Hospitalized patients with breakthrough COVID-19: Clinical features and poor outcome predictors.
Por:
Moreno-Perez O, Ribes I, Boix V, Martinez-García MÁ, Otero-Rodriguez S, Reus S, Sánchez-Martínez R, Ramos JM, Chico-Sánchez P, Merino E and On behalf the COVID-19 ALC research group
Publicada:
1 may 2022
Ahead of Print:
13 feb 2022
Resumen:
OBJECTIVES: To describe breakthrough COVID-19 in patients who needed hospitalization and the factors associated with poor outcomes. METHODS: A retrospective study on complete (diagnosed two weeks after the second dose of the Pfizer/Moderna/AstraZeneca or first dose of the Janssen vaccine was administered) or partial vaccine scheme (CV or PV) patients hospitalized for COVID-19 between December 27, 2020, and October 17, 2021, was conducted. The main outcomes were all-cause mortality and the need for invasive mechanical ventilation (IMV). The baseline factors associated with the outcomes were analyzed by multiple logistic regression, estimating the odds ratios (OR; 95% CI). RESULTS: One hundred and forty-five patients (101 CV) were included. The CV subgroup was mainly composed of elderly males with high comorbidity (Charlson index =3, 72%; immunosuppression, 20%), with bilateral pneumonia in 63.4%; limited therapeutic effort (LTE) was agreed upon for 28% of the patients. In the CV subgroup, endotracheal intubation was required in 10.9%, reaching 15.3% when excluding LTE patients; the global mortality was 22.8% and 41.4% in the subgroup with LTE. Although the PV patients were younger and had fewer comorbidities, the main outcomes did not differ significantly between the CV and PV groups. The predictors of poor outcomes were age = 65 years, confusion, ferritin > 500 mg/L, extensive lung infiltrates, and a Charlson index = 3. CONCLUSIONS: Fully vaccinated patients hospitalized due to breakthrough COVID-19 tend to be elderly, with comorbidities, and have high mortality.
Filiaciones:
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Endocrinology and Nutrition Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain
Clinical Medicine Department, Miguel Hernández University of Elche, Spain
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Internal Medicine Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain. Electronic address:
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Unit of Infectious Diseases, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
Clinical Medicine department, Miguel Hernández University, Elche, Spain
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Pneumology department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
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Unit of Infectious Diseases, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain. Electronic address:
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Unit of Infectious Diseases, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
Clinical Medicine department, Miguel Hernández University, Elche, Spain
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Clinical Medicine Department, Miguel Hernández University, Elche, Spain
Internal Medicine department, Alicante General University Hospital - Alicante Institute of Health and Biomedical Research (ISABIAL), Alicante, Spain
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Preventive Department, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain
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Unit of Infectious Diseases, Alicante General University Hospital - Alicante Institute of Sanitary and Biomedical Research (ISABIAL), Alicante, Spain. Electronic address:
Green Published, gold
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