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The Effect of Vaccination with Pfizer-BioNTech or CoronaVac on Disease Prognosis Among Hospitalized COVID-19 Patients
Mustafa Güldan1, Sena Tuğana Ateş1, Sebile Sarıoğlu1
1Koç University School of Medicine, Istanbul, Turkey.
Insights
COVID-19 vaccination with Pfizer-BioNTech significantly reduced mortality in hospitalized patients. However, CoronaVac vaccines showed no significant effect in preventing fatalities, highlighting Pfizer-BioNTech
Area of Science:
- Infectious Diseases
- Vaccinology
- Public Health
Background:
- COVID-19 remains a significant global health threat, necessitating effective vaccination strategies.
- Turkey offers CoronaVac and Pfizer-BioNTech vaccines, with varying clinical impacts needing evaluation.
- Understanding vaccine effectiveness in hospitalized patients is crucial for public health policy.
Purpose of the Study:
- To assess the impact of CoronaVac and Pfizer-BioNTech COVID-19 vaccines on clinical outcomes.
- To compare mortality rates between vaccinated and unvaccinated hospitalized COVID-19 patients.
- To identify predictors of mortality in hospitalized COVID-19 patients.
Main Methods:
- Retrospective study of 444 RT-PCR confirmed COVID-19 patients hospitalized between June and December 2021.
- Data collected on patient demographics, comorbidities, vaccination status, and clinical outcomes.
- Multivariate analysis used to identify factors associated with mortality.
Main Results:
- Unvaccinated status, older age (>65), cancer, and chronic kidney disease were significant predictors of mortality.
- Hospitalized patients who received at least one vaccine dose had lower mortality rates compared to unvaccinated patients (17.6% vs. p=0.002).
- None of the patients who received two doses of Pfizer-BioNTech vaccine died, while two doses of CoronaVac showed no significant protective effect against fatality.
Conclusions:
- Being unvaccinated, advanced age, cancer, and chronic kidney disease increase mortality risk in hospitalized COVID-19 patients.
- Two doses of Pfizer-BioNTech vaccine were highly effective in preventing mortality among vaccinated COVID-19 inpatients.
- Two doses of CoronaVac vaccine did not demonstrate significant protection against fatality in this hospitalized patient cohort.
Objective:
The Turkish Ministry of Health offered two types of vaccines by January 13, 2021, which are CoronaVac (Sinovac Biotech, China) and Pfizer-BioNTech. We aimed to describe the impact of the CoronaVac and Pfizer-BioNTech vaccines on clinical outcomes among hospitalized patients during a six-month period.
Methods:
We included patients older than 18 years old and hospitalized because of COVID-19 when the vaccines were available. We conducted the study at Koç University Hospital and American Hospital between June 2021, six months after the vaccination started, and December 2021.
Results:
In total, 444 RT-PCR confirmed hospitalized patients were included. The mean age of the patients was 59 (standard deviation [SD]=18), and 42.8% were female. The most common comorbidity was hypertension (39%), followed by diabetes mellitus (27%), cardiovascular diseases (18.4%), chronic lung diseases (14.6%), cancer (9.2%), and chronic renal diseases (8%). In multivariate analysis, no vaccination (OR=4.7, CI=2.25-10.06; p<0.001), age >65 (OR=5.2, CI=2.25-11.98; p<0.001), cancer (OR=7.6, CI=3.04-19.31; p<0.001), and chronic kidney disease (OR=3.1, CI=1.14-8.74; p=0.026) significantly increased mortality in COVID-19 patients. Eighteen percent of patients were in the intensive care unit (ICU). One hundred eighty-one patients (40.8%) were non-vaccinated before their admission, and their mortality (17.6%) was higher compared to the patients who were vaccinated with at least one type of vaccine (p=0.002). None of the patients who received two doses of Pfizer-BioNTech vaccines died.
Conclusion:
Among the inpatients with COVID-19, the predictors for mortality were being unvaccinated, older age, cancer, chronic kidney disease, and cardiovascular diseases. Among the vaccinated inpatients, having two doses of the Pfizer-BioNTech vaccine was the only effective protective measure against mortality, and two doses of the CoronaVac vaccine had no significant effect in preventing fatality.
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