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. (c) 2024 The Author(s). Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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, 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, S. Biscarini, V. Castelli, E. Palomba, M. Fava, C.A. Peri, P. Saltini, 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, 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. 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, 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. - 17:3(2024 Mar), pp. 467-473. [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;M. Colaneri;G. Scaglione;F. Bai;B. Varisco;V. Bono;G. Viero;M. Mantero;F. Peyvandi;A. Gori;A. Bandera;S. Bosari;L. Valenti;D. Mangioni;R. Ungaro;V. Castelli;C.A. Peri;P. Saltini;V. Pastore;A. Liparoti;T. Muheberimana;A. Giommi;C. Bobbio;R. Gualtierotti;E. Pagliaro;C. Massimo;M. De Caro;A. Giachi;N. Montano;B. Vigone;C. Bellocchi;A. Carandina;E. Tobaldini;F. Blasi;S. Aliberti;M. Spotti;L. Terranova;S. Misuraca;M. Contarini;L. Morlacchi;A. Gramegna;M. Pappalettera;A. Buscemi;M. Vicenzi;G. Costantino;M. Solbiati;A. Fanin;M. Passarella;V. Monzani;F. Billi;S. Accordino;D. Maira;N. Scaramellini;A.L. Fracanzani;R. Lombardi;A. Cespiati;M. Cesari;M. Proietti;L. Calcaterra;G. Grasselli;S. Harari;
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. (c) 2024 The Author(s). Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Breakthrough infection; SARS-COV-2; Vaccination
Settore MED/17 - Malattie Infettive
mar-2024
17-gen-2024
Article (author)
File in questo prodotto:
File Dimensione Formato  
COVID 19 NETWORK. Clinical characteristics and outcomes of vaccinated patients.pdf

accesso aperto

Descrizione: Original Article
Tipologia: Publisher's version/PDF
Dimensione 671.41 kB
Formato Adobe PDF
671.41 kB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/1049787
Citazioni
  • ???jsp.display-item.citation.pmc??? 0
  • Scopus 0
  • ???jsp.display-item.citation.isi??? 0
social impact