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Beraud G, Bouetard L, Civljak R, Michon J, Tulek N, Lejeune S, Millot R, Garchet-Beaudron A, Lefebvre M, Velikov P, Festou B, Abgrall S, Lizatovic IK, Baldolli A, Esmer H, Blanchi S, Froidevaux G, Kapincheva N, Faucher JF, Duvnjak M, Afşar E, Švitek L, Yarimoglu S, Yarimoglu R, Janssen C, Epaulard O. Impact of vaccination on the presence and severity of symptoms in hospitalized patients with an infection of the Omicron variant (B.1.1.529) of the SARS-CoV-2 (subvariant BA.1). Clin Microbiol Infect 2022; 29:642-650. [PMID: 36587737 PMCID: PMC9798780 DOI: 10.1016/j.cmi.2022.12.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/23/2022] [Accepted: 12/24/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVES The emergence of SARS-CoV-2 variants raised questions about the extent to which vaccines designed in 2020 have remained effective. We aimed to assess whether vaccine status was associated with the severity of Omicron SARS-CoV-2 infection in hospitalized patients. METHODS We conducted an international, multi-centric, retrospective study in 14 centres (Bulgaria, Croatia, France, and Turkey). We collected data on patients hospitalized for ≥24 hours between 1 December 2021 and 3 March 2022 with PCR-confirmed infection at a time of exclusive Omicron circulation and hospitalization related or not related to the infection. Patients who had received prophylaxis by monoclonal antibodies were excluded. Patients were considered fully vaccinated if they had received at least two injections of either mRNA and/or ChAdOx1-S or one injection of Ad26.CoV2-S vaccines. RESULTS Among 1215 patients (median age, 73.0 years; interquartile range, 57.0-84.0; 51.3% men), 746 (61.4%) were fully vaccinated. In multivariate analysis, being vaccinated was associated with lower 28-day mortality (Odds Ratio [95% Confidence Interval] (OR [95CI]) = 0.50 [0.32-0.77]), intensive care unit admission (OR [95CI] = 0.40 [0.26-0.62]), and oxygen requirement (OR [95CI] = 0.34 [0.25-0.46]), independent of age and comorbidities. When co-analysing these patients with Omicron infection with 948 patients with Delta infection from a study we recently conducted, Omicron infection was associated with lower 28-day mortality (OR [95CI] = 0.53 [0.37-0.76]), intensive care unit admission (OR [95CI] = 0.19 [0.12-0.28]), and oxygen requirements (OR [95CI] = 0.50 [0.38-0.67]), independent of age, comorbidities, and vaccination status. DISCUSSION Originally designed vaccines have remained effective on the severity of Omicron SARS-CoV-2 infection. Omicron is associated with a lower risk of severe forms, independent of vaccination and patient characteristics.
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Affiliation(s)
- Guillaume Beraud
- Infectious Disease Department, University Hospital of Poitiers, Poitiers, France.
| | - Laura Bouetard
- Assistance Publique des Hôpitaux de Paris, Hôpital Antoine Béclère, Service de Médecine Interne, Clamart, France,Université Paris-Saclay, Université de Versailles Saint-Quentin-en-Yvelines, INSERM U1018, Centre de Recherche en Épidémiologie et Santé des Populations, Le Kremlin-Bicêtre, France
| | - Rok Civljak
- University Hospital for Infectious Diseases ‘Dr. Fran Mihaljevic’ Zagreb, Croatia,University of Zagreb School of Medicine, Zagreb, Croatia
| | - Jocelyn Michon
- Department of Infectious Diseases, University Hospital of Caen, Caen, France
| | - Necla Tulek
- Atilim University, Department of Infectious Diseases and Clinical Microbiology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Sophie Lejeune
- Infectious Diseases, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Romain Millot
- Infectious Disease Department, University Hospital of Poitiers, Poitiers, France
| | | | - Maeva Lefebvre
- Infectious Diseases Department, Centre for Prevention of Infectious and Transmissible Diseases, Centre Hospitalier Universitaire de Nantes, Nantes, France,INSERM Centre d'Investigation Clinique 1413 Nantes University, Nantes, France
| | - Petar Velikov
- Infectious Diseases Hospital ‘Prof. Ivan Kirov’, Medical University of Sofia, Sofia, Bulgaria
| | - Benjamin Festou
- Centre Hospitalier Universitaire de Limoges, Department of Infectious Diseases and Tropical Medicine, Limoges, France
| | - Sophie Abgrall
- Assistance Publique des Hôpitaux de Paris, Hôpital Antoine Béclère, Service de Médecine Interne, Clamart, France,Université Paris-Saclay, Université de Versailles Saint-Quentin-en-Yvelines, INSERM U1018, Centre de Recherche en Épidémiologie et Santé des Populations, Le Kremlin-Bicêtre, France
| | - Ivan K. Lizatovic
- University Hospital for Infectious Diseases ‘Dr. Fran Mihaljevic’ Zagreb, Croatia
| | - Aurélie Baldolli
- Department of Infectious Diseases, University Hospital of Caen, Caen, France
| | - Huseyin Esmer
- Atilim University, Department of Infectious Diseases and Clinical Microbiology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Sophie Blanchi
- Infectious Diseases Department, Centre Hospitalier, Le Mans, France
| | - Gabrielle Froidevaux
- Infectious Diseases Department, Centre for Prevention of Infectious and Transmissible Diseases, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Nikol Kapincheva
- Infectious Diseases Hospital ‘Prof. Ivan Kirov’, Medical University of Sofia, Sofia, Bulgaria
| | - Jean-François Faucher
- Centre Hospitalier Universitaire de Limoges, Department of Infectious Diseases and Tropical Medicine, Limoges, France,INSERM U1094, Limoges, France
| | - Mario Duvnjak
- Clinic for Infectious Diseases, University Hospital Centre Osijek, Osijek, Croatia,Faculty of Medicine Osijek, J. J. Strossmayer University of Osijek, Osijek, Croatia
| | - Elçin Afşar
- Atılım University, Vocational School of Health Services, Ankara, Turkey
| | - Luka Švitek
- Clinic for Infectious Diseases, University Hospital Centre Osijek, Osijek, Croatia,Faculty of Medicine Osijek, J. J. Strossmayer University of Osijek, Osijek, Croatia
| | | | | | - Cécile Janssen
- Infectious Disease Unit, Centre Hospitalier Annecy Genevois, Annecy, France
| | - Olivier Epaulard
- Infectious Diseases, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
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