Disease Severity in Vaccinated Adults Hospitalized with Breakthrough COVID-19
Arkadiy Finn1, Vijairam Selvaraj1, Atin Jindal1
1Division of Hospital Medicine, Department of Medicine, Warren Alpert School of Medicine at Brown University, Providence, RI, USA.
Insights
COVID-19 vaccination reduces disease severity in hospitalized patients. However, protection may wane over time, as longer intervals between vaccination and infection correlated with increased illness indicators.
Area of Science:
- Infectious Diseases
- Immunology
- Public Health
Background:
- COVID-19 vaccines are widely implemented, offering protection against severe illness and death.
- Limited data exists on disease severity and outcomes for fully vaccinated individuals hospitalized with COVID-19.
Purpose of the Study:
- To investigate the impact of vaccination status on COVID-19 disease severity.
- To determine if the time elapsed since vaccination influences disease severity in hospitalized COVID-19 patients.
Main Methods:
- A multicenter retrospective cohort study analyzed 424 hospitalized COVID-19 patients (January 1 - September 8, 2021).
- Patients were matched (3:1 unvaccinated to vaccinated).
- Disease severity markers included C-reactive protein, D-Dimer, and supplemental oxygen needs.
Main Results:
- Vaccinated patients exhibited lower peak C-reactive protein and reduced supplemental oxygen requirements compared to unvaccinated individuals.
- A longer interval between vaccination and hospitalization was linked to higher C-reactive protein and increased need for supplemental oxygen.
Conclusions:
- SARS-CoV-2 vaccination demonstrates a protective effect against severe COVID-19 during hospitalization for breakthrough infections.
- The time since vaccination is associated with indicators of greater disease severity, suggesting waning vaccine efficacy over time.
Abstract:
Background: Vaccination against SARS-CoV-2 is widely used and confers protection against morbidity and mortality in COVID-19. Little is known about disease severity and outcomes in fully vaccinated patients during hospitalization for COVID-19. Aim: To determine whether vaccination status and time from vaccination-to-hospitalization impacted disease severity in patients admitted with COVID-19. Methods: A multicenter retrospective cohort study was conducted on hospitalized adults with COVID-19 between January 1 and September 8, 2021, in Rhode Island, USA. Vaccination status and markers of disease severity, including C-reactive protein, D-Dimer values, and supplemental oxygen use during hospitalization, were obtained. Results: Two thousand three hundred forty-four patients were included. For every vaccinated patient, three unvaccinated patients were matched for a total of 424 patients in the analytic sample. Vaccinated patients had lower peak C-reactive protein (beta = -39.10, 95% CI [-79.10, -0. 65]) and supplemental oxygen requirements (beta = -38.14, 95% CI [-61.62, -9.91]) compared to unvaccinated patients. Patients who had a greater discrepancy between date of vaccination and admission had higher C-reactive protein (beta = 0.37, 95% CI [0.02, 0.71]) and supplemental oxygen requirements (beta = 0.44, 95% CI [0.15, 0.75]. Conclusion: Vaccination against SARS-CoV-2 was associated with a protective effect on disease severity during hospitalization for breakthrough COVID-19. Time elapsed since vaccination was associated with indicators of greater disease severity suggestive of waning protection over time.
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