS Statistics Version 19.0 (IBM Corp., Armonk, NY). Results A total of 289 patients were included in the study, of whom 90.3% were unvaccinated and 9.7% were vaccinated with at least one dose of a two-dose regimen. Only 4.5% of the 289 patients were fully vaccinated. Among those fully or partially vaccinated, the mean time from symptom onset to hospitalization was shorter but the hospital stay was longer compared to the unvaccinated group. The mortality rate was higher in the unvaccinated group (25.7%) compared to 14.3% among the vaccinated. The vaccine effectiveness compared to the national vaccination rate (22.5% in the population after the first and second dose) was 71.71% and 83.78% respectively. Conclusion The findings of this study highlight the fact that complete/partial vaccination against COVID-19 was highly protective against severe disease and hospitalization during the period with a predominance of the Delta variant in Lebanon.
Collapse
|
20
|
d’Arminio Monforte A, Tavelli A, De Benedittis S, Bai F, Tincati C, Gazzola L, Viganò O, Allegrini M, Mondatore D, Tesoro D, Barbanotti D, Mulé G, Castoldi R, De Bona A, Bini T, Chiumello D, Centanni S, Passarella S, Orfeo N, Marchetti G, Cozzi-Lepri A. Real World Estimate of Vaccination Protection in Individuals Hospitalized for COVID-19. Vaccines (Basel) 2022; 10:vaccines10040550. [PMID: 35455299 PMCID: PMC9031136 DOI: 10.3390/vaccines10040550] [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] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 12/17/2022] Open
Abstract
Whether vaccination confers a protective effect against progression after hospital admission for COVID-19 remains to be elucidated. Observational study including all the patients admitted to San Paolo Hospital in Milan for COVID-19 in 2021. Previous vaccination was categorized as: none, one dose, full vaccination (two or three doses >14 days before symptoms onset). Data were collected at hospital admission, including demographic and clinical variables, age-unadjusted Charlson Comorbidity index (CCI). The highest intensity of ventilation during hospitalization was registered. The endpoints were in-hospital death (primary) and mechanical ventilation/death (secondary). Survival analysis was conducted by means of Kaplan-Meier curves and Cox regression models. Effect measure modification by age was formally tested. We included 956 patients: 151 (16%) fully vaccinated (18 also third dose), 62 (7%) one dose vaccinated, 743 (78%) unvaccinated. People fully vaccinated were older and suffering from more comorbidities than unvaccinated. By 28 days, the risk of death was of 35.9% (95%CI: 30.1−41.7) in unvaccinated, 41.5% (24.5−58.5) in one dose and 28.4% (18.2−38.5) in fully vaccinated (p = 0.63). After controlling for age, ethnicity, CCI and month of admission, fully vaccinated participants showed a risk reduction of 50% for both in-hospital death, AHR 0.50 (95%CI: 0.30−0.84) and for mechanical ventilation or death, AHR 0.49 (95%CI: 0.35−0.69) compared to unvaccinated, regardless of age (interaction p > 0.56). Fully vaccinated individuals in whom vaccine failed to keep them out of hospital, appeared to be protected against critical disease or death when compared to non-vaccinated. These data support universal COVID-19 vaccination.
Collapse
Affiliation(s)
- Antonella d’Arminio Monforte
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
- Correspondence:
| | - Alessandro Tavelli
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
| | - Sara De Benedittis
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
| | - Francesca Bai
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
| | - Camilla Tincati
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
| | - Lidia Gazzola
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
| | - Ottavia Viganò
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
| | - Marina Allegrini
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
| | - Debora Mondatore
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
| | - Daniele Tesoro
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
| | - Diletta Barbanotti
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
| | - Giovanni Mulé
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
| | - Roberto Castoldi
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
| | - Anna De Bona
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
| | - Teresa Bini
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
| | - Davide Chiumello
- Intensive Care Unit ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy;
| | - Stefano Centanni
- Pneumology Unit ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy;
| | - Sabrina Passarella
- Medical Direction ASST Santi Paolo e Carlo, 20142 Milan, Italy; (S.P.); (N.O.)
| | - Nicola Orfeo
- Medical Direction ASST Santi Paolo e Carlo, 20142 Milan, Italy; (S.P.); (N.O.)
| | - Giulia Marchetti
- Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy; (A.T.); (S.D.B.); (F.B.); (C.T.); (L.G.); (O.V.); (M.A.); (D.M.); (D.T.); (D.B.); (G.M.); (R.C.); (A.D.B.); (T.B.); (G.M.)
| | | | | |
Collapse
|
21
|
Tian W, Ren X, Han M, Zhang Y, Gao X, Chen Z, Zhang W. Epidemiological and clinical characteristics of vaccinated COVID-19 patients: A meta-analysis and systematic review. Int J Immunopathol Pharmacol 2022; 36:3946320221141802. [PMID: 36412572 PMCID: PMC9692180 DOI: 10.1177/03946320221141802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: With the global epidemic of coronavirus disease 2019 (COVID-19),
vaccination rates are increasing globally. This study evaluated the relevant
clinical manifestations of vaccinated COVID-19 patients. Methods: We searched
carefully in 11 databases such as PubMed, Embase, Scopus, Cochrane Library, Web
of Science, Ovid, China National Knowledge Infrastructure Database, Wan Fang
Data, Sinomed, VIP Database, and Reading Showing Database up to 26 March 2022.
To search for articles that have described the characteristics of vaccinated
patients including epidemiological and clinical symptoms. Statistical analysis
of the extracted data using STATA 14.0. Results: A total of 58 articles and
263,708 laboratory-confirmed COVID-19 patients were included. Most of the
patients in the vaccinated group had more asymptomatic infection and fewer
severe illnesses. There were significant differences in ethnicity, and strain
infected with COVID-19, and comorbidities (hyperlipidemia, diabetes, obesity,
kidney disease, immunocompromised, cardiovascular disease, and tumor) and
symptoms (fever, cough, gastrointestinal symptoms, neurological symptoms, and
dysgeusia/anosmia) between vaccinated group and unvaccinated group. Oxygen
support, use of steroid, days in hospital, hospital treatment, ICU treatment,
death, and poor prognosis were also significantly different. Conclusion:
Compared with the vaccinated group, patients in the unvaccinated group had a
more severe clinical manifestations. Vaccines are also protective for infected
people.
Collapse
Affiliation(s)
- Wen Tian
- Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Xingxiang Ren
- Department of Endocrinology, Peking University International Hospital, Beijing, China
| | - Mei Han
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yuanyuan Zhang
- Beijing Key Laboratory of Emerging Infectious Disease, Beijing Ditan Hospital, Captital Medical University, Beijing, China
| | - Xu Gao
- Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Zhihai Chen
- Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Wei Zhang
- Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| |
Collapse
|