Yavuz Serap Şimşek, Tunçer Gülşah, Altuntaş-Aydın Özlem, Aydın Mehtap, Pehlivanoğlu Filiz, Tok Yeşim, Mese Sevim, Gündüz Alper, Güçlü Ceyda Geyiktepe, Özdoğan İklima, Hemiş-Aydın Börçe, Soğuksu Pınar, Benli Aysun, Başaran Seniha, Midilli Kenan, Eraksoy Haluk
Department of Infectious Disease and Clinical Microbiology, İstanbul Faculty of Medicine, İstanbul University, İstanbul 34093, Turkey.
Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, İstanbul 34093, Turkey.
Vaccines (Basel). 2022 May 7;10(5):733. doi: 10.3390/vaccines10050733.
COVID-19 vaccines are highly protective against severe disease; however, vaccine breakthrough infections resulting in hospitalization may still occur in a small percentage of vaccinated individuals. We investigated whether the clinical and microbiological features and outcomes were different between hospitalized COVID-19 patients who were either fully vaccinated with Coronovac or not. All hospitalized COVID-19 patients who had at least one dose of Coronavac were included in the study. The oldest unvaccinated patients with comorbidities, who were hospitalized during the same period, were chosen as controls. All epidemiologic, clinical and laboratory data of the patients were recorded and compared between the fully vaccinated and unvaccinated individuals. There were 69 and 217 patients who had been either fully vaccinated with Coronavac or not, respectively. All breakthrough infections occurred in the first 3 months of vaccination. Fully vaccinated patients were older and had more comorbidities than unvaccinated patients. There were minor differences between the groups in symptoms, physical and laboratory findings, anti-spike IgG positivity rate and level, the severity of COVID-19, complications, and clinical improvement rate. The mortality rate of fully vaccinated patients was higher than the mortality rate in unvaccinated patients in univariate analysis, which was attributed to the fact that vaccinated patients were older and had more comorbidities. The severity and clinical outcomes of hospitalized patients with breakthrough COVID-19 after Coronavac vaccination were similar to those of unvaccinated patients. Our findings suggest that the immune response elicited by Coronovac could be insufficient to prevent COVID-19-related severe disease and death within 3 months of vaccination among elderly people with comorbidities.
新冠病毒疫苗对重症具有高度保护作用;然而,在一小部分接种疫苗的个体中,仍可能发生导致住院的疫苗突破性感染。我们调查了接种科兴新冠疫苗的住院新冠患者与未接种疫苗的住院新冠患者在临床、微生物学特征及预后方面是否存在差异。本研究纳入了所有至少接种一剂科兴新冠疫苗的住院新冠患者。选取同期住院的年龄最大的未接种疫苗且患有合并症的患者作为对照。记录并比较了接种疫苗和未接种疫苗个体的所有流行病学、临床和实验室数据。分别有69例和217例患者接种或未接种科兴新冠疫苗。所有突破性感染均发生在接种后的前3个月内。接种疫苗的患者比未接种疫苗的患者年龄更大且合并症更多。两组在症状、体格检查和实验室检查结果、抗刺突IgG阳性率及水平、新冠病情严重程度、并发症和临床改善率方面存在细微差异。在单因素分析中,接种疫苗患者的死亡率高于未接种疫苗患者,这归因于接种疫苗的患者年龄更大且合并症更多。科兴新冠疫苗接种后出现突破性新冠感染的住院患者的严重程度和临床结局与未接种疫苗的患者相似。我们的研究结果表明,科兴新冠疫苗引发的免疫反应可能不足以在接种后3个月内预防合并症老年人发生与新冠相关的重症和死亡。