Characteristics of COVID-19 vaccinated and unvaccinated patients admitted to Careggi University Hospital, Florence, Italy

Abstract

More than 11.5 billion COVID-19 vaccine doses have been administered around the world. Although vaccine effectiveness for severe infections is reported to be 89.0%, breakthrough infections are common and may lead to severe outcome in fragile population. We conducted a real-world observational study on 420 COVID-19 admitted patients from July 2021 to January 2022 in a tertiary level Italian hospital. We collected patient’s vaccination and SARS-CoV-2 serological status, SARS-CoV-2 treatments, oxygen supports, intensive (ICU) and subintensive (sub-ICU) care unit admissions, length of staying (LoS) and in-hospital mortality. One-hundred-seventy-two vaccinated and 248 unvaccinated patients were admitted during the study period. Vaccinated group (Vg) had a significantly more elevated Charlson Comorbidity Index than Unvaccinated group (UVg), and no statistical differences were found in terms of in-hospital mortality, LoS or ICU and sub-ICU admissions. Among Vg, anti-S antibodies were detected in 86.18% of patients (seropositives). Vaccinated seronegative patients’ in-hospital mortality was significantly higher than vaccinated seropositive patients (33.33% vs 10.69%, p = 0.0055): in particular, mortality rate in 45–69 years old population was higher in vaccinated seronegative group, and comparable in patients ≥ 70 years old. No differences in terms of outcome were registered between Vg and UVg, taking into account that Vg was considerably older and with more comorbidities. In line with other recent observations, higher mortality rate was evidenced for seronegative vaccinated patients. Primary prophylaxis and early treatments result to be necessary, especially for older and immunosuppressed populations.

The impact of comorbidity status in COVID-19 vaccines effectiveness before and after SARS-CoV-2 omicron variant in northeastern Mexico: a retrospective multi-hospital study

“…It has been shown that in patients with diabetes mellitus, there is an increased expression of ACE-2, the main receptor of SARS-CoV-2, in the lung and other organs ( 90 ), which situates diabetic patients at increased risk. Paggi et al ( 82 ) demonstrated, with 420 COVID-19 positive patients, that the vaccinated group had a higher Charlson comorbidity index compared to the unvaccinated group ( 82 ), where the most frequent diseases were cardiovascular diseases, pulmonary diseases, renal diseases, diabetes mellitus, dementia, cancer, and hematological diseases. No difference in terms of in-hospital mortality, was observed.…”

Latent Tuberculosis Infection and COVID-19: Analysis of a Cohort of Patients from Careggi University Hospital (Florence, Italy)

“…COVID-19-associated mortality is notably increased by aging, disabilities, and underlying medical conditions [14,[19][20][21]. However, data regarding the relationship between COVID-19 outcome and active or latent TB are few and discordant in the available literature.…”