Vaccination status and clinical outcome of COVID-19 in hospitalized patients
DOI:
https://doi.org/10.36517/2175-6783.20252695529Keywords:
COVID-19; COVID-19 Vaccines; Hospitalization; Outcome Expectations.Abstract
Objective: to analyze the relationship between the vaccination status of patients hospitalized for COVID-19 and clinical outcomes. Methods: retrospective cohort study conducted at a referral hospital for COVID-19, including 305 patients ≥ 5 years of age admitted to wards and/or intensive care units with a diagnosis of COVID-19. Hospitalization data were collected from electronic medical records, and vaccination status data were obtained from the VaciVida system. The analysis was performed using Poisson regression models. Results: the comparison between patients who did not receive any vaccine doses and those who received a booster dose showed a relative risk of 1.46 (p = 0.160), suggesting an increased risk of death among the unvaccinated; however, this was not statistically significant. The comparison between unvaccinated individuals and those with an incomplete vaccination schedule revealed a relative risk of 2.42 (p = 0.350). Conclusion: it was observed that most patients who died or required intensive care did not have a complete vaccination schedule, which points to a possible trend toward worse outcomes among unvaccinated individuals. Contributions to practice: the findings underscore the importance of vaccination and active surveillance of clinical factors associated with severity to inform management in patients with COVID-19.
References
1. Kumar A, Singh R, Kaur J, Pandey S, Sharma V, Thakur L, et al. Wuhan to world: the COVID-19 pandemic. Front Cell Infect Microbiol. 2021;11:596201. doi: https://doi.org/10.3389/fcimb.2021.596201
2. Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC. Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): a review. JAMA. 2020;324(8):782-93. doi: https://doi.org/10.1001/jama.2020.12839
3. Ministério da Saúde (BR). Plano Nacional de Ope- racionalização da Vacinação contra a COVID-19 [Internet]. 2022 [cited Jun 10, 2025]. Available from:https://bvsms.saude.gov.br/bvs/publicacoes/plano_nacional_operacionalizacao_vacinacao_covid19.pdf
4. Watson OJ, Barnsley G, Toor J, Hogan AB, Winskill P, Ghani AC. Global impact of the first year of COVID-19 vaccination: a mathematical modelling study. Lancet Infect Dis. 2022;22(9):1293-302. doi: http://doi.org/10.1016/S1473-3099(22)00320-6
5. Chenchula S, Karunakaran P, Sharma S, Chavan M. Current evidence on efficacy of COVID-19 booster dose vaccination against the Omicron variant: a systematic review. J Med Virol. 2022;94(7):2969-76. doi: https://doi.org/10.1002/jmv.27697
6. Oraganização Pan-Americana de Saúde (OPAS). OMS declara fim da Emergência de Saúde Pública de Importância Internacional referente à COVID-19 [Internet]. 2023 [cited May 19, 2025]. Available from: https://www.paho.org/pt/noticias/5-5-2023-oms-declara-fim-da-emergencia-saude-publica-importancia-internacional-referente
7. Zhang J-J, Dong X, Liu G-H, Gao Y-D. Risk and protective factors for COVID-19 morbidity, severity, and mortality. Clin Rev Allergy Immunol. 2023;64(1):90-107. doi: http://doi.org/10.1007/s12016-022-08921-5
8. Secretaria de Saúde do Estado de São Paulo. Documento Técnico: campanha de vacinação contra a COVID-19 [Internet]. 2023 [cited May 9, 2025]. Available from: https://saude.sp.gov.br/cve-centro-de-vigilancia-epidemiologica-prof.-alexandre-vranjac/areas-de-vigilancia/imunizacao/campanhas-de-vacinacao/documento-tecnico
9. Zou G. A Modified Poisson Regression approach to prospective studies with binary data. Am J Epidemiol. 2004;159(7):702-6. doi: https://doi.org/10.1093/aje/kwh090
10. Ranzani OT, Bastos LSL, Gelli JGM, Marchesi JF, Baião F, Hamacher S, Bozza FA. Characterisation of the first 250,000 hospital admissions for COVID-19 in Brazil: a retrospective analysis of nationwide data. Lancet Respir Med. 2021;9(4):407-18. doi: http://doi.org/10.1016/S2213-2600(20)30560-9
11. Fidecicchi T, Franca F, Ignacio LL, Calaf J. COVID-19, gender and estroprogestins, what do we know? Eur J Contracept Reprod Health Care. 2022;27(1):67-74. doi: https://doi.org/10.1080/13625187.2021.2000959
12. Al-Kuraishy HM, Al-Gareeb AI, Faidah H, Al-Maiahy TJ, Cruz-Martins N, Batiha GES. The looming effects of estrogen in Covid-19: a rocky rollout. Front Nutr. 2021;8:649128. doi: http://doi.org/10.3389/fnut.2021.649128
13. Mauvais-Jarvis F, Merz NB, Barnes PJ, Brinton RD, Carrero JJ, DeMeo DL, et al. Sex and gender: modifiers of health, disease, and medicine. Lancet. 2020;396(10250):565-82. doi: http://dx.doi.org/10.1016/S0140-6736(20)31561-0
14. Instituto Brasileiro de Geografia e Estatística (IBGE). Panorama: Censo 2022 [Internet]. 2023 [cited May 19, 2025]. Available from: https://censo2022.ibge.gov.br/panorama/
15. Ludvigsson JF. Systematic review of COVID‐19 in children shows milder cases and a better prognosis than adults. Acta Paediatr. 2020;109(6):1088-95. doi: https://doi.org/10.1111/apa.15270
16. Chen J, Kelley WJ, Goldstein DR. Role of aging and the immune response to respiratory viral infections: potential implications for COVID-19. J Immunol. 2020;205(2):313-20. doi: https://doi.org/10.4049/jimmunol.2000380
17. Feng E, Balint E, Poznanski SM, Ashkar AA, Loeb M. Aging and interferons: impacts on inflammation and viral disease outcomes. Cells. 2021;10(3):708. doi: https://doi.org/10.3390/cells10030708
18. Silaghi-Dumitrescu R, Patrascu I, Lehene M, Bercea I. Comorbidities of COVID-19 patients. Medicina (Kaunas). 2023;59(8):1393. doi: https://dx.doi.org/10.3390/medicina59081393
19. Costa P, Pereira J, Cañigral A, Quintana E, Sanchez-Nieto J, Delis P, et al. Vaccination status and outcomes in critical COVID-19 patients. J Bras Pneumol. 2024;50(1):e20230116. doi: http://doi.org/10.36416/1806-3756/e20230116
20. Grasselli G, Zanella A, Carlesso E, Florio G, Canakoglu A, Bellani G, et al. Association of COVID-19 vaccinations with intensive care unit admissions and outcome of critically Ill patients with COVID-19 pneumonia in Lombardy, Italy. JAMA. 2022;5(10):e2238871. doi: https://dx.doi.org/10.1001/jamanetworkopen.2022.38871
21. Sales-Moioli AIL, Galvão-Lima LJ, Pinto TKB, Cardoso PH, Silva RD, Fernandes F, et al. Effectiveness of COVID-19 vaccination on reduction of hospitalizations and deaths in elderly patients in Rio Grande do Norte, Brazil. Int J Environ Res Public Health. 2022;19(21):13902. doi: https://doi.org/10.3390/ijerph192113902
22. Bušić N, Lucijanić T, Baršić B, Lukšić I, Busic I, Kurdija G, et al. Vaccination provides protection from respiratory deterioration and death among hospitalized COVID‐19 patients: differences between vector and mRNA vaccines. J Med Virol. 2022;94(6):2849-54. doi: https://dx.doi.org/10.1002/jmv.27666
23. Van Diepen S, McAlister FA, Chu LM, Youngson E, Kaul P, Kadri SS. Association between vaccination status and outcomes in patients admitted to the ICU with COVID-19. Crit Care Med. 2023;51(9):1201-9. doi: http://doi.org/10.1097/CCM.0000000000005928
24. Chang R, Elhusseiny KM, Yeh YC, Sun WZ. COVID-19 ICU and mechanical ventilation patient characteristics and outcomes—A systematic review and meta-analysis. PLoS One. 2021;16(2):e0246318. doi: https://doi.org/10.1371/journal.pone.0246318
25. Cronin JN, Camporota L, Formenti F. Mechanical ventilation in COVID-19: a physiological perspective. Exp Physiol. 2022;107(7):683-93. doi: https://doi.org/10.1113/EP089400
26. Green A, Rachoin JS, Schorr C, Dellinger P, Casey JD, Park I, et al. Timing of invasive mechanical ventilation and death in critically ill adults with COVID-19: a multicenter cohort study. PLoS One. 2023;18(6):e0285748. doi: https://dx.doi.org/10.1371/journal.pone.0285748
27. Murillo-Zamora E, Hernandez-Suarez CM. Survival in adult inpatients with COVID-19. Public Health. 2021;190:1-3. doi: https://dx.doi.org/10.1016/j.puhe.2020.10.029
28. López L, Portugal W, Huamán K, Obregón C. Efectividad de vacunas COVID-19 y riesgo de mortalidad en Perú: un estudio poblacional de cohortes pareadas. An Fac Med. 2022;83(2):87-94. doi: https://doi.org/10.15381/anales.v83i2.21531
29. Sayeed M, Shalim E, Farooqui F, Farman S, Khan M, Iqbal A, et al. Comparison of the disease severity and outcome of vaccinated COVID-19 patients with unvaccinated patients in a specialized COVID-19 facility: a retrospective cohort study from Karachi, Pakistan. Vaccines (Basel). 2023;11(7):1178. doi: https://doi.org/10.3390/vaccines11071178
30. Martins-Filho PR, Araújo AAS, Quintans-Júnior LJ, Soares BS, Barboza WS, Cavalcante TF, et al. Dynamics of hospitalizations and in-hospital deaths from COVID-19 in northeast Brazil: a retrospective analysis based on the circulation of SARS-CoV-2 variants and vaccination coverage. Epidemiol Health. 2022;44:e2022036. doi: https://doi.org/10.4178/epih.e2022036
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Rev Rene
This work is licensed under a Creative Commons Attribution 4.0 International License.
