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The impact of vaccination status on post-acute sequelae in hospitalized COVID-19 survivors using a multi-disciplinary
Lucia Ilaria Birtolo1, Gianluca Di Pietro1, Antonella Ciuffreda1
1Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, "Policlinico Umberto I" Hospital, Rome, Italy.
Insights
COVID-19 vaccination significantly reduces severe illness and may decrease the prevalence of Long COVID-19 syndrome. Vaccinated survivors experienced fewer post-acute sequelae and persistent symptoms compared to unvaccinated individuals.
Area of Science:
- Immunology
- Infectious Diseases
- Pulmonology
- Cardiology
Background:
- While COVID-19 vaccines are effective against severe disease, their impact on Long COVID-19 syndrome remains unclear.
- This study investigated the prevalence of post-acute sequelae in vaccinated versus unvaccinated hospitalized COVID-19 survivors.
Purpose of the Study:
- To compare short-term and long-term post-acute sequelae in vaccinated and unvaccinated COVID-19 survivors.
- To assess the potential of COVID-19 vaccination in mitigating Long COVID-19 syndrome.
Main Methods:
- A multidisciplinary follow-up of 458 hospitalized COVID-19 survivors (229 vaccinated, 229 unvaccinated) at 2 months and 1 year post-discharge.
- Evaluations included cardiovascular assessments, blood tests, chest CT, 6-minute walking test (6MWT), and spirometry.
- A 1:1 case-control matching analysis adjusted for baseline characteristics was performed.
Main Results:
- Vaccinated patients had significantly lower rates of ICU admission and severe respiratory complications.
- At 2-month follow-up, vaccinated survivors showed fewer persistent lung opacities and consolidations.
- Unvaccinated patients experienced higher rates of myocarditis, pulmonary embolism, and respiratory impairment (reduced 6MWT performance, altered spirometry).
- At 1-year follow-up, unvaccinated individuals reported more dyspnea, psychological symptoms, and chronic rhinosinusitis/cough.
Conclusions:
- COVID-19 vaccination is associated with improved short-term outcomes and a potentially reduced prevalence of Long COVID-19.
- Vaccination appears to mitigate various post-acute sequelae, including respiratory and cardiovascular complications, as well as persistent symptoms.
Background:
COVID-19 vaccines reduced mortality, hospitalizations and ICUs admissions. Conversely, the impact of vaccination on Long COVID-19 syndrome is still unclear. This study compared the prevalence of post-acute sequelae at short and long-term follow-up among hospitalized unvaccinated and vaccinated COVID-19 survivors through a multidisciplinary approach.
Methods:
After 2 months from discharge, unvaccinated and vaccinated COVID-19 survivors underwent a follow-up visit at a dedicated "post-COVID-19 Outpatient Clinic". The follow-up visit included a cardiovascular evaluation, blood tests, chest computed tomography, 6-min walking test (6MWT), spirometry. A one-year telephone follow-up was performed to assess re-hospitalizations, death and long-lasting symptoms. An additional 1:1 case-control matching analysis adjusted for baseline characteristics was performed.
Results:
Between June 2020 and June 2022, a total of 458 unvaccinated and vaccinated patients (229 per group) underwent the follow-up visit. Vaccinated patients had lower rates of ICU admissions (1.7 % vs 9.6 %, p= <0.001) and severe respiratory complications requiring intubation (1.3 % vs 7 %, p = 0.002) or non-invasive ventilation such as high-flow nasal oxygen therapy (1.7 % vs 7.9 %, p = 0.02), CPAP (1.3 % vs 20.1 %, p= < 0.001), and low-flow oxygen therapy (3.5 % vs 63.3 %, p= <0.001) compared to unvaccinated ones. At 2-month follow-up, vaccinated patients had fewer persistent ground-glass opacities (2.6 % vs 52.8 %, p= <0.001) or consolidations (0.9 % vs 8.3 %, p= <0.001). Additionally, unvaccinated patients experienced more frequent myocarditis (4.8 % vs 0.9 %, p = 0.013) and pulmonary embolism (1.8 % vs 0 %, p = 0.042) and exhibited more significant respiratory impairment as evidenced by desaturation during the 6MWT(10.2 % vs 3.5 %, p = 0.005) and altered spirometry (14 % vs 8.7 %, p = 0.043) compared to vaccinated ones. At one-year, unvaccinated patients reported more symptoms such as dyspnea (20.5 % vs 10 %, p = 0.002), psychological symptoms (10 % vs 3.5 %, p = 0.005) and chronic rhinosinusitis/cough (6,6 % vs 2,6 %, p = 0.04) as compared to vaccinated ones. The 1:1 case-control matching analysis also confirmed these results.
Conclusions:
COVID-19 vaccines improve short-term outcomes and may reduce Long COVID-19 prevalence.
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