Clinical characteristics and respiratory care in hospitalized vaccinated SARS-CoV-2 patients

Jose Rafael Teran-Tinedo; Jesus Gonzalez-Rubio; Alberto Najera; Andrea Castany-Faro; Maria de Las Nieves Contreras; Isabel Maria Garcia; Lourdes Lopez-Mellado; Miguel Lorente-Gonzalez; Patricia Perez-Garvin; Galaxia Sacristan-Crespo; Miguel Suarez-Ortiz; Juan D Navarro-Lopez; Lydia Jimenez-Diaz; Pedro Landete

doi:10.1016/j.eclinm.2022.101453

Clinical characteristics and respiratory care in hospitalized vaccinated SARS-CoV-2 patients

EClinicalMedicine. 2022 Jun:48:101453. doi: 10.1016/j.eclinm.2022.101453. Epub 2022 May 20.

Authors

Jose Rafael Teran-Tinedo^{1

2

3}, Jesus Gonzalez-Rubio⁴, Alberto Najera⁴, Andrea Castany-Faro⁵, Maria de Las Nieves Contreras⁵, Isabel Maria Garcia^{6

7}, Lourdes Lopez-Mellado⁵, Miguel Lorente-Gonzalez¹, Patricia Perez-Garvin⁵, Galaxia Sacristan-Crespo⁵, Miguel Suarez-Ortiz¹, Juan D Navarro-Lopez⁸, Lydia Jimenez-Diaz⁸, Pedro Landete^{1

9}

Affiliations

¹ Respiratory intermediate Care Unit, "Enfermera Isabel Zendal" Emergency Hospital, Madrid, Spain.
² Pneumology Service, General Universitary Hospital "Gregorio Marañón", Madrid, Spain.
³ Universidad Complutense de Madrid, Madrid, Spain.
⁴ University of Castilla-La Mancha, NeuroPhysiology & Behavior Lab, Centre for Regional Biomedical Reserch (CRIB), Faculty of Medicine of Albacete, Spain.
⁵ Admission Service, "Enfermera Isabel Zendal" Emergency Hospital, Madrid, Spain.
⁶ Nursering Management, "Enfermera Isabel Zendal" Emergency Hospital, Madrid, Spain.
⁷ Pneumology Service. Hospital Universitario "La Paz", Madrid, Spain.
⁸ University of Castilla-La Mancha, NeuroPhysiology & Behavior Lab, Centre for Regional Biomedical Reserch (CRIB), Faculty of Medicine of Ciudad Real, Spain.
⁹ Department of Pneumology, Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.

Abstract

Background: The main objective of the present study was to analyze both clinical characteristics and evolution during hospitalization of a cohort of patients admitted for COVID-19 pneumonia who were not vaccinated, or with a complete or incomplete vaccination schedule.

Methods: This COVID-19 specialized single-center cohort study of 1888 COVID-19 patients hospitalized at the "Enfermera Isabel Zendal" Emergencies Hospital (HEEIZ), Madrid (Spain) was performed between July 1 and September 30, 2021. It compared the results of 1327 hospitalized unvaccinated patients to 209 hospitalized fully vaccinated and 352 hospitalized partially vaccinated patients. The four different COVID-19 vaccines authorized in Spain during the time-period studied were: BNT162b2 (Pfizer); ChAdOx1 nCoV-19 (AstraZeneca), mRNA-1273 (Moderna); Ad26.COV2.S (Janssen).

Findings: Hospitalized patients' median age was 41 years (IQR 33-50) for the unvaccinated and 61 years (IQR 53-67) for the fully vaccinated ones. The main comorbidities were obesity, hypertension and diabetes mellitus. 20% of unvaccinated patients (266) required noninvasive respiratory care, as did 14% (51) of partially and 14% (30) of fully vaccinated; 6% (78) of the unvaccinated patients also needed invasive respiratory care, as did 5% (16) of partially and 11 (5%) fully vaccinated.

Interpretation: Fully vaccinated patients were 84% (95% CI: 82-86%) less likely to be admitted to hospital, and protection rose for those aged <50 years. Once hospitalized, vaccinated patients displayed more protection against requiring respiratory care than unvaccinated ones, despite being older and having more comorbidities. No differences appeared for the four studied COVID-19 vaccines and complying with vaccination recommendations proved relevant.

Funding: The research was funded by the "Plan Propio de Investigación" Program of the Castilla-La Mancha University /European Regional Development Fund (2021-GRIN-31,039).

Keywords: Ad26.COV2.S; AstraZeneca; Azd1222; BNT162b2; COVID-19; Invasive respiratory care; Janssen; Moderna; Non-invasive respiratory care; Pfizer; Vaccinated patients; Vaccines; mRNA-1273.