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
article
Author
Andrea LombardiSimone VillaMarta ColaneriGiovanni ScaglioneFrancesca BaiBenedetta VariscoValeria BonoAntonio VenaChiara DentoneChiara RussoMauro TettamantiGiulia RenisiGiulia VieroCecilia AzzaràMarco ManteroFlora PeyvandiMatteo BassettiGiulia MarchettiAntonio MuscatelloAlessandro NobiliAndrea GoriAlessandra BanderaSilvano BosariLuigia ScudellerGiuliana FusettiLaura RusconiSilvia Dell’OrtoDaniele PratiLuca ValentiSilvia GiovannelliMaria ManuntaGiuseppe LamorteFrancesca FerarriAndrea Gori.Davide MangioniLaura AlagnaGiorgio BozziAndrea Lombardi.Riccardo UngaroGiuseppe AnconaMarco MussaBianca Veronica MarianiMatteo BolisNathalie IannottiSerena LudovisiAgnese ComelliSimona BiscariniValeria CastelliEmanuele PalombaMarco FavaCarlo Alberto PeriPaola SaltiniTeresa ItriValentina FerroniValeria PastoreRoberta MassafraArianna LiparotiToussaint MuheberimanaAlessandro GiommiRosaria BiancoGrazia Eliana ChitaniChiara BobbioIrene De MatteisAngelo Bianchi BonomiRoberta GualtierottiBarbara FerrariRaffaella RossioNadia BoasiErica PagliaroCostanza MassimoMichele De CaroAndrea GiachiNicola MontanoBarbara VigoneChiara BellocchiAngelica CarandinaElisa FiorelliValerie MelliEleonora TobaldiniFrancesco BlasiStefano AlibertiMaura SpottiLeonardo TerranovaSofia MisuracaAlice D’AddaSilvia Della FioreMarta Di PasqualeMarco Mantero.Martina ContariniMargherita OriLetizia MorlacchiValeria RossettiAndrea GramegnaMaria PappaletteraMirta CavalliniAgata BuscemiMarco VicenziIrena RotaGiorgio CostantinoMonica SolbiatiLudovico FurlanMarta MancarellaGiulia ColomboGiorgio ColomboAlice FaninMariele PassarellaValter MonzaniCiro CanettaAngelo RovelliniLaura BarbettaFilippo BilliChristian FolliSilvia AccordinoDiletta MairaCinzia Maria HuIrene MottaNatalia ScaramelliniAnna Ludovica FracanzaniRosa LombardiAnnalisa CespiatiMatteo CesariTiziano LucchiMarco ProiettiLaura CalcaterraClara MandelliCarlotta CoppolaArturo CerizzaAntonio Maria PesentiGiacomo GrasselliAlessandro GalazziAlessandro Nobili.Igor MontiAlessia Antonella GalbusseraErnesto CrisafulliDomenico GirelliAlessio MarocciaDaniele GabbianiFabiana BustiAlice VianelloMarta BiondanFilippo SartoriPaola FaverioAlberto PesciStefano ZucchettiPaolo BonfantiMarianna RossiIlaria BerettaAnna SpoltiSergio HarariDavide EliaRoberto CassandroAntonella CaminatiFrancesco CipolloneMaria Teresa GuagnanoDamiano D’ArdesIlaria RossiFrancesca VezzaniAntonio SpanevelloFrancesca CherubinoDina ViscaMarco ContoliAlberto PapiLuca MorandiNicholas BattistiniGuido Luigi MoreoPasqualina IannuzziDaniele FumagallaSara Leone
Source
Journal of Infection and Public Health, Vol 17, Iss 3, Pp 467-473 (2024)
Subject
Vaccination
Breakthrough infection
SARS-COV-2
Infectious and parasitic diseases
RC109-216
Public aspects of medicine
RA1-1270
Language
English
ISSN
1876-0341
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.