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.
Clinical characteristics and outcomes of vaccinated patients hospitalised with SARS-CoV-2 breakthrough infection: Multi-IPV, a multicentre study in Northern Italy / A. Lombardi, S. Villa, M. Colaneri, G. Scaglione, F. Bai, B. Varisco, V. Bono, A. Vena, C. Dentone, C. Russo, M. Tettamanti, G. Renisi, G. Viero, C. Azzarà, M. Mantero, F. Peyvandi, M. Bassetti, G. Marchetti, A. Muscatello, A. Nobili, A. Gori, A. Bandera, S. Bosari, L. Scudeller, G. Fusetti, L. Rusconi, S. Dell’Orto, D. Prati, L. Valenti, S. Giovannelli, M. Manunta, G. Lamorte, F. Ferarri, A. Gori., A. Bandera, A. Muscatello, D. Mangioni, L. Alagna, G. Bozzi, A. Lombardi., R. Ungaro, G. Ancona, M. Mussa, B.V. Mariani, M. Bolis, N. Iannotti, S. Ludovisi, A. Comelli, G. Renisi, S. Biscarini, V. Castelli, E. Palomba, M. Fava, C.A. Peri, P. Saltini, G. Viero, T. Itri, V. Ferroni, V. Pastore, R. Massafra, A. Liparoti, T. Muheberimana, A. Giommi, R. Bianco, G.E. Chitani, C. Bobbio, I. De Matteis, A.B. Bonomi, F. Peyvandi, R. Gualtierotti, B. Ferrari, R. Rossio, N. Boasi, E. Pagliaro, C. Massimo, M. De Caro, A. Giachi, N. Montano, B. Vigone, C. Bellocchi, A. Carandina, E. Fiorelli, V. Melli, E. Tobaldini, F. Blasi, S. Aliberti, M. Spotti, L. Terranova, S. Misuraca, A. D’Adda, S. Della Fiore, M. Di Pasquale, M. Mantero., M. Contarini, M. Ori, L. Morlacchi, V. Rossetti, A. Gramegna, M. Pappalettera, M. Cavallini, A. Buscemi, M. Vicenzi, I. Rota, G. Costantino, M. Solbiati, L. Furlan, M. Mancarella, G. Colombo, G. Colombo, A. Fanin, M. Passarella, V. Monzani, C. Canetta, A. Rovellini, L. Barbetta, F. Billi, C. Folli, S. Accordino, D. Maira, C.M. Hu, I. Motta, N. Scaramellini, A.L. Fracanzani, R. Lombardi, A. Cespiati, M. Cesari, T. Lucchi, M. Proietti, L. Calcaterra, C. Mandelli, C. Coppola, A. Cerizza, A.M. Pesenti, G. Grasselli, A. Galazzi, A. Nobili., M. Tettamanti, I. Monti, A.A. Galbussera, E. Crisafulli, D. Girelli, A. Maroccia, D. Gabbiani, F. Busti, A. Vianello, M. Biondan, F. Sartori, P. Faverio, A. Pesci, S. Zucchetti, P. Bonfanti, M. Rossi, I. Beretta, A. Spolti, S. Harari, D. Elia, R. Cassandro, A. Caminati, F. Cipollone, M.T. Guagnano, D. D’Ardes, I. Rossi, F. Vezzani, A. Spanevello, F. Cherubino, D. Visca, M. Contoli, A. Papi, L. Morandi, N. Battistini, G.L. Moreo, P. Iannuzzi, D. Fumagalla, S. Leone. - In: JOURNAL OF INFECTION AND PUBLIC HEALTH. - ISSN 1876-0341. - (2024), pp. 1-14. [Epub ahead of print] [10.1016/j.jiph.2023.12.026]
Clinical characteristics and outcomes of vaccinated patients hospitalised with SARS-CoV-2 breakthrough infection: Multi-IPV, a multicentre study in Northern Italy
A. Lombardi
;S. Villa;G. Scaglione;F. Bai;B. Varisco;V. Bono;G. Viero;M. Mantero;F. Peyvandi;A. Gori;A. Bandera;S. Bosari;S. Dell’Orto;L. Valenti;A. Gori.;A. Bandera;D. Mangioni;G. Bozzi;R. Ungaro;G. Ancona;M. Bolis;N. Iannotti;V. Castelli;E. Palomba;M. Fava;C.A. Peri;G. Viero;V. Pastore;A. Liparoti;T. Muheberimana;A. Giommi;C. Bobbio;F. Peyvandi;R. Gualtierotti;R. Rossio;E. Pagliaro;M. De Caro;A. Giachi;N. Montano;B. Vigone;C. Bellocchi;A. Carandina;E. Tobaldini;F. Blasi;S. Aliberti;L. Terranova;S. Misuraca;A. D’Adda;M. Di Pasquale;M. Mantero.;M. Contarini;L. Morlacchi;A. Gramegna;M. Pappalettera;M. Cavallini;A. Buscemi;M. Vicenzi;G. Costantino;M. Solbiati;L. Furlan;M. Mancarella;A. Fanin;M. Passarella;F. Billi;S. Accordino;D. Maira;I. Motta;N. Scaramellini;A.L. Fracanzani;R. Lombardi;A. Cespiati;M. Cesari;M. Proietti;L. Calcaterra;C. Mandelli;A. Cerizza;G. Grasselli;F. Sartori;P. Bonfanti;S. Harari;D. Elia;I. Rossi;P. Iannuzzi;S. Leone
2024
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.File | Dimensione | Formato | |
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