Comparative Study of Outcomes of COVID-19
Infection in Vaccinated and Unvaccinated Patients- A Retrospective Analysis
Published: January 1, 2023 | DOI: https://doi.org/10.7860/JCDR/2023/56184.17239
Bhaskar Kakarla, Swaroopa Deme, Sugunasree Aakula, Abhilash Naini, Radhika Soanker, Nageswara Rao Modugu, Raju YSN
1. Associate Professor, Department of Pulmonary Medicine, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India.
2. Associate Professor, Department of Internal Medicine, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India.
3. Junior Resident, Department of Internal Medicine, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India.
4. Junior Resident, Department of Internal Medicine, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India.
5. Additional Professor, Department of Clinical Pharmacology and Therapeutics, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India.
6. Professor and Head, Department of Internal Medicine, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India.
7. Professor, Department of Internal Medicine, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India.
Correspondence
Swaroopa Deme,
Associate Professor, Department of Internal Medicine, Nizams Institute of Medical Sciences, Hyderabad, Telangana, India.
E-mail: swaroopareddymd@gmail.com
Introduction: Vaccine development was the highest priority during the Coronavirus disease 2019 (COVID-19) pandemic. An ideal vaccine should decrease the risk of infection and reduce the incidence and severity of the disease. Risk of disease or infection following COVID-19 vaccination needs to be evaluated for its efficacy and effectiveness.
Aim: To compare the severity of the disease, oxygen requirement, and mortality between vaccinated and unvaccinated COVID-19 patients.
Materials and Methods: This retrospective study was done on the data of the patients who were admitted to Nizams Institute of Medical Sciences, Hyderabad, Telangana, India. All the admitted patients with COVID-19 disease, diagnosed by either Reverse Transcriptase Polymerase Chain Reaction (RTPCR) or rapid antigen detection method from April 2021 to October 2021, were included. Parameters recorded were: age, gender, co-morbidities, clinical staging as per institute protocol, vaccination status, oxygen requirement, the requirement of non invasive or invasive ventilation, inflammatory markers like C-Reactive Protein (CRP), ferritin, D dimer, Computed Tomography (CT) severity index, and outcomes.
Results: The mean age of patients was 49.7±14.8 yrs in the unvaccinated group, and 52.75±16.2 yrs in the vaccinated group. Out of 175 patients, 102 (58.28%) were unvaccinated. There were 25 (14.28%) deaths, of which 20 (80%) were unvaccinated and 5 (20%) were vaccinated. Oxygen requirement was more among the unvaccinated 73/96 (76.04%). High flow oxygen/mechanical ventilation requirement was higher in unvaccinated compared to vaccinated, 38 (76%) vs 12 (24%), respectively (p-value <0.005). The mortality rate was higher in unvaccinated patients with co-morbidity, with an odds ratio of 3.32 (1.2-9.3), p-value=0.02. Serum ferritin levels were significantly higher in the unvaccinated group, 858.15±935.5 vs 473.4±663.2 ng/mL, p-value 0.007. CT severity index in the unvaccinated group was 13.82±5.4, and for the vaccinated group, it was 11.58±5.49.
Conclusion: Severe disease, oxygen requirement, and mortality were low in vaccinated patients. Vaccination has also resulted in a statistically significant decrease in mortality in patients with co-morbidities. Serum ferritin levels were also found to be lower in vaccinated patients.
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