The effect of variants and vaccines on prognosis in coronavirus disease 2019 patients: a retrospective observational study

Year 2022, , 293 - 301, 27.09.2022

Hakan Aydın , Göksu Bozdereli Berikol , Mehmet Koçak , Halil Doğan

https://doi.org/10.21673/anadoluklin.1061232

Abstract

Aim: The effect of novel coronavirus disease 2019 (COVID-19) vaccines on variants of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) is unclear. In this study, we aimed to investigate the prognostic effect of variants and vaccines in hospitalized COVID-19 patients.

Methods: This retrospective study was conducted on 588 hospitalized patients with COVID-19 between May 1st, 2021, and August 31st, 2021. The patients were divided into groups according to variant analysis and demographic characteristics, laboratory data, vaccination status, and in-hospital mortality rates were compared.

Results: Variants (Alpha [B.1.1.7], Beta [B.1.351], Delta [B.1.617.2]) were detected in 46.3% of the patients. The intensive care unit (ICU) admission rate was 46.8%, and the in-hospital mortality rate was 33.3%. There was no statistically significant difference between the patients with variant detection and those without variant detection in terms of ICU admission and in-hospital mortality. The rate of unvaccinated patients was 63.6%. The in-hospital mortality rate was similar in those vaccinated with two doses of CoronaVaC (37.1%) to that in the unvaccinated (32.9%) but higher than in those vaccinated with two doses of BNT162B2 (16.7%).

Conclusion: There was no increase in the mortality rates in hospitalized between patients with or without variants compared to those without. The mortality rate in those vaccinated with two doses of CoronaVaC was similar to that in those not vaccinated.

Keywords

BNT16B2, CoronaVaC, COVID-19 vaccine, SARS-CoV-2 variants

Koronavirüs hastalığı 2019 hastalarında varyantların ve aşıların prognoza etkisi: retrospektif gözlemsel çalışma

Abstract

Amaç: Koronavirüs hastalığı 2019 (COVID-19) aşılarının şiddetli akut solunum yolu sendromu koronavirüsü 2 (SARS-CoV-2) varyantları üzerindeki etkisi belirsizdir. Bu çalışmadaki amacımız, hastanede yatan COVID-19 hastalarında varyantların ve aşıların prognostik etkisini araştırmaktır.

Yöntemler: Bu retrospektif çalışma, 01 Mayıs-31 Ağustos 2021 tarihleri arasında hastanede yatan 588 COVID-19 hastası üzerinde yapıldı. Varyant analizine göre gruplandırılan hastalar, demografik özellikleri, laboratuvar verileri, aşılanma durumları ve hastane içi ölüm oranları açısından karşılaştırıldı.

Bulgular: Hastaların %46,3’ünde varyant (Alfa [B.1.1.7], Beta [B.1.351], Delta [B.1.617.2]) saptandı. Yoğun bakım ünitesine (YBÜ) yatış oranı %46,8 ve hastane içi ölüm oranı %33,3 idi. Varyant saptanan hastalar ile varyant saptanmayanlar arasında YBÜ’ye yatış ve hastane içi mortalite açısından istatistiksel olarak anlamlı fark yoktu. Aşısız hasta oranı %63,6 idi. İki doz CoronaVaC ile aşılanan hastaların hastane içi mortalite oranları (%37,1) ile aşılanmayanların mortalite oranları (%32,9) benzerdi, ancak 2 doz BNT162B2 ile aşılananların hastane içi mortalite oranlarından (%16,7) daha yüksekti.

Sonuç: Hastanede yatan hastalarda varyant saptananlar ile varyantı olmayanlar arasında mortalite açısından anlamlı bir fark saptanmadı. İki doz CoronaVaC ile aşılananlarda ölüm oranı, aşılanmayanlarla benzerdi.

Keywords

COVID-19 aşıları, ölüm oranı, SARS-CoV-2

References

• Polack FP, Thomas SJ, Kitchin N, et al. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. N Engl J Med. 2020;383:2603-15.
• Tanriover MD, Doğanay HL, Akova M, et al. Efficacy and safety of an inactivated whole-virion SARS-CoV-2 vaccine (CoronaVac): interim results of a double-blind, randomised, placebo-controlled, phase 3 trial in Turkey. The Lancet. 2021;398(10296):213-22.
• Mahase E. Covid-19: Novavax vaccine efficacy is 86% against UK variant and 60% against South African variant. BMJ. 2021;372:296.
• Jia Z, Gong W. Will Mutations in the Spike Protein of SARS-CoV-2 Lead to the Failure of COVID-19 Vaccines?. J Korean Med Sci. 2021;36(18):e124.
• Plante JA, Mitchell BM, Plante KS, Debbink K, Weaver SC, Menachery VD. The variant Gambit: COVID’s next move. Cell host microbe. 2021;29(4):508-15.
• Hou YJ, Chiba S, Halfmann P, et al. SARS-CoV-2 D614G variant exhibits efficient replication ex vivo and transmission in vivo. J Science. 2020;370(6523):1464-8.
• Volz E, Mishra S, Chand M, et al. Assessing transmissibility of SARS-CoV-2 lineage B. 1.1. 7 in England. Nature. 2021;593(7858):266-9.
• Dhar MS, Marwal R, Radhakrishnan V, et al. Genomic characterization and Epidemiology of an emerging SARS-CoV-2 variant in Delhi, India. Science. 2021; 374(6570), 995-9.
• World Health Organization. Tracking SARS-CoV-2 variants [Internet]. Who.int [cited date: 2022 July 20]. Available from: https://www.who.int/en/activities/tracking-SARS-CoV-2-variants/
• DC. SARS-CoV-2 variant classifications and definitions [Internet]. Centers for Disease Control and Prevention. 2022 [cited date: 2022 July 21]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/variants/variant-info.htm
• Baden LR, El Sahly HM, Essink B, et al. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. N Engl J Med. 2021;384(5):403-16.
• Bernal JL, Andrews N, Gower C, et al. Effectiveness of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines on covid-19 related symptoms, hospital admissions, and mortality in older adults in England: test negative case-control study. BMJ. 2021;373:1088.
• Wall EC, Wu M, Harvey R, et al. Neutralising antibody activity against SARS-CoV-2 VOCs B. 1.617. 2 and B. 1.351 by BNT162b2 vaccination. The Lancet. 2021;397(10292):2331-3.
• Chen Y, Shen H, Huang R, Tong X, Wu C. Serum neutralising activity against SARS-CoV-2 variants elicited by CoronaVac. Lancet Infect Dis. 2021;21(8):1071-2.
• Li J, Huang DQ, Zou B, et al. Epidemiology of COVID-19: A systematic review and meta-analysis of clinical characteristics, risk factors, and outcomes. J Med Virol. 2021; 93(3):1449-58.
• Mafham MM, Spata E, Goldacre R, et al. COVID-19 pandemic and admission rates for and management of acute coronary syndromes in England. The Lancet. 2020;396(10248):381-9.
• İlhan B, Bozdereli Berikol G, Aydın H, Arslan Erduhan M, Doğan H. COVID-19 outbreak impact on emergency trauma visits and trauma surgery in a level 3 trauma center. Ir J Med Sci. 2021:1-6.
• Aydin H, Doğan H. COVID-19 outbreak impact on discharge against medical advice from the ED: A retrospective study. Am J Emerg Med. 2022;57:21-6.
• Aydın H, Beştemir A, Berikol GB, Doğan H. Pandemi Hastanesinin Acil Servisine Başvuran Hastaların Analizi: Bir Retrospektif Türkiye Çalışması. Tıbbi Sosyal Hizmet Dergisi. 2022;(19):76-85.
• Hannah Ritchie, Edouard Mathieu, Lucas Rodés-Guirao, et al. Coronavirus Pandemic (COVID-19) [cited 2021 Nov 20]. Available from: https://ourworldindata.org/coronavirus [Online Resource]
• O’Toole Á, Hill V, Pybus OG, et al. Tracking the international spread of SARS-CoV-2 lineages B. 1.1. 7 and B. 1.351/501Y-V2. Wellcome Open Res. 2021;6:121.
• SARS-CoV-2 variants of concern and variants under investigation in England [Internet]. Gov.uk. 2021 [cited date: 2022 June 14]. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/ attachment_data/file/1018547/Technical_Briefing_23_21_09_16.pdf
• Goldberg Y, Mandel M, Bar-On YM, et al. Waning Immunity after the BNT162b2 Vaccine in Israel. N Engl J Med. 2021;385(24):e85.
• Hoffmann M, Arora P, Groß R, et al. SARS-CoV-2 variants B. 1.351 and P. 1 escape from neutralizing antibodies. Cell. 2021;184(9):2384-93. e12.
• Hoffmann M, Hofmann-Winkler H, Krüger N, et al. SARS-CoV-2 variant B. 1.617 is resistant to Bamlanivimab and evades antibodies induced by infection and vaccination. Cell Rep. 2021;36(3):109415.
• Haas EJ, Angulo FJ, McLaughlin JM, et al. Impact and effectiveness of mRNA BNT162b2 vaccine against SARS-CoV-2 infections and COVID-19 cases, hospitalisations, and deaths following a nationwide vaccination campaign in Israel: an observational study using national surveillance data. Lancet. 2021;397(10287):1819-29.
• Velavan TP, Meyer CG. Mild versus severe COVID-19: laboratory markers. Int J Infect Dis. 2020;95:304-7.
• Pourbagheri-Sigaroodi A, Bashash D, Fateh F, Abolghasemi H. Laboratory findings in COVID-19 diagnosis and prognosis. Clin Chim Acta. 2020;510:475-82.
• Dagcioglu BF, Keskin A, Guner R, et al. Thiol levels in mild or moderate Covid-19 patients: a comparison of variant and classic Covid-19 cases. Int J Clin Pract. 2021;75:e14753.
• Hu Z, Huang X, Zhang J, Fu S, Ding D, Tao Z. Differences in Clinical Characteristics Between Delta Variant and Wild-Type SARS-CoV-2 Infected Patients. Front Med (Lausanne). 2022;8:792135.