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Introduction: The COVID-19 vaccination campaign was implemented in Sibu, Malaysia in February 2021. We assessed the effectiveness of the CoronaVac vaccine against severe acute respiratory infections (SARI) hospitalisation associated with laboratory-confirmed SARS-CoV-2 by time since vaccination. Method(s): A test-negative case-control design was employed using a web-based national information system for PCR results of SARS-CoV-2 infection and COVID-19 vaccination, and the hospitalisation dataset in Sibu Hospital. Eligible SARI cases with SARS-CoV-2 RT-PCR positive were matched to those SARI cases with negative RT-PCR tests by age and workplace. Vaccine effectiveness was measured by conditional logistic regression with adjustment for gender, comorbidity, smoking and education level. Result(s): Between 15 March and 30 September 2021, in the dominance of lineages B.1.466.2 and B.1.617.2 (Delta variant), a total of 838 eligible SARI patients were identified. Vaccine effectiveness was 42.4% (95% confidence interval [CI]: -28.3, 74.1), and 76.5% (95% CI: 45.6, 89.8) for partial vaccination (after the first dose through 14 days after the second dose) and complete vaccination (at 15 days or more after receipt of the second dose), respectively. Sensitivity analysis using propensity score matching yielded a conservative estimate of 57.4% (95% CI: 9.2, 80.1) for complete vaccination. Conclusion(s): Primary immunisation with two doses of CoronaVac vaccine provided satisfactory protection against SARI caused by SARS-CoV-2 in the short term. However, the duration of protection, incremental effectiveness induced by boosting, as well as performance against new variants need to be studied continuously.
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Objectives. To determine characteristics associated with a more severe COVID-19 outcome in people with Sjogren's disease (SJD). Methods. People with SJD and COVID-19 reported to two international registries (Sjogren Big Data Consortium and COVID-19 Global Rheumatology Alliance) from March 2020 to October 2021 were included. An ordinal COVID-19 severity scale was defined: (1) not hospitalized, (2) hospitalized with no ventilation, (3) hospitalized requiring non-invasive ventilation, (4) hospitalized requiring invasive ventilation, and (5) death. Odds ratios (OR) were estimated using a multivariable ordinal logistic regression model adjusted for age, sex, comorbidities and anti-rheumatic medications included as covariates. Results. A total of 898 people with SJD were included (825 (91.8%) women, mean age SARS-CoV-2 infection diagnosis: 55.5 years), including 652 patients with primary SJD and 246 with other associated systemic rheumatic diseases. 33.9% were hospitalized, 14.5% required ventilation, and 4.3% died. In the multivariable model, older age (OR 1.03, 95% CI 1.02 to 1.05), male sex (OR 1.81, 95% CI 1.10 to 2.92), two or more comorbidities (OR 2.99, 95% CI 1.92 to 4.67;vs none), baseline therapy with corticosteroids (OR 2.04, 95% CI 1.20 to 3.46), immunosuppressive agents (OR 2.09, 95% CI 1.30 to 3.38) and B-cell depleting agents (OR 5.38, 95% CI 2.77 to 10.47) were associated with worse outcomes (reference for all medications: hydroxychloroquine only). Conclusions. More severe COVID-19 outcomes in individuals with Sjogren's are largely driven by demographic factors and baseline comorbidities. Patients using immunosuppressants, especially rituximab, also experienced more severe outcomes.