Arashiro Takeshi, Solante Rontgene, Sayo Ana Ria, Garcia Reby Marie, Kris Marie, Suzuki Shuichi, Malijan Greco Mark, Salazar Mary Jane, Salazar Mary Ann, Ortal-Cruz Abby, Go Grace Devota, Miranda Edna, Carandang-Cuvin Michelle, Calayo Joy Potenciano, Shin Jinho, Hibberd Martin, Ariyoshi Koya, Smith Chris
Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
Epidemiol Infect. 2024 Dec 20;153:e18. doi: 10.1017/S0950268824001845.
COVID-19 vaccine effectiveness (VE) studies are limited in low- and middle-income countries. A case-control study was conducted among COVID-19 and other pneumonia patients admitted to a hospital in the Philippines during the pre-Omicron and Omicron periods. To elucidate factors associated with in-hospital death, 1782 COVID-19 patients were assessed. To estimate absolute VE for various severe outcomes, 1059 patients were assessed (869 [82.1%] COVID-19 cases; 190 [17.9%] controls). Factors associated with in-hospital death included older age, tuberculosis (adjusted odds ratio [aOR] 2.45 [95% confidence interval {95% CI} 1.69-3.57]), HIV (aOR 3.30 [95% CI 2.03-5.37]), and current smokers (aOR 2.65 [95% CI 1.72-4.10]). Pre-Omicron, the primary series provided high protection within a median of 2 months (hospitalization: 85.4% [95% CI 35.9-96.7%]; oxygen requirement: 91.0% [95% CI 49.4-98.4%]; invasive mechanical ventilation (IMV): 97.0% [95% CI 65.7-99.7%]; death: 96.5% [95% CI 67.1-99.6%]). During Omicron, the primary series provided moderate-high protection within a median of 6-9 months (hospitalization: 70.2% [95% CI 27.0-87.8%]; oxygen requirement: 71.4% [95% CI 29.3-88.4%]; IMV: 72.7% [95% CI -11.6-93.3%]; death: 58.9% [95% CI -82.8-90.8%]). Primary series VE against severe COVID-19 outcomes was consistently high for both pre-Omicron and Omicron in a setting where approximately half of the vaccinees received inactivated vaccines.
在低收入和中等收入国家，关于新冠病毒疾病（COVID-19）疫苗效力（VE）的研究有限。在菲律宾一家医院对奥密克戎毒株出现之前和奥密克戎毒株时期收治的COVID-19患者及其他肺炎患者开展了一项病例对照研究。为阐明与院内死亡相关的因素，对1782例COVID-19患者进行了评估。为估计各种严重结局的绝对疫苗效力，对1059例患者进行了评估（869例[82.1%]COVID-19病例；190例[17.9%]对照）。与院内死亡相关的因素包括年龄较大、结核病（调整优势比[aOR]2.45[95%置信区间{95%CI}1.69 - 3.57]）、艾滋病毒（aOR 3.30[95%CI 2.03 - 5.37]）以及当前吸烟者（aOR 2.65[95%CI 1.72 - 4.10]）。在奥密克戎毒株出现之前，主要系列疫苗在中位数2个月内提供了高度保护（住院：85.4%[95%CI 35.9 - 96.7%]；吸氧需求：91.0%[95%CI 49.4 - 98.4%]；有创机械通气（IMV）：97.0%[95%CI 65.7 - 99.7%]；死亡：96.5%[95%CI 67.1 - 99.6%]）。在奥密克戎毒株时期，主要系列疫苗在中位数6 - 9个月内提供了中高度保护（住院：70.2%[95%CI 27.0 - 87.8%]；吸氧需求：71.4%[95%CI 29.3 - 88.4%]；IMV：72.7%[95%CI - 11.6 - 93.3%]；死亡：58.9%[95%CI - 82.8 - 90.8%]）。在大约一半接种者接种灭活疫苗的情况下，主要系列疫苗对严重COVID-19结局的疫苗效力在奥密克戎毒株出现之前和奥密克戎毒株时期均持续保持较高水平。
