Cargando…

Risk factors for death and illness severity in vaccinated versus unvaccinated COVID-2019 inpatients: a retrospective cohort study

OBJECTIVE: To determine the clinical profile of COVID-19 inpatients who were vaccinated prior to hospitalization and to compare the risk factors for death and the 28-day survival rate of between those inpatients vaccinated with one, two, or three doses and unvaccinated COVID-19 inpatients. METHODS:...

Descripción completa

Detalles Bibliográficos
Autores principales: Costa, Guilherme Jorge, da Silva, José Roberto, da Silva, Caio Cesar Arruda, de Lima, Tiago Pessoa Ferreira, Costa, Mariana Menezes, Sousa, Marcos Henrique Oliveira, Costa, Gabriela Carla dos Santos, Costa, José Iran, Sales, Mozart Júlio Tabosa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Pneumologia e Tisiologia 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10578947/
https://www.ncbi.nlm.nih.gov/pubmed/37729337
http://dx.doi.org/10.36416/1806-3756/e20230145
_version_ 1785121622609362944
author Costa, Guilherme Jorge
da Silva, José Roberto
da Silva, Caio Cesar Arruda
de Lima, Tiago Pessoa Ferreira
Costa, Mariana Menezes
Sousa, Marcos Henrique Oliveira
Costa, Gabriela Carla dos Santos
Costa, José Iran
Sales, Mozart Júlio Tabosa
author_facet Costa, Guilherme Jorge
da Silva, José Roberto
da Silva, Caio Cesar Arruda
de Lima, Tiago Pessoa Ferreira
Costa, Mariana Menezes
Sousa, Marcos Henrique Oliveira
Costa, Gabriela Carla dos Santos
Costa, José Iran
Sales, Mozart Júlio Tabosa
author_sort Costa, Guilherme Jorge
collection PubMed
description OBJECTIVE: To determine the clinical profile of COVID-19 inpatients who were vaccinated prior to hospitalization and to compare the risk factors for death and the 28-day survival rate of between those inpatients vaccinated with one, two, or three doses and unvaccinated COVID-19 inpatients. METHODS: This was a retrospective observational cohort study involving COVID-19 patients admitted to a referral hospital in the city of Recife, Brazil, between July of 2020 and June of 2022. RESULTS: The sample comprised 1,921 inpatients, 996 of whom (50.8%) were vaccinated prior to hospitalization. After adjusting the mortality risk for vaccinated patients, those undergoing invasive mechanical ventilation (IMV) had the highest mortality risk (adjusted OR [aOR] = 7.4; 95% CI, 3.8-14.1; p < 0.001), followed by patients > 80 years of age (aOR = 7.3; 95% CI, 3.4-15.4; p < 0.001), and those needing vasopressors (aOR = 5.6; 95% CI, 2.9-10.9; p < 0.001). After adjusting the mortality risk for all patients, having received three vaccine doses (aOR = 0.06; 95% CI, 0.03-0.11; p < 0.001) was the most important protective factor against death. There were progressive benefits of vaccination, reducing the frequency of ICU admissions, use for IMV, and death (respectively, from 44.9%, 39.0% and 39.9% after the first dose to 16.7%, 6.2% and 4.4% after the third dose), as well as significant improvements in survival after each subsequent dose (p < 0.001). CONCLUSIONS: Vaccines were effective in reducing illness severity and death in this cohort of COVID-19 inpatients, and the administration of additional doses conferred them with accumulative vaccine protection.
format Online
Article
Text
id pubmed-10578947
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Sociedade Brasileira de Pneumologia e Tisiologia
record_format MEDLINE/PubMed
spelling pubmed-105789472023-10-17 Risk factors for death and illness severity in vaccinated versus unvaccinated COVID-2019 inpatients: a retrospective cohort study Costa, Guilherme Jorge da Silva, José Roberto da Silva, Caio Cesar Arruda de Lima, Tiago Pessoa Ferreira Costa, Mariana Menezes Sousa, Marcos Henrique Oliveira Costa, Gabriela Carla dos Santos Costa, José Iran Sales, Mozart Júlio Tabosa J Bras Pneumol Original Article OBJECTIVE: To determine the clinical profile of COVID-19 inpatients who were vaccinated prior to hospitalization and to compare the risk factors for death and the 28-day survival rate of between those inpatients vaccinated with one, two, or three doses and unvaccinated COVID-19 inpatients. METHODS: This was a retrospective observational cohort study involving COVID-19 patients admitted to a referral hospital in the city of Recife, Brazil, between July of 2020 and June of 2022. RESULTS: The sample comprised 1,921 inpatients, 996 of whom (50.8%) were vaccinated prior to hospitalization. After adjusting the mortality risk for vaccinated patients, those undergoing invasive mechanical ventilation (IMV) had the highest mortality risk (adjusted OR [aOR] = 7.4; 95% CI, 3.8-14.1; p < 0.001), followed by patients > 80 years of age (aOR = 7.3; 95% CI, 3.4-15.4; p < 0.001), and those needing vasopressors (aOR = 5.6; 95% CI, 2.9-10.9; p < 0.001). After adjusting the mortality risk for all patients, having received three vaccine doses (aOR = 0.06; 95% CI, 0.03-0.11; p < 0.001) was the most important protective factor against death. There were progressive benefits of vaccination, reducing the frequency of ICU admissions, use for IMV, and death (respectively, from 44.9%, 39.0% and 39.9% after the first dose to 16.7%, 6.2% and 4.4% after the third dose), as well as significant improvements in survival after each subsequent dose (p < 0.001). CONCLUSIONS: Vaccines were effective in reducing illness severity and death in this cohort of COVID-19 inpatients, and the administration of additional doses conferred them with accumulative vaccine protection. Sociedade Brasileira de Pneumologia e Tisiologia 2023-08-24 /pmc/articles/PMC10578947/ /pubmed/37729337 http://dx.doi.org/10.36416/1806-3756/e20230145 Text en © 2023 Sociedade Brasileira de Pneumologia e Tisiologia https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License which permits unrestricted non-commercial use, distribution, and reproduction in any medium provided the original work is properly cited.
spellingShingle Original Article
Costa, Guilherme Jorge
da Silva, José Roberto
da Silva, Caio Cesar Arruda
de Lima, Tiago Pessoa Ferreira
Costa, Mariana Menezes
Sousa, Marcos Henrique Oliveira
Costa, Gabriela Carla dos Santos
Costa, José Iran
Sales, Mozart Júlio Tabosa
Risk factors for death and illness severity in vaccinated versus unvaccinated COVID-2019 inpatients: a retrospective cohort study
title Risk factors for death and illness severity in vaccinated versus unvaccinated COVID-2019 inpatients: a retrospective cohort study
title_full Risk factors for death and illness severity in vaccinated versus unvaccinated COVID-2019 inpatients: a retrospective cohort study
title_fullStr Risk factors for death and illness severity in vaccinated versus unvaccinated COVID-2019 inpatients: a retrospective cohort study
title_full_unstemmed Risk factors for death and illness severity in vaccinated versus unvaccinated COVID-2019 inpatients: a retrospective cohort study
title_short Risk factors for death and illness severity in vaccinated versus unvaccinated COVID-2019 inpatients: a retrospective cohort study
title_sort risk factors for death and illness severity in vaccinated versus unvaccinated covid-2019 inpatients: a retrospective cohort study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10578947/
https://www.ncbi.nlm.nih.gov/pubmed/37729337
http://dx.doi.org/10.36416/1806-3756/e20230145
work_keys_str_mv AT costaguilhermejorge riskfactorsfordeathandillnessseverityinvaccinatedversusunvaccinatedcovid2019inpatientsaretrospectivecohortstudy
AT dasilvajoseroberto riskfactorsfordeathandillnessseverityinvaccinatedversusunvaccinatedcovid2019inpatientsaretrospectivecohortstudy
AT dasilvacaiocesararruda riskfactorsfordeathandillnessseverityinvaccinatedversusunvaccinatedcovid2019inpatientsaretrospectivecohortstudy
AT delimatiagopessoaferreira riskfactorsfordeathandillnessseverityinvaccinatedversusunvaccinatedcovid2019inpatientsaretrospectivecohortstudy
AT costamarianamenezes riskfactorsfordeathandillnessseverityinvaccinatedversusunvaccinatedcovid2019inpatientsaretrospectivecohortstudy
AT sousamarcoshenriqueoliveira riskfactorsfordeathandillnessseverityinvaccinatedversusunvaccinatedcovid2019inpatientsaretrospectivecohortstudy
AT costagabrielacarladossantos riskfactorsfordeathandillnessseverityinvaccinatedversusunvaccinatedcovid2019inpatientsaretrospectivecohortstudy
AT costajoseiran riskfactorsfordeathandillnessseverityinvaccinatedversusunvaccinatedcovid2019inpatientsaretrospectivecohortstudy
AT salesmozartjuliotabosa riskfactorsfordeathandillnessseverityinvaccinatedversusunvaccinatedcovid2019inpatientsaretrospectivecohortstudy