Survival after primary and booster COVID-19 vaccination in patients with COPD

This study aimed to evaluate the primary vaccination status against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the administration of variant-modified vaccine boosters and the 1-year survival due to coronavirus disease 2019 (COVID-19) in individuals over 65 years old diagnosed with chronic obstructive pulmonary disease (COPD).

This cross-sectional study was conducted between July 2021 and February 2023. Among 108 COPD patients registered with the home healthcare unit, 97 were included after informed consent. Demographic and clinical characteristics (age, sex, vaccine type, dose count, smoking, diabetes, hypertension) were evaluated for their impact on mortality and survival. The Log-rank test assessed associations with one-year mortality, and Cox regression evaluated independent effects.

Among participants, 64% were aged 65-75 and 52% were male. Of these, 41% completed only the primary vaccination series (2 doses) and 29% received a booster dose. By one-year follow-up, 38% (n=37) had died due to COVID-19. Vaccination status (p=0.018), number of doses (p=0.017), and diabetes (p=0.001) were significantly associated with mortality. Cox analysis indicated diabetes (Exp[β]=3.125) and incomplete vaccination (Exp[β]=0.456) significantly decreased survival (p<0.05).

Completing at least the primary vaccination series was associated with improved survival, while incomplete primary vaccination and comorbid diabetes had negative effects on outcomes. Booster dose uptake was lower than completion of the primary series. Routine SARS-CoV-2 vaccination remains essential for protecting vulnerable populations, especially amid the ongoing emergence of new variants.