The Effect of Vaccination on Biochemical and Inflammatory Markers in Hospitalized COVID-19 Patients

Öz

Aim: Coronavirus disease 2019 (COVID-19) vaccines have been proven beneficial in preventing hospitalization, serious illness, and death. However, whether immunization affects biochemical and inflammatory markers, prognostic factors in hospitalization remain unknown. The effects of vaccination status on blood biochemistry and inflammatory markers were investigated in our study of patients hospitalized with COVID-19. Material and Method: A total of 107 patients comprising 67 unvaccinated and 40 vaccinated individuals who were hospitalized for COVID-19 from two different centers between November 1, 2021, and January 1, 2021, were included in our study. The patients’ demographics, comorbidities, and biochemical and inflammatory markers were recorded during hospitalization. Results: We identified 107 patients (62 men and 45 women; mean age, 63.7±14.8 years), with a mean age of 68.6±12.2 (37–89) and 60.7±15.5 (27–88) for the vaccinated and unvaccinated groups (p=0.005), respectively. Lymphocyte level in the 0–55 age group was 1.4±0.46×109/L in vaccinated patients and 0.96±0.5×109/L in unvaccinated patients. The difference was statistically significant (p=0.05). The lactate dehydrogenase (LDH) value was higher in the unvaccinated patients in all age groups (0–55 and over 55 years old) (p=0.04). Using logistic regression analysis, LDH was demonstrated to be a predictive factor for admission to the intensive care unit (ICU) in the 0–55 age range of unvaccinated patients. It was determined that the increase in LDH in all age groups elevates the ICU admission risk by 1.004 times. Conclusion: Our study showed that COVID-19 vaccination is effective against lymphopenia induced by COVID-19 in people under 55 and LDH in people of all ages. The impact of vaccination status on LDH may be meaningful, considering that elevated LDH has been associated with a higher risk of ICU support, mortality, and complications.

Anahtar Kelimeler

• COVID-19
• COVID-19 vaccine
• lactate dehydrogenase
• lymphopenia

Kaynakça

1. 1. Hong LZ, Shou ZX, Zheng DM, et al. The most important biomarker associated with coagulation and inflammation among COVID-19 patients. Mol Cell Biochem. 2021;476:2877–85.
2. 2. Terpos E, Ntanasis-Stathopoulos I, Elalamy I, Kastritis E, Sergentanis TN, Politou M, et al. Hematological findings and complications of COVID‐19. Am J Hematol. 2020;95:834–47.
3. 3. Uzun O, Akpolat T, Varol A, Turan S, Bektas SG, Cetinkaya PD, et al. COVID- 19: vaccination vs hospitalization. Infection. 2022;1:6.
4. 4. Haas EJ, Angulo FJ, McLaughlin JM, Anis E, Singer SR, Khan F, 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;397:1819–29.
5. 5. Jara A, Undurraga EA, González C, Paredes F, Fontecilla T, Jara G, et al. Effectiveness of an inactivated SARS-CoV-2 vaccine in Chile. N Engl J Med. 2021;385:875–84.
6. 6. Malik P, Patel U, Mehta D, Patel N, Kelkar R, Akrmah M, et al. Biomarkers and outcomes of COVID-19 hospitalisations: systematic review and meta-analysis. BMJ Evid Based Med. 2021;26:107–8.
7. 7. Yang AP, Li HM, Tao WQ, Yang XJ, Wang M, Yang WJ, et al. Infection with SARS-CoV-2 causes abnormal laboratory results of multiple organs in patients. Aging (Albany NY.). 2020;12:10059.
8. 8. Huang I, Pranata R. Lymphopenia in severe coronavirus disease-2019 (COVID-19): systematic review and metaanalysis. J Intensive Care. 2020;8:1–10.

9. 9. Xu H, Zhong L, Deng J, Peng J, Dan H, Zeng X, et al. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. Int J Oral Sci. 2020; 12:1–5.
10. 10. Liao YC, Liang WG, Chen FW, Hsu JH, Yang JJ, Chang MS. IL-19 induces production of IL-6 and TNF-α and results in cell apoptosis through TNF-α. The. J Immunol. 2002;169:42884297.
11. 11. Han Y, Zhang H, Mu S, Wei W, Jin C, Tong C, et al. Lactate dehydrogenase, an independent risk factor of severe COVID-19 patients: a retrospective and observational study. Aging (Albany NY). 2020;12:11245.
12. 12. Das KM, Lee EY, Singh R, Enani MA, Al Dossari K, Van Gorkom K, et al. Follow-up chest radiographic findings in patients with MERS-CoV after recovery. Indian J Radiol Imaging. 2017;27:342–9.
13. 13. Lee N, Hui D, Wu A, Chan P, Cameron P, Joynt GM, et al. A major outbreak of severe acute respiratory syndrome in Hong Kong. N Engl J Med. 2003;348:1986–94.