Evaluation of clinical outcomes of vaccinated and unvaccinated patients with hospitalization for COVID-19

Ozdemir, Yusuf Emre and Kizilcay, Burak and Sonmezisik, Muge and Tarhan, Muhammet Salih and Borcak, Deniz and Ozdemir, Meryem Sahin and Bayramlar, Osman Faruk and Yesilbag, Zuhal and Senoglu, Sevtap and Gedik, Habip (2022) Evaluation of clinical outcomes of vaccinated and unvaccinated patients with hospitalization for COVID-19. ACTA MICROBIOLOGICA ET IMMUNOLOGICA HUNGARICA, 69 (4). pp. 270-276. ISSN 1217-8950

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Abstract

We aimed to compare vaccinated and unvaccinated patients hospitalized with COVID-19 in terms of disease severity, need for intensive care unit (ICU) admission, and death. In addition, we determined the factors affecting the COVID-19 severity in vaccinated patients. Patients aged 18-65 years who were hospitalized for COVID-19 between September and December 2021 were retrospectively analyzed in three groups: unvaccinated, partially vaccinated, and fully vaccinated. A total of 854 patients were included. Mean age was 47.9 +/- 10.6 years, 474 patients (55.5%) were male. Of these, 230 patients (26.9%) were fully vaccinated, 97 (11.3%) were partially vaccinated, and 527 (61.7%) were unvaccinated. Of the fully vaccinated patients, 67% (n 5 153) were vaccinated with CoronaVac and 33% (n 5 77) were vaccinated with Pfizer-BioNTech. All patients (n 5 97) with a single dose were vaccinated with Pfizer-BioNTech. One hundred thirteen (13.2%) patients were transferred to ICU. A hundred (11.7%) patients were intubated and 77 (9.0%) patients died. Advanced age (P 5 0.028, 95% CI 5 1.00-1.07, OR 5 1.038) and higher Charlson Comorbidity Index (CCI) (P < 0.001, 95% CI 5 1.20-1.69, OR 5 1.425) were associated with increased mortality, while being fully vaccinated (P 5 0.008, 95% CI 5 0.23-0.80, OR 5 0.435) was associated with survival in multivariate analysis. Full dose vaccination reduced the need for ICU admission by 49.7% (95% CI 5 17-70) and mortality by 56.5% (95% CI 5 20-77). When the fully vaccinated group was evaluated, we found that death was observed more frequent in patients with CCI>3 (19.1 vs 5.8%, P < 0.01, OR 5 3.7). Therefore, the booster vaccine especially in individuals with comorbidities should not be delayed, since the survival expectation is low in patients with a high comorbidity index.

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