학술논문
Clinical characteristics and outcomes of vaccinated patients hospitalised with SARS-CoV-2 breakthrough infection: Multi-IPV, a multicentre study in Northern Italy.
Document Type
Academic Journal
Author
Lombardi A; Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Infectious Diseases Unit, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy. Electronic address: andrea.lombardi@unimi.it.; Villa S; Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy.; Colaneri M; Department of Infectious Diseases, Ospedale Luigi Sacco, Milan, Italy.; Scaglione G; Department of Infectious Diseases, Ospedale Luigi Sacco, Milan, Italy.; Bai F; Department of Health Sciences, Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, Milan, Italy.; Varisco B; Department of Health Sciences, Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, Milan, Italy.; Bono V; Department of Health Sciences, Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, Milan, Italy.; Vena A; Department of Health Sciences, University of Genoa, Genoa, Italy; Infectious Diseases Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.; Dentone C; Department of Health Sciences, University of Genoa, Genoa, Italy; Infectious Diseases Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.; Russo C; Department of Health Sciences, University of Genoa, Genoa, Italy; Infectious Diseases Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.; Tettamanti M; Department of Health Policy, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy.; Renisi G; Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Infectious Diseases Unit, Milan, Italy.; Viero G; Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Infectious Diseases Unit, Milan, Italy.; Azzarà C; Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Infectious Diseases Unit, Milan, Italy.; Mantero M; 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.; Peyvandi F; 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.; Bassetti M; Department of Health Sciences, University of Genoa, Genoa, Italy; Infectious Diseases Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.; Marchetti G; Department of Health Sciences, Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, Milan, Italy.; Muscatello A; Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Infectious Diseases Unit, Milan, Italy.; Nobili A; Department of Health Policy, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy.; Gori A; Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy; Department of Infectious Diseases, Ospedale Luigi Sacco, Milan, Italy.; Bandera A; Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Infectious Diseases Unit, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy.
Source
Publisher: Elsevier Country of Publication: England NLM ID: 101487384 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1876-035X (Electronic) Linking ISSN: 18760341 NLM ISO Abbreviation: J Infect Public Health Subsets: MEDLINE
Subject
Language
English
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.
Competing Interests: Declaration of Competing Interest All authors declare no competing interests.
(Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
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.
Competing Interests: Declaration of Competing Interest All authors declare no competing interests.
(Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)