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Characteristics of COVID-19 vaccinated and unvaccinated patients admitted to Careggi University Hospital, Florence,

Riccardo Paggi1, Anna Barbiero1, Tommaso Manciulli1

  • 1Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.

Internal and Emergency Medicine
|February 28, 2023
PubMed

Insights

COVID-19 vaccinated patients, even those with breakthrough infections, showed similar outcomes to unvaccinated individuals. However, vaccinated patients lacking antibodies had higher mortality, emphasizing the need for early treatment in vulnerable groups.

Area of Science:

  • Immunology
  • Epidemiology
  • Public Health

Background:

  • Over 11.5 billion COVID-19 vaccine doses administered globally.
  • Vaccine effectiveness against severe disease is high (89.0%), but breakthrough infections occur.
  • Fragile populations remain at risk for severe outcomes despite vaccination.

Purpose of the Study:

  • To evaluate COVID-19 outcomes in vaccinated versus unvaccinated patients in a real-world setting.
  • To investigate the impact of serological status on outcomes among vaccinated individuals.
  • To identify factors influencing in-hospital mortality and resource utilization.

Main Methods:

  • Real-world observational study of 420 COVID-19 admitted patients (July 2021-January 2022).
  • Collected data on vaccination status, SARS-CoV-2 serology, treatments, oxygen support, ICU/sub-ICU admissions, length of stay, and mortality.
  • Compared outcomes between vaccinated (Vg) and unvaccinated (UVg) groups, and stratified vaccinated patients by serological status.

Main Results:

  • Vg had higher Charlson Comorbidity Index than UVg; no significant differences in mortality, LoS, or ICU/sub-ICU admissions.
  • 86.18% of vaccinated patients had detectable anti-S antibodies (seropositive).
  • Vaccinated seronegative patients had significantly higher in-hospital mortality (33.33%) than seropositive patients (10.69%).
  • Higher mortality in vaccinated seronegative patients aged 45-69; comparable mortality in those ≥70.
  • No outcome differences between Vg and UVg when adjusting for age and comorbidities.

Conclusions:

  • Vaccination did not significantly alter outcomes between vaccinated and unvaccinated groups, considering comorbidities.
  • Vaccinated individuals who were seronegative exhibited a higher mortality rate.
  • Primary prophylaxis and early treatment are crucial, particularly for older and immunosuppressed populations.

Keywords:
Breakthrough infectionCOVID-19 serological testingCovid-19HospitalisationMortalitySARS-CoV-2 vaccines

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