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Real World Estimate of Vaccination Protection in Individuals Hospitalized for COVID-19.
d'Arminio Monforte, Antonella; Tavelli, Alessandro; De Benedittis, Sara; Bai, Francesca; Tincati, Camilla; Gazzola, Lidia; Viganò, Ottavia; Allegrini, Marina; Mondatore, Debora; Tesoro, Daniele; Barbanotti, Diletta; Mulé, Giovanni; Castoldi, Roberto; De Bona, Anna; Bini, Teresa; Chiumello, Davide; Centanni, Stefano; Passarella, Sabrina; Orfeo, Nicola; Marchetti, Giulia; Cozzi-Lepri, Alessandro.
  • d'Arminio Monforte A; Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy.
  • Tavelli A; Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy.
  • De Benedittis S; Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy.
  • Bai F; Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy.
  • Tincati C; Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy.
  • Gazzola L; Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy.
  • Viganò O; Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy.
  • Allegrini M; Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy.
  • Mondatore D; Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy.
  • Tesoro D; Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy.
  • Barbanotti D; Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy.
  • Mulé G; Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy.
  • Castoldi R; Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy.
  • De Bona A; Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy.
  • Bini T; Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy.
  • Chiumello D; Intensive Care Unit ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy.
  • Centanni S; Pneumology Unit ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy.
  • Passarella S; Medical Direction ASST Santi Paolo e Carlo, 20142 Milan, Italy.
  • Orfeo N; Medical Direction ASST Santi Paolo e Carlo, 20142 Milan, Italy.
  • Marchetti G; Unit of Infectious Diseases ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, 20142 Milan, Italy.
  • Cozzi-Lepri A; Institute for Global Health, University College London, London NW3 2PF, UK.
Vaccines (Basel) ; 10(4)2022 Apr 01.
Article in English | MEDLINE | ID: covidwho-1776373
ABSTRACT
Whether vaccination confers a protective effect against progression after hospital admission for COVID-19 remains to be elucidated. Observational study including all the patients admitted to San Paolo Hospital in Milan for COVID-19 in 2021. Previous vaccination was categorized as none, one dose, full vaccination (two or three doses >14 days before symptoms onset). Data were collected at hospital admission, including demographic and clinical variables, age-unadjusted Charlson Comorbidity index (CCI). The highest intensity of ventilation during hospitalization was registered. The endpoints were in-hospital death (primary) and mechanical ventilation/death (secondary). Survival analysis was conducted by means of Kaplan-Meier curves and Cox regression models. Effect measure modification by age was formally tested. We included 956 patients 151 (16%) fully vaccinated (18 also third dose), 62 (7%) one dose vaccinated, 743 (78%) unvaccinated. People fully vaccinated were older and suffering from more comorbidities than unvaccinated. By 28 days, the risk of death was of 35.9% (95%CI 30.1-41.7) in unvaccinated, 41.5% (24.5-58.5) in one dose and 28.4% (18.2-38.5) in fully vaccinated (p = 0.63). After controlling for age, ethnicity, CCI and month of admission, fully vaccinated participants showed a risk reduction of 50% for both in-hospital death, AHR 0.50 (95%CI 0.30-0.84) and for mechanical ventilation or death, AHR 0.49 (95%CI 0.35-0.69) compared to unvaccinated, regardless of age (interaction p > 0.56). Fully vaccinated individuals in whom vaccine failed to keep them out of hospital, appeared to be protected against critical disease or death when compared to non-vaccinated. These data support universal COVID-19 vaccination.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study Topics: Vaccines Language: English Year: 2022 Document Type: Article Affiliation country: Vaccines10040550

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study Topics: Vaccines Language: English Year: 2022 Document Type: Article Affiliation country: Vaccines10040550