PDF(Pubmed)
Abstract：
COVID-19 disease resulted in over six million deaths worldwide. Although vaccines against SARS-CoV-2 demonstrated efficacy, breakthrough infections became increasingly common. There is still a lack of data regarding the severity and outcomes of COVID-19 among vaccinated compared to unvaccinated individuals.
This was a historical cohort study of adult COVID-19 patients hospitalized in five Ascension hospitals in southeast Michigan. Electronic medical records were reviewed. Vaccine information was collected from the Michigan Care Improvement Registry. Data were analyzed using Student\'s t-test, analysis of variance, the chi-squared test, the Mann-Whitney and Kruskal-Wallis tests, and multivariable logistic regression.
Of 341 patients, the mean age was 57.9 ± 18.3 years, 54.8% (187/341) were female, and 48.7% (166/341) were black/African American. Most patients were unvaccinated, 65.7%, 8.5%, and 25.8% receiving one dose or at least two doses, respectively. Unvaccinated patients were younger than fully vaccinated (p = 0.001) and were more likely to be black/African American (p = 0.002). Fully vaccinated patients were 5.3 times less likely to have severe/critical disease (WHO classification) than unvaccinated patients (p < 0.001) after controlling for age, BMI, race, home steroid use, and serum albumin levels on admission. The case fatality rate in fully vaccinated patients was 3.4% compared to 17.9% in unvaccinated patients (p = 0.003). Unvaccinated patients also had higher rates of complications.
Patients who were unvaccinated or partially vaccinated had more in-hospital complications, severe disease, and death as compared to fully vaccinated patients. Factors associated with severe COVID-19 disease included advanced age, obesity, low serum albumin, and home steroid use.
This was a historical cohort study of adult COVID-19 patients hospitalized in five Ascension hospitals in southeast Michigan. Electronic medical records were reviewed. Vaccine information was collected from the Michigan Care Improvement Registry. Data were analyzed using Student\'s t-test, analysis of variance, the chi-squared test, the Mann-Whitney and Kruskal-Wallis tests, and multivariable logistic regression.
Of 341 patients, the mean age was 57.9 ± 18.3 years, 54.8% (187/341) were female, and 48.7% (166/341) were black/African American. Most patients were unvaccinated, 65.7%, 8.5%, and 25.8% receiving one dose or at least two doses, respectively. Unvaccinated patients were younger than fully vaccinated (p = 0.001) and were more likely to be black/African American (p = 0.002). Fully vaccinated patients were 5.3 times less likely to have severe/critical disease (WHO classification) than unvaccinated patients (p < 0.001) after controlling for age, BMI, race, home steroid use, and serum albumin levels on admission. The case fatality rate in fully vaccinated patients was 3.4% compared to 17.9% in unvaccinated patients (p = 0.003). Unvaccinated patients also had higher rates of complications.
Patients who were unvaccinated or partially vaccinated had more in-hospital complications, severe disease, and death as compared to fully vaccinated patients. Factors associated with severe COVID-19 disease included advanced age, obesity, low serum albumin, and home steroid use.
摘要：
背景：COVID-19疾病在全球导致600多万人死亡。尽管针对SARS-CoV-2的疫苗显示出功效，突破性感染变得越来越普遍。与未接种疫苗的个体相比，仍缺乏关于COVID-19疫苗严重程度和结果的数据。
方法：这是一项在密歇根州东南部的五家阿森松医院住院的成人COVID-19患者的历史队列研究。审查了电子病历。疫苗信息是从密歇根州护理改善登记处收集的。数据采用学生t检验进行分析，方差分析，卡方检验,Mann-Whitney和Kruskal-Wallis测试,和多变量逻辑回归。
结果：在341名患者中，平均年龄为57.9±18.3岁，54.8%(187/341)为女性，黑人/非洲裔美国人占48.7%（166/341）。大多数患者没有接种疫苗，65.7%,8.5%,和25.8%接受一个剂量或至少两个剂量，分别。未接种疫苗的患者比完全接种疫苗的患者年轻（p=0.001），并且更可能是黑人/非裔美国人（p=0.002）。在控制年龄后，完全接种疫苗的患者患严重/危重症（WHO分类）的可能性比未接种疫苗的患者低5.3倍（p<0.001）。BMI,种族,家庭使用类固醇，入院时血清白蛋白水平。完全接种疫苗的患者的病死率为3.4%,而未接种疫苗的患者为17.9%(p=0.003)。未接种疫苗的患者也有较高的并发症发生率。
结论：未接种或部分接种疫苗的患者院内并发症较多，严重疾病,与完全接种疫苗的患者相比，死亡。与严重COVID-19疾病相关的因素包括高龄，肥胖，低血清白蛋白,和家庭使用类固醇。
方法：这是一项在密歇根州东南部的五家阿森松医院住院的成人COVID-19患者的历史队列研究。审查了电子病历。疫苗信息是从密歇根州护理改善登记处收集的。数据采用学生t检验进行分析，方差分析，卡方检验,Mann-Whitney和Kruskal-Wallis测试,和多变量逻辑回归。
结果：在341名患者中，平均年龄为57.9±18.3岁，54.8%(187/341)为女性，黑人/非洲裔美国人占48.7%（166/341）。大多数患者没有接种疫苗，65.7%,8.5%,和25.8%接受一个剂量或至少两个剂量，分别。未接种疫苗的患者比完全接种疫苗的患者年轻（p=0.001），并且更可能是黑人/非裔美国人（p=0.002）。在控制年龄后，完全接种疫苗的患者患严重/危重症（WHO分类）的可能性比未接种疫苗的患者低5.3倍（p<0.001）。BMI,种族,家庭使用类固醇，入院时血清白蛋白水平。完全接种疫苗的患者的病死率为3.4%,而未接种疫苗的患者为17.9%(p=0.003)。未接种疫苗的患者也有较高的并发症发生率。
结论：未接种或部分接种疫苗的患者院内并发症较多，严重疾病,与完全接种疫苗的患者相比，死亡。与严重COVID-19疾病相关的因素包括高龄，肥胖，低血清白蛋白,和家庭使用类固醇。
