Association of disease severity and death outcome with vaccination status of admitted COVID-19 patients in delta period of SARS-COV-2 in mixed variety of vaccine background

Aslam, Javaria; Hassan, Muhammad Rauf ul; Fatima, Qindeel; Hashmi, Hala Bashir; Alshahrani, Mohammad Y.; Alkhathami, Ali G.; Aneela, Irrum

doi:10.1016/j.sjbs.2022.103329

Cited by 14 publications

(12 citation statements)

References 25 publications

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“…The most prevalent symptoms and signs, including dyspnea, fever, dry cough, tachypnea, and decreased oxygen saturation, were consistent with previous studies [39][40][41][42][43][44][45][46][47][48][49][50]. Unvaccinated patients had a higher prevalence of dyspnea, increased respiratory rate, and lower oxygen saturation values, corroborating ndings from similar studies [51][52][53][54][55]. Interestingly, despite a higher incidence of asthma in the vaccinated group, this comorbidity has been linked to reduced mortality in hospitalized patients due to its association with T H 2 lymphocyte in ammation, which acts as a protective…”

Section: Discussionsupporting

confidence: 90%

COVID-19 Vaccination and Mortality Reduction: A Prospective Cohort Study in Venezuela

Forero-Peña,

Leyva,

Valenzuela

et al. 2023

Preprint

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Background While rigorous randomized clinical trials have substantiated the efficacy of COVID-19 vaccines in reducing hospitalization and mortality rates, there is a paucity of post-authorization analyses conducted in real-world settings. In Venezuela, the primary vaccines administered are Sinopharm and Sputnik-V. However, the performance and effectiveness of these vaccines within this specific population remain to be thoroughly investigated. Methods A prospective cohort study was undertaken from October 5, 2021, to March 31, 2022, across four sentinel hospitals in Venezuela. The outcomes were evaluated at two time points: day 28 and day 48, utilizing the WHO’s COVID-19 Clinical Progression Scale. For the purpose of analysis, patients were classified into two groups: vaccinated and unvaccinated. Results The study included a total of 175 patients, of which 85 (48.6%) were categorized as vaccinated, with the majority (76.5%) having received two doses. The median age of the patients was 68 years, with a slight predominance of females (53.1%), and the majority being unemployed/retired (60.6%). Hypertension (53.1%) and diabetes (18.3%) were the most prevalent comorbidities. The median Charlson index of the patients was 3 points, with no statistically significant differences observed between the groups (p = 0.2). Upon admission, dyspnea was more commonly observed in unvaccinated patients compared to vaccinated patients (76.7% vs. 62.4%, p = 0.039). Almost all laboratory parameters were comparable in both groups, with the exception of the median D-dimer level, which was significantly higher in unvaccinated patients (7.6 vs. 1.4 µg/mL, p = 0.015). A total of 50 patients (28.6%) died of the disease, with a higher proportion of deaths observed in unvaccinated patients compared to vaccinated patients (35.6% vs. 21.2%, p = 0.035). Factors such as advanced age (OR = 1.043, 95%CI = 1.015–1.071, p = 0.002) were associated with increased odds of death, while factors such as vaccination against COVID-19 (OR = 0.428, 95%CI = 0.185–0.99, p = 0.047), high oxygen saturation (OR = 0.964, 95%CI = 0.934–0.995, p = 0.024), and enoxaparin administration (OR = 0.292, 95%CI = 0.093–0.917, p = 0.035) were associated with decreased odds of death. Conclusion In the course of the third and fourth waves of the pandemic, vaccination against COVID-19 was found to be associated with a 57% reduction in mortality among patients treated in four public hospitals in Venezuela.

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Section: Discussionsupporting

confidence: 90%

COVID-19 Vaccination and Mortality Reduction: A Prospective Cohort Study in Venezuela

Forero-Peña,

Leyva,

Valenzuela

et al. 2023

Preprint

View full text Add to dashboard Cite

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“…Research with relatively small samples of hospitalized patients shows that vaccination reduces mortality. 4 , 10 , 11 However, the small sample sizes of these studies limit the ability to determine associations between vaccination and disease severity in specific patient groups. Such information could reveal groups who would benefit from additional preventive or ameliorative actions to reduce their risk of COVID-19 morbidity or mortality.…”

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confidence: 99%

The Relationship of COVID-19 Vaccination with Mortality Among 86,732 Hospitalized Patients: Subpopulations, Patient Factors, and Changes over Time

et al. 2023

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Information on COVID-19 vaccination effects on mortality among patients hospitalized with COVID-19 could inform vaccination outreach efforts and increase understanding of patient risk. Determine the associations of vaccination status with mortality in adult patients hospitalized with COVID-19. This retrospective cohort study assessed the characteristics and mortality rates of adult patients hospitalized with COVID-19 across 21 healthcare systems in the USA from January 1, 2021, to January 31, 2022. Adult patients admitted to participating hospitals who had COVID-19 diagnoses and/or positive PCR tests and completed their hospital stay via discharge or death. In-hospital mortality vs. discharge (outcome) and patient age, sex, race, ethnicity, BMI, insurance status, comorbidities, and vaccination status extracted from the electronic health record (EHR). Of 86,732 adult patients hospitalized with COVID-19, 45,082 (52%) were female, mean age was 60 years, 20,800 (24%) were Black, and 22,792 (26.3%) had one or more COVID-19 vaccinations. Statistically adjusted mortality rates for unvaccinated and vaccinated patients were 8.3% (95% CI, 8.1–8.5) and 5.1% (95% CI, 4.8–5.4) respectively (7.9% vs. 4.5% with no immune compromise). Vaccination was associated with especially large reductions in mortality for obese (OR = 0.67; 95% CI 0.56–0.80) and severely obese (OR = 0.52; 95% CI, 0.41–0.67) patients and for older patients (OR = 0.99; 95% CI, 0.98–0.99). Mortality likelihood was higher later in the study period (August 2021–January 31, 2022) than earlier (January 1, 2021–July 30, 2021) (OR = 1.10; 95% CI = 1.04–1.17) and increased significantly for vaccinated patients from 4.6% (95% CI, 3.9–5.2%) to 6.5% (95% CI, 6.2–6.9%). Patients vaccinated for COVID-19 had reduced mortality, especially for obese/severely obese and older individuals. Vaccination’s protective effect against mortality declined over time and hospitalized obese and older individuals may derive especially great benefit from prior vaccination against SARS-CoV-2.

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“…Pre-existing immunity acquired through vaccination substantially contributes to preventing the spread of SARS-CoV-2, thus having a positive impact on hospitalization rate, disease progression, mechanical ventilation ratio and fatality rate in COVID-19 patients. 12 , 13 However, the rapid evolution and constant mutation of SARS-CoV-2 have enabled it to evade pre-existing immunity acquired through vaccination or natural infection and potentially induce breakthrough or recurrent infections of different variants, thus making it impossible to completely control the COVID-19 epidemic by vaccination alone. 14 – 16 In this context, timely detection of COVID-19 patients at high risk of disease deterioration during hospitalization is a prerequisite for prompt and appropriate interventions to reduce the proportion of critically ill patients and even fatality rate, especially when COVID-19 outbreaks overwhelm relatively limited medical resources.…”

Section: Discussionmentioning

confidence: 99%

Dynamic lymphocyte-CRP ratio as a predictor: a single-centre retrospective study on disease severity and progression in adult COVID-19 patients

Wang,

Gao,

Lai

et al. 2024

J Int Med Res

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Objective To assess the efficacy of dynamic changes in lymphocyte-C-reactive protein ratio (LCR) on differentiating disease severity and predicting disease progression in adult patients with Coronavirus disease 2019 (COVID-19). Methods This single-centre retrospective study enrolled adult COVID-19 patients categorized into moderate, severe and critical groups according to the Diagnosis and Treatment of New Coronavirus Pneumonia (ninth edition). Demographic and clinical data were collected. LCR and sequential organ failure assessment (SOFA) score were calculated. Lymphocyte count and C-reactive protein (CRP) levels were monitored on up to four occasions. Disease severity was determined concurrently with each LCR measurement. Results This study included 145 patients assigned to moderate ( n = 105), severe ( n = 33) and critical groups ( n = 7). On admission, significant differences were observed among different disease severity groups including age, comorbidities, neutrophil proportion, lymphocyte count and proportion, D-Dimer, albumin, total bilirubin, direct bilirubin, indirect bilirubin, CRP and SOFA score. Dynamic changes in LCR showed significant differences across different disease severity groups at different times, which were significantly inversely correlated with disease severity of COVID-19, with correlation coefficients of −0.564, −0.548, −0.550 and −0.429 at four different times. Conclusion Dynamic changes in LCR can effectively differentiate disease severity and predict disease progression in adult COVID-19 patients.

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Association of disease severity and death outcome with vaccination status of admitted COVID-19 patients in delta period of SARS-COV-2 in mixed variety of vaccine background

Cited by 14 publications

References 25 publications

COVID-19 Vaccination and Mortality Reduction: A Prospective Cohort Study in Venezuela

COVID-19 Vaccination and Mortality Reduction: A Prospective Cohort Study in Venezuela

The Relationship of COVID-19 Vaccination with Mortality Among 86,732 Hospitalized Patients: Subpopulations, Patient Factors, and Changes over Time

Dynamic lymphocyte-CRP ratio as a predictor: a single-centre retrospective study on disease severity and progression in adult COVID-19 patients

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