Wada Noriaki, Li Yi, Hino Takuya, Gagne Staci, Valtchinov Vladimir I, Gay Elizabeth, Nishino Mizuki, Madore Bruno, Guttmann Charles R G, Bond Sheila, Ishigami Kousei, Hunninghake Gary M, Levy Bruce D, Kaye Kenneth M, Christiani David C, Hatabu Hiroto
Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
Department of Biostatistics, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
Eur J Radiol Open. 2022 Nov 11;9:100456. doi: 10.1016/j.ejro.2022.100456. eCollection 2022.
To investigate the effect of vaccinations and boosters on the severity of COVID-19 pneumonia on CT scans during the period of Delta and Omicron variants.
Retrospectively studied were 303 patients diagnosed with COVID-19 between July 2021 and February 2022, who had obtained at least one CT scan within 6 weeks around the COVID-19 diagnosis (-2 to +4 weeks). The severity of pneumonia was evaluated with a 6-point scale Pneumonia Score. The association between demographic and clinical data and vaccination status (booster/additional vaccination, complete vaccination and un-vaccination) and the difference between Pneumonia Scores by vaccination status were investigated.
Of 303 patients (59.4 ± 16.3 years; 178 females), 62 (20 %) were in the booster/additional vaccination group, 117 (39 %) in the complete vaccination group, and 124 (41 %) in the unvaccinated group. Interobserver agreement of the Pneumonia Score was high (weighted kappa score = 0.875). Patients in the booster/additionally vaccinated group tended to be older (P = 0.0085) and have more underlying comorbidities (P < 0.0001), and the Pneumonia Scores were lower in the booster/additionally vaccinated [median 2 (IQR 0-4)] and completely vaccinated groups [median 3 (IQR 1-4)] than those in the unvaccinated group [median 4 (IQR 2-4)], respectively (P < 0.0001 and P < 0.0001, respectively). A multivariable linear analysis adjusted for confounding factors confirmed the difference.
Vaccinated patients, with or without booster/additional vaccination, had milder COVID-19 pneumonia on CT scans than unvaccinated patients during the period of Delta and Omicron variants. This study supports the efficacy of the vaccine against COVID-19 from a radiological perspective.
研究在德尔塔和奥密克戎变异株流行期间，接种疫苗及加强针对于新冠病毒肺炎CT扫描严重程度的影响。
回顾性研究了2021年7月至2022年2月期间确诊为新冠病毒肺炎的303例患者，这些患者在新冠病毒肺炎诊断前后6周内（-2至+4周）至少进行了一次CT扫描。采用6分制肺炎评分评估肺炎的严重程度。研究了人口统计学和临床数据与疫苗接种状态（加强针/额外接种、全程接种和未接种）之间的关联，以及不同疫苗接种状态下肺炎评分的差异。
303例患者（年龄59.4±16.3岁；女性178例）中，62例（20%）属于加强针/额外接种组，117例（39%）属于全程接种组，124例（41%）属于未接种组。肺炎评分的观察者间一致性较高（加权kappa评分=0.875）。加强针/额外接种组的患者往往年龄较大（P=0.0085）且合并症更多（P<0.0001），加强针/额外接种组[中位数2（四分位间距0-4）]和全程接种组[中位数3（四分位间距1-4）]的肺炎评分分别低于未接种组[中位数4（四分位间距2-4）]（分别为P<0.0001和P<0.0001）。经混杂因素调整的多变量线性分析证实了这一差异。
在德尔塔和奥密克戎变异株流行期间，接种疫苗的患者，无论是否接种加强针/额外接种，CT扫描显示的新冠病毒肺炎都比未接种疫苗的患者症状轻。本研究从放射学角度支持了疫苗对新冠病毒的有效性。
