ABSTRACT
Objective. To assess the adherence of COVID-19 convalescents to vaccination against SARS-CoV-2 and immune status based on long-term follow-up (12 months or more after hospital discharge). Material and methods. Using the TARGET-VIP registry, 775 patients (age 57.5+/-1.4 years;50.6% males) with the in-hospital diagnosis of COVID-19 were followed for 13.7+/-3.0 months after discharge. Comparison groups included 190 (24.5%) subjects vaccinated against SARS-CoV-2 and 585 (75.5%) unvaccinated during the follow-up period. Immune status was assessed in a representative sample of 283 (36.5%) patients (age 56.9+/-12.7 years, 44.9% males) who came for outpatient visits 14.6+/-4.1 months after hospital discharge, including 97 (34.3%) vaccinated and 186 (65.7%) unvaccinated against SARS-CoV-2. Results. No significant differences were found between the SARS-CoV-2 vaccinated and unvaccinated groups in age, gender char-acteristics, cardiovascular disease rate, chronic non-cardiac disease rate, and proportion of smokers. In the unvaccinated group, a higher proportion of patients with a history of ICU treatment for COVID-19 and/or grade 3-4 lung injury measured by CT scans was observed: 55.0% versus 46.8% (p=0.048). The vaccinated group included less active smokers: 3.7% versus 6.0% (p=0.22). Among the patients who came to the visit, antibody titer of IgG type N was increased in 50.4% of cases, and antibody titer of IgG type S (quantitatively) - in 98.6% of cases. After 14.6+/-4.1 months of follow-up, the SARS-CoV-2 vaccinated group (12.3+/-2.7 months after COVID-19) had higher IgG type S levels (505+/-103 versus 376+/-171 BAU/mL;p<0.001) compared with unvaccinated patients and no statistically significant difference in IgG (type N) and IgM titers. The SARS-CoV-2 vaccinated group had significantly higher rates of influenza vaccination both before COVID-19 (34.8% versus 21.9%;p=0.0004) and after hospitalization for COVID-19 (37.0% versus 15.0%;p<0.0001) compared with the unvaccinated group. After COVID-19, compared to the period before hospitalization, the proportion of vaccinated against influenza in the group vaccinated against SARS-CoV-2 increased (from 34.8% to 37.0%;p=0.65) and decreased in the group unvaccinated against SARS-CoV-2 (from 21.9% to 15.0%;p=0.003). Conclusion. The study showed that only 24.5% of COVID-19 survivors were subsequently vaccinated against SARS-CoV-2 over a fol-low-up period of 13.7+/-3.0 months. One year after hospital discharge, 50.4% of patients had elevated IgG type N titer, and 98.6% of patients had high IgG type S titer, significantly higher in vaccinated patients. Adherence to influenza vaccination after hospitalization for COVID-19 increased in patients subsequently vaccinated against SARS-CoV-2 and decreased in unvaccinated patients. Copyright © 2022, Media Sphera Publishing Group. All rights reserved.
ABSTRACT
Aim. Based on the data from the register of patients with COVID-19 and community-acquired pneumonia (CAP), analyze the duration of the prehospital period, cardiovascular comorbidity and the quality of prehospital pharmacotherapy of concomitant cardiovascular diseases (CVD). Material and methods. Patients were included to the study which admitted to the FSBI "NMHC named after N.I. Pirogov" of the Ministry of Health of the Russian Federation with a suspected or confirmed diagnosis of COVID-19 and/or CAP. The data for prehospital therapy, information from medical histories and a patients’survey in the hospital or by telephone contact 1-2 weeks after discharge were study. The duration of the prehospital stage was determined from the date of the appearance of clinical symptoms of coronavirus infection to the date of hospitalization. Results. The average age of the patients (n=1130;579 [51.2%] men and 551 [48.8%] women) was 57.5±12.8 years. The prehospital stage was 7 (5,0;10,0) days and did not differ significantly in patients with the presence and absence of CVD, but was significantly less in the deceased than in the surviving patients, as well as in those who required artificial lung ventilation (ALV). 583 (51.6%) patients had at least one CVD. Cardiovascular comorbidity was registered in 222 (42.7%) patients with hypertension, 210 (95.5%) patients with coronary heart disease (CHD), 104 (91.2%) patients with atrial fibrillation (AF). The inclusion of non-cardiac chronic diseases in the analysis led to an increase in the total proportion of patients with concomitant diseases to 65.8%. Approximately a quarter of hypertensive patients did not receive antihypertensive therapy, a low proportion of patients receiving antiplatelet agents and statins for CHD was revealed – 53% and 31.8%, respectively, anticoagulants for AF – 50.9%. Conclusion. The period from the onset of symptoms to hospitalization was significantly shorter in the deceased than in the surviving patients, as well as in those who required ALV. The proportion of people with a history of at least one CVD was about half of the entire cohort of patients. In patients with CVD before COVID-19 disease, a low frequencies of prescribing antihypertensive drugs, statins, antiplatelet agents and anticoagulants (in patients with AF) were recorded at the prehospital stage. © 2021 Stolichnaya Izdatelskaya Kompaniya. All rights reserved.