Effect of vaccine on prognosis and mortality in COVID-19

Abstract

Aim: The aim of our study is to reveal the factors affecting the clinical course of COVID-19 infection and mortality in immune and non-immune patients aged 65 and over.
Material and Method: The study was carried out by scanning the files of a total of 1,642 COVID-19 cases aged 65 and over. The 1337 cases included in the study were divided into two groups as follows: patients who were vaccinated with the 2nd dose of CoronaVac but became infected with COVID-19 after the 14-day period in which immunization should develop (Group I) and the others who were unvaccinated, or infected with COVID-19 after a single dose of vaccination or infected after receiving a 2nd dose of vaccination in 14 days (Group II). The groups were compared with each other about mortality and the factors affecting mortality.
Results: The length of intensive care unit (ICU) stay, and the total length of hospital stay were significantly longer in Group II than Group I (p<0.05). The need for mechanical ventilation (MV) and the length of MV were also significantly higher in Group II than Group I (p<0.05). All patients enrolled in the study had lung involvement. The percentage of Computed tomography (CT) involvement over 50% was statistically significant in Group II (p<0.05). The percentage of severe and critically severe patients and mortality were significantly high in Group II vs. Group I (p<0.05).
Conclusion: When we compared the vaccinated and unvaccinated groups of 65 years of age, we found that hospitalization in the ICU and the need for MV increased mortality, and the vaccine reduced the need for intensive care and MV.

Keywords

• Vaccine
• COVID-19
• elder age

References

1. Wang FS, Zhang C. What to do next to control the 2019-nCoV epidemic? Lancet 2020; 395: 391-3.
2. Shang W, Yang Y, Rao Y. The outbreak of SARS-CoV-2 pneumonia calls for viral vaccines. NPJ Vaccines 2020; 5: 1-3
3. Kaur SP, Gupta V. COVID-19 Vaccine: A comprehensive status report. Virus Res 2020; 288: 198114.
4. Zhang, Y, Zeng G, Pan H, et al. Safety, tolerability, and immunogenicity of an inactivated SARS-CoV-2 vaccine in healthy adults aged 18-59 years: a randomised, double-blind, placebo-controlled, phase 1/2 clinical trial. The Lancet 2021; 21: 181-92.
5. COVID-19 Aşı Uygulanacak Grup Sıralaması. Access address: https://covid19asi.saglik.gov.tr/TR-77707/asi-uygulanacak-grupsiralamasi.html. Access date: 23.03.2021.
6. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395: 1054-62.
7. Lian J, Jin C, Hao S, et al. High neutrophil-to- lymphocyte ratio associated with progression to critical illness in older patients with COVID-19: A multicenter retrospective study. Aging (Albany NY) 2020; 12: 13849-59.
8. National Health Commission of China. The guidelines for diagnosis and treatment of novel coronavirus (2019-nCoV) infected pneumonia (the sixth edition draft) issued by the National Health Commission of China. http: //www.gov.cn/zhengce/zhengceku/2020-02/19/content_5480948.htm2020. Accessed February, 2020.

9. Chen Y, Klein SL, Garibaldi BT, et al. Aging in COVID-19: Vulnerability, immunity and intervention. Ageing Res Rev 2021; 65: 101205.
10. Carbone M, Lednicky J, Xiao SY, Venditti M, Bucci E. Coronavirus 2019 infectious disease epidemic: where we are, what can be done and hope for. J Thorac Oncol 202; 16: 546-71.
11. Henig O, Kaye KS. Bacterial pneumonia in older adults. Infect Dis Clin North Am 2017; 31: 689-13.
12. Richardson S, Hirsch JS, Narasimhan M, et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City Area. JAMA 2020; 323: 2052-9.
13. Ojha V, Mani A, Pandey N, Sharma S, Kumar, S. CT in coronavirus disease 2019 (COVID-19): a systematic review of chest CT findings in 4410 adult patients. European radiology2020; 30,6129-38.
14. Xu Y-H, Dong J-H, An W-M, et al. Clinical and computed tomographic imaging features of novel coronavirus pneumonia caused by SARS-CoV-2. J Infect 2020; 80: 394-00.
15. Grasselli G, Zangrillo A, Zanella A, et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region, Italy. JAMA 2020; 323: 1574-81.
16. Lim ZJ, Subramaniam A, Ponnapa Reddy M, et al. Case fatality rates for patients with COVID-19 requiring invasive mechanical ventilation. a meta-analysis. Am J Respir Crit Care Med 2021; 203: 54-66.
17. Tanriover MD, Doğanay HL, Akova M, et al. CoronaVac Study Group. 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. Lancet 2021 Jul 17; 398: 213-22.
18. Jara A, Undurraga EA, González C, et al. Effectiveness of an Inactivated SARS-CoV-2 Vaccine in Chile. N Engl J Med 2021; 385: 875-84.
19. Seyahi E, Bakhdiyarli G, Oztas M, et al. Antibody response to inactivated COVID-19 vaccine (CoronaVac) in immune-mediated diseases: a controlled study among hospital workers and elderly. Rheumatol Int 2021; 41: 1429-40.
20. Bayram A, Demirbakan H, Günel Karadeniz P, Erdoğan M, Koçer I. Quantitation of antibodies against SARS-CoV-2 spike protein after two doses of CoronaVac in healthcare workers. J Med Virol 2021; 93: 5560-67.
21. Müller L, Andrée M, Moskorz W, et al. Age-dependent immune response to the Biontech/Pfizer BNT162b2 COVID-19 vaccination. Clin Infect Dis 2021; 73: 2065-72.