Munigela Apoorva, Sowpati Divya Tej, M Sasikala, Banu Sofia, Siva Archana Bharadwaj, V Jagadeesh Kumar, Nutalapati Chandrasekhar, Vishnubhotla Ravikanth, Kulkarni Anand, Mukherjee Payel, Zaveri Lamuk, Rao G V, Tallapaka Karthik Bharadwaj, Nageshwar Reddy D
AIG Hospitals, Internal Medicine, Gachibowli, Hyderabad, Telangana, India.
CSIR - Centre for Cellular and Molecular Biology, Habsiguda, Hyderabad, Telangana, India.
IJID Reg. 2022 Dec;5:104-110. doi: 10.1016/j.ijregi.2022.08.016. Epub 2022 Sep 5.
Covishield (ChAdOx) and Covaxin (BBV-152) are the mainstream vaccines against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) used in India and a few other countries.
To assess the clinical outcomes of patients hospitalized with coronavirus disease 2019 (COVID-19) who had been vaccinated with either Covishield or Covaxin.
This prospective, single-centre, observational cohort study of 1160 patients hospitalized with COVID-19 was conducted between April and June 2021. Severity of disease at admission and during hospitalization, requirement for intensive care unit (ICU) admission and ventilatory support, inflammatory markers (C-reactive protein, ferritin, lactate dehydrogenase, D-dimer), neutralizing antibody levels and mortality were assessed in vaccinated and unvaccinated patients.
More than 90% of patients in this study harboured the Delta variant (Pango lineage B.1.617.2) of SARS-CoV-2. Severity of disease at admission and during hospitalization (3.44% vs 7.51%; =0.0032) and requirement for ICU admission and ventilatory support (2.83% vs 5.86%; =0.0154) were significantly lower in vaccinated patients compared with unvaccinated patients. Vaccinated patients also had significantly (<0.0001) higher antibody levels and lower inflammatory marker levels compared with unvaccinated patients. A subset of vaccinated, deceased patients mounted minimal antibody response ['non-responders': 4.53 (standard deviation 1.40) AU/mL].
These results demonstrate the effectiveness of Covishield and Covaxin against severe disease in patients hospitalized with COVID-19 with breakthrough infections caused by the Delta variant. Strategies targeting non-responders are desirable to minimize morbidity and mortality.
Covishield（ChAdOx）和Covaxin（BBV-152）是印度和其他一些国家用于预防严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的主流疫苗。
评估接种了Covishield或Covaxin的2019冠状病毒病（COVID-19）住院患者的临床结局。
2021年4月至6月，对1160例COVID-19住院患者进行了这项前瞻性、单中心观察性队列研究。对接种疫苗和未接种疫苗的患者评估入院时和住院期间的疾病严重程度、重症监护病房（ICU）入院和通气支持需求、炎症标志物（C反应蛋白、铁蛋白、乳酸脱氢酶、D-二聚体）、中和抗体水平和死亡率。
本研究中超过90%的患者感染了SARS-CoV-2的Delta变异株（Pango谱系B.1.617.2）。与未接种疫苗的患者相比，接种疫苗的患者入院时和住院期间的疾病严重程度（3.44%对7.51%；P=0.0032）以及ICU入院和通气支持需求（2.83%对5.86%；P=0.0154）显著更低。与未接种疫苗的患者相比，接种疫苗的患者抗体水平也显著更高（P<0.0001），炎症标志物水平更低。一部分接种疫苗的死亡患者产生的抗体反应极小[“无反应者”：4.53（标准差1.40）AU/mL]。
这些结果证明了Covishield和Covaxin在Delta变异株引起突破性感染的COVID-19住院患者中预防重症的有效性。针对无反应者的策略有助于将发病率和死亡率降至最低。
