Mondi Annalisa, Mastrorosa Ilaria, Navarra Assunta, Cimaglia Claudia, Pinnetti Carmela, Mazzotta Valentina, Agresta Alessandro, Corpolongo Angela, Zolezzi Alberto, Al Moghazi Samir, Loiacono Laura, Bocci Maria Grazia, Matusali Giulia, D'Annunzio Alberto, Gallì Paola, Maggi Fabrizio, Vairo Francesco, Girardi Enrico, Antinori Andrea
Clinical and Research Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy.
Department of Epidemiology, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, 00149 Rome, Italy.
Vaccines (Basel). 2024 Sep 6;12(9):1018. doi: 10.3390/vaccines12091018.
This is a retrospective observational study including all COVID-19 patients admitted at our Institute throughout three successive pandemic waves, from January 2021 to June 2023. The main in-hospital outcomes (clinical progression [CP], defined as admission to Intensive Care Unit [ICU]/death, and death within 28 days) were compared among participants unvaccinated (NV), fully vaccinated (FV), with one (FV&B1) and two (FV&B2) booster doses. Vaccinated participants were stratified into recently and waned FV/FV&B1/FV&B2, depending on the time elapsed from last dose (≤ and >120 days, respectively). There were 4488 participants: 2224 NV, 674 FV, 1207 FV&B1, and 383 FV&B2. Within 28 days, there were 604 ICU admissions, 396 deaths, and 737 CP. After adjusting for the main confounders, the risk of both in-hospital outcomes was reduced in vaccinated individuals, especially in those who received the booster dose (approximately by 36% for FV and >50% for FV&B1 and FV&B2 compared to NV). Similarly, after restricting the analysis to vaccinated participants only, we observed a risk reduction of approximately 40% for FV&B1 and 50% for FV&B2, compared to FV, regardless of the distance since the last dose. Our data confirm the vaccine's effectiveness in preventing severe COVID-19 and support the efforts to increase the uptake of booster doses, mainly among older and frailer individuals, still at a greater risk of clinical progression.
这是一项回顾性观察研究，纳入了2021年1月至2023年6月在我院连续三个疫情波次期间收治的所有新冠病毒病（COVID-19）患者。比较了未接种疫苗（NV）、全程接种疫苗（FV）、接种一剂加强针（FV&B1）和接种两剂加强针（FV&B2）的参与者的主要院内结局（临床进展[CP]，定义为入住重症监护病房[ICU]/死亡，以及28天内死亡）。根据距最后一剂疫苗接种时间（分别≤120天和>120天），将接种疫苗的参与者分为近期接种和接种后抗体减弱的FV/FV&B1/FV&B2。共有4488名参与者：2224名NV、674名FV、1207名FV&B1和383名FV&B2。28天内，有604例入住ICU、396例死亡和737例CP。在对主要混杂因素进行调整后，接种疫苗的个体发生这两种院内结局的风险降低，尤其是接受加强针接种的个体（与NV相比，FV降低约36%，FV&B1和FV&B2降低>50%）。同样，在仅对接种疫苗的参与者进行分析后，我们观察到，与FV相比，FV&B1和FV&B2的风险分别降低了约40%和50%，与距最后一剂疫苗接种时间无关。我们的数据证实了疫苗在预防重症COVID-19方面的有效性，并支持为提高加强针接种率所做的努力，主要是在临床进展风险仍然较高的老年人和体弱人群中。
