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Clinical Course of 53 Previously Vaccinated Patients Admitted to the National Hospital in Warsaw, Poland with

Artur Zaczyński1, Michał Hampel1, Paweł Piątkiewicz2

  • 1Central Clinical Hospital of the Ministry of Interior and Administration in Warsaw, Warsaw, Poland.

Medical Science Monitor : International Medical Journal of Experimental and Clinical Research
|April 29, 2023
PubMed

Insights

Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reduces severe coronavirus disease 2019 (COVID-19) hospitalizations. However, longer intervals since vaccination were associated with fewer intensive care unit admissions and lower mortality rates in breakthrough COVID-19 cases.

Area of Science:

  • Infectious Diseases
  • Vaccinology
  • Public Health

Background:

  • Current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines and boosters aim to prevent severe coronavirus disease 2019 (COVID-19) hospitalizations.
  • Vaccination does not entirely prevent SARS-CoV-2 infection, leading to breakthrough cases.
  • Understanding breakthrough infections is crucial for ongoing public health strategies.

Purpose of the Study:

  • To evaluate factors associated with the clinical course of breakthrough COVID-19 in vaccinated patients.
  • To analyze the impact of time since vaccination on COVID-19 severity.
  • To compare clinical outcomes across different vaccine types.

Main Methods:

  • Retrospective study of 53 hospitalized patients with breakthrough COVID-19 between November 2021 and March 2022.
  • Patients received one of four vaccines: mRNA-1273 (Spikevax), BNT162b2 (Comirnaty), Ad26.COV2.S (Jcovden), or AZD1222 (Vaxzevria).
  • Clinical data including ICU stay, mortality, and hospitalization duration were analyzed.

Main Results:

  • Vaccination intervals longer than 24 weeks were associated with significantly lower ICU admissions (P=0.021) and reduced mortality (P=0.046).
  • Women experienced longer hospital stays compared to men (P=0.011).
  • Age and comorbidities did not significantly impact the clinical course of breakthrough infections.

Conclusions:

  • While COVID-19 vaccines offer significant benefits, breakthrough infections can occur.
  • The time elapsed since vaccination appears to influence disease severity, with longer intervals potentially indicating waning immunity.
  • Further research comparing vaccine efficacy and identifying factors influencing immunity duration is warranted.

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