School of Public Health, Nanjing Medical University, 101 Longmian Ave, Nanjing, 211166, China.
The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China.
Ann Clin Microbiol Antimicrob. 2023 Mar 21;22(1):22. doi: 10.1186/s12941-023-00569-z.
Chest computerized tomography (CT) scan is an important strategy that quantifies the severity of COVID-19 pneumonia. To what extent inactivated COVID-19 vaccines could impact the COVID-19 pneumonia on chest CT is not clear.
This study recruited 357 SARS-COV-2 B.1.617.2 (Delta) variant-infected patients admitted to the Second Hospital of Nanjing from July to August 2021. An artificial intelligence-assisted CT imaging system was used to quantify the severity of COVID-19 pneumonia. We compared the volume of infection (VOI), percentage of infection (POI) and chest CT scores among patients with different vaccination statuses.
Of the 357 Delta variant-infected patients included for analysis, 105 were unvaccinated, 72 were partially vaccinated and 180 were fully vaccinated. Fully vaccination had the least lung injuries when quantified by VOI (median VOI of 222.4 cm, 126.6 cm and 39.9 cm in unvaccinated, partially vaccinated and fully vaccinated, respectively; p < 0.001), POI (median POI of 7.60%, 3.55% and 1.20% in unvaccinated, partially vaccinated and fully vaccinated, respectively; p < 0.001) and chest CT scores (median CT score of 8.00, 6.00 and 4.00 in unvaccinated, partially vaccinated and fully vaccinated, respectively; p < 0.001). After adjustment for age, sex, comorbidity, time from illness onset to hospitalization and viral load, fully vaccination but not partial vaccination was significantly associated with less lung injuries quantified by VOI {adjust coefficient[95%CI] for "full vaccination": - 106.10(- 167.30,44.89); p < 0.001}, POI {adjust coefficient[95%CI] for "full vaccination": - 3.88(- 5.96, - 1.79); p = 0.001} and chest CT scores {adjust coefficient[95%CI] for "full vaccination": - 1.81(- 2.72, - 0.91); p < 0.001}. The extent of reduction of pulmonary injuries was more profound in fully vaccinated patients with older age, having underlying diseases, and being female sex, as demonstrated by relatively larger absolute values of adjusted coefficients. Finally, even within the non-severe COVID-19 population, fully vaccinated patients were found to have less lung injuries.
Fully vaccination but not partially vaccination could significantly protect lung injury manifested on chest CT. Our study provides additional evidence to encourage a full course of vaccination.
胸部计算机断层扫描（CT）是量化 COVID-19 肺炎严重程度的重要策略。灭活的 COVID-19 疫苗在多大程度上会影响胸部 CT 上的 COVID-19 肺炎尚不清楚。
本研究招募了 2021 年 7 月至 8 月期间因 SARS-COV-2 B.1.617.2（Delta）变异株感染而入住南京第二医院的 357 名患者。使用人工智能辅助 CT 成像系统来量化 COVID-19 肺炎的严重程度。我们比较了不同疫苗接种状态患者的感染体积（VOI）、感染百分比（POI）和胸部 CT 评分。
在纳入分析的 357 名 Delta 变异株感染患者中，105 名未接种疫苗，72 名部分接种疫苗，180 名完全接种疫苗。完全接种疫苗时肺部损伤最小，VOI（未接种、部分接种和完全接种组的中位数 VOI 分别为 222.4cm、126.6cm 和 39.9cm；p<0.001）、POI（未接种、部分接种和完全接种组的中位数 POI 分别为 7.60%、3.55%和 1.20%；p<0.001）和胸部 CT 评分（未接种、部分接种和完全接种组的中位数 CT 评分分别为 8.00、6.00 和 4.00；p<0.001）。在校正年龄、性别、合并症、发病到住院时间和病毒载量后，完全接种疫苗但不是部分接种疫苗与 VOI 量化的肺部损伤减少显著相关{“完全接种疫苗”的调整系数[95%CI]：-106.10（-167.30，44.89）；p<0.001}、POI{“完全接种疫苗”的调整系数[95%CI]：-3.88（-5.96，-1.79）；p=0.001}和胸部 CT 评分{“完全接种疫苗”的调整系数[95%CI]：-1.81（-2.72，-0.91）；p<0.001}。在年龄较大、有基础疾病和女性的完全接种疫苗患者中，肺部损伤减少的程度更为明显，调整后的系数绝对值较大。最后，即使在非重症 COVID-19 人群中，完全接种疫苗的患者肺部损伤也较少。
完全接种疫苗而不是部分接种疫苗可以显著保护胸部 CT 上的肺部损伤。我们的研究提供了额外的证据，鼓励进行全程接种。
