Differences in the Evolution of Clinical, Biochemical, and Hematological Indicators in Hospitalized Patients with COVID-19 According to Their Vaccination Scheme: A Cohort Study in One of the World's Highest Hospital Mortality Populations.
Martha A Mendoza-HernandezJosé Guzman-EsquivelMarco A Ramos-RojasVanessa V Santillan-LunaCarmen A Sanchez-RamirezGustavo A Hernandez-FuentesJanet Diaz-MartinezValery MelnikovFabián Rojas-LariosMargarita L Martinez-FierroDaniel Tiburcio-JimenezIram Pablo Rodriguez-SanchezOsiris G Delgado-EncisoAriana Cabrera-LiconaIván Delgado-EncisoPublished in: Vaccines (2024)
COVID-19 vaccines primarily prevent severe illnesses or hospitalization, but there is limited data on their impact during hospitalization for seriously ill patients. In a Mexican cohort with high COVID-19 mortality, a study assessed vaccination's effects. From 2021 to 2022, 462 patients with 4455 hospital days were analyzed. The generalized multivariate linear mixed model (GENLINMIXED) with binary logistic regression link, survival analysis and ROC curves were used to identify risk factors for death. The results showed that the vaccinated individuals were almost half as likely to die (adRR = 0.54, 95% CI = 0.30-0.97, p = 0.041). When stratifying by vaccine, the Pfizer group (BNT162b2) had a 2.4-times lower risk of death (adRR = 0.41, 95% CI = 0.2-0.8, p = 0.008), while the AstraZeneca group (ChAdOx1-S) group did not significantly differ from the non-vaccinated (adRR = 1.04, 95% CI = 0.5-2.3, p = 0.915). The Pfizer group exhibited a higher survival, the unvaccinated showed increasing mortality, and the AstraZeneca group remained intermediate ( p = 0.003, multigroup log-rank test). Additionally, BNT162b2-vaccinated individuals had lower values for markers, such as ferritin and D-dimer. Biochemical and hematological indicators suggested a protective effect of both types of vaccines, possibly linked to higher lymphocyte counts and lower platelet-to-lymphocyte ratio (PLR). It is imperative to highlight that these results reinforce the efficacy of COVID-19 vaccines. However, further studies are warranted for a comprehensive understanding of these findings.
Keyphrases
- prognostic factors
- coronavirus disease
- sars cov
- cardiovascular events
- healthcare
- peripheral blood
- risk factors
- chronic kidney disease
- coronary artery disease
- end stage renal disease
- respiratory syndrome coronavirus
- emergency department
- type diabetes
- adverse drug
- ionic liquid
- machine learning
- free survival
- ejection fraction
- drug induced
- visible light
- artificial intelligence