A COVID-19 vaccine is an effective and important tool for pandemic control. However, vaccines are not 100% effective in preventing disease. Breakthrough infection was defined as the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ribonucleic acid (RNA) or antigen in a respiratory specimen collected from a person aged 14 days or more after receiving the full recommended dose of COVID-19 vaccine.
Breakthrough cases are on the rise with the highly contagious Omicron variant. Therefore, it is important to know how vaccination impacts not only the severity of COVID-19 disease but also clinical data and medical imaging results.
The study’s senior author, Yeon Joo Jeong, MD, said: “Although the risk of infection is much lower in vaccinated individuals and vaccination reduces the severity of illness, the data do not. Clinical and imaging findings of COVID-19 breakthrough infections have not yet been reported in detail. PhD from the Department of Radiology and Biomedical Research Institute at Pusan National University Hospital in Busan, South Korea. “The aim of this study was to document the clinical and imaging features of the COVID-19 breakthrough infection and compare them with infections in unvaccinated patients.”
In this retrospective multicenter cohort study, Dr. Jeong and colleagues analyzed data from adult patients enrolled in the open data repository for COVID-19 ?? Korea Imaging Cohort for COVID-19 (KICC-19) ?? from June to August 2021. Hospitalization of baseline chest X-ray patients were divided into three groups, according to their immunization status. The researchers assessed differences between clinical and imaging features and analyzed associations between clinical factors, including vaccination status, and clinical outcomes.
Of the 761 patients hospitalized with COVID-19, the median age was 47 years and 385 (51%) were women. Forty-seven patients (6.2%) were fully immunized (mutant infection), 127 were partially vaccinated (17%), and 587 (77%) were unvaccinated. Chest CT was performed on 412 (54%) patients during hospitalization. Among patients undergoing CT scan, the rate of CT scan without pneumonia was 22% (71/326) of unvaccinated patients, 30% (19/64) of partially vaccinated patients, and 59% (13/ 22) the patient was fully immunized. Fully immunized status is associated with a lower risk of needing supplemental oxygen compared with unvaccinated status, as well as a lower risk of admission to the intensive care unit (ICU).
The results also showed an association between the risk of severe disease and clinical features such as older age, history of diabetes, lymphopenia, thrombocytopenia, elevated LDH (lactate dehydrogenase) and elevated CRP. C-reactive proteins). Notably, age has also been implicated as an important predictor of worsening illness in COVID-19 patients, even in those with sporadic infections.
The observed differences in clinical features may reflect differences in vaccination preferences based on underlying comorbidities, the researchers note. During the study period, high-risk groups, such as people over 65, healthcare workers, and people with disabilities were prioritized for COVID-19 vaccinations. Therefore, elderly patients and patients with at least one comorbidity were more frequent in the vaccinated group than in the unvaccinated group in the study.
“Despite these differences, mechanical ventilation and hospital deaths occurred only in the unvaccinated group,” said Dr. Jeong. “Furthermore, after adjusting for baseline clinical features, the analysis showed that fully immunized patients had a significantly lower risk of requiring supplemental oxygen and ICU admission compared with patients who were not. vaccinated.”
Source: Eurekalert
