Analysis of the relationship of COVID-19 vaccination and critical cases of inpatients infected with Omicron variants_Chinese Journal of Evidence-Based Medicine

Authors：

HU Yuexia ¹ , XIA Xin ² , TIAN Xin ¹ ,  WANG Yanyan ¹

1. Department of Science and Technology, West China Hospital/ West China School of Nursing, Sichuan University, Chengdu 610041, P. R. China;
2. Center of Gerontology and Geriatrics, West China Hospital, Sichuan University/National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

WANG Yanyan, Email: kittyanwang520@scu.edu.cn

Keywords：

COVID-19; Omicron variants; Critical cases; Vaccine

DOI：

10.7507/1672-2531.202309089

Video：

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Objective To analyze the correlation between the vaccination status of inpatients with Omicron variant infection and the risk of Omicron critical illness. Methods A retrospective analysis was performed on the clinical data of patients with Omicron infection admitted to a designated hospital for COVID-19 in Chengdu from December 1, 2022 to January 31, 2023. Patients were divided into critical group and non-critical group according to their condition and the "COVID-19 Diagnosis and Treatment Program (Tenth Edition)". According to the vaccination status, the patients were divided into incomplete vaccination group, full vaccination group and booster vaccination group. Multivariate logistic regression was used to analyze the association between vaccination, symptoms and signs at admission, and the risk of critical illness. Results A total of 3 603 inpatients with Omicron infection were included, including 730 cases (20.3%) in the critical group and 2 873 cases (79.7%) in the non-critical group. There were 2 399 people (66.6%) in the incomplete vaccination group, 433 people (12%) in the full vaccination group, and 771 people (21.4%) in the booster vaccination group. Compared with the incomplete vaccination group, the proportion of critical illness in the full vaccination group and booster vaccination group was lower, and the critical illness rate increased with age (P<0.05). After adjusting for age, gender, and underlying diseases, the results of multivariate logistic analysis showed that full vaccination (OR=0.67, 95%CI 0.50 to 0.89) and booster vaccination (OR=0.76, 95% CI 0.61 to 0.94) were significantly associated with a reduced risk of critical illness. Conclusion Full vaccination and booster dose can effectively reduce the risk of critical illness after infection.

Citation： HU Yuexia, XIA Xin, TIAN Xin, WANG Yanyan. Analysis of the relationship of COVID-19 vaccination and critical cases of inpatients infected with Omicron variants. Chinese Journal of Evidence-Based Medicine, 2024, 24(3): 258-264. doi: 10.7507/1672-2531.202309089 Copy

1.	Viana R, Moyo S, Amoako DG, et al. Rapid epidemic expansion of the SARS-CoV-2 Omicron variant in southern Africa. Nature, 2022, 603(7902): 679-686.
2.	Tracking of VOC Omicron. Global initiative of sharing all influenza data (GISAID). 2022.
3.	Ren SY, Wang WB, Gao RD, et al. Omicron variant (B. 1.1. 529) of SARS-CoV-2: mutation, infectivity, transmission, and vaccine resistance. World J Clin Cases, 2022, 10(1): 1-11.
4.	Veneti L, Bøås H, Kristoffersen AB, et al. Reduced risk of hospitalisation among reported COVID-19 cases infected with the SARS-CoV-2 Omicron BA. 1 variant compared with the Delta variant, Norway, December 2021 to January 2022. Euro Surveill, 2022, 27(4): 2200077.
5.	Cheung PH, Chan CP, Jin DY. Lessons learned from the fifth wave of COVID-19 in Hong Kong in early 2022. Emerg Microbes Infect, 2022, 11(1): 1072-1078.
6.	Garcia-Del-Barco D, Risco-Acevedo D, Berlanga-Acosta J, et al. Revisiting pleiotropic effects of type Ⅰ interferons: rationale for its prophylactic and therapeutic use against SARS-CoV-2. Front Immunol, 2021, 12: 655528.
7.	Andrews N, Stowe J, Kirsebom F, et al. COVID-19 vaccine effectiveness against the Omicron (B. 1.1. 529) variant. N Engl J Med, 2022, 386(16): 1532-1546.
8.	Buchan SA, Chung H, Brown KA, et al. Estimated effectiveness of COVID-19 vaccines against Omicron or Delta symptomatic infection and severe outcomes. JAMA Netw Open, 2022, 5(9): e2232760.
9.	新型冠状病毒感染诊疗方案(试行第十版). 江苏中医药, 2023, 55(2): 后插1-后插5.
10.	赵建楠, 宋洋, 王英, 等. 奥密克戎BA. 1变异株在全球的流行和刺突蛋白的进化分析. 病毒学报, 2023, 39(3): 609-619.
11.	Fu Y, Zhao J, Wei X, et al. Effectiveness and cost-effectiveness of inactivated vaccine to address COVID-19 pandemic in China: evidence from randomized control trials and real-world studies. Front Public Health, 2022, 10: 917732.
12.	Huang Z, Xu S, Liu J, et al. Effectiveness of inactivated and Ad5-nCoV COVID-19 vaccines against SARS-CoV-2 Omicron BA. 2 variant infection, severe illness, and death. BMC Med, 2022, 20(1): 400.
13.	Li M, Liu Q, Wu D, et al. Association of COVID-19 vaccination and clinical severity of patients infected with Delta or Omicron variants - China, May 21, 2021-February 28, 2022. China CDC Wkly, 2022, 4(14): 293-297.
14.	Xu H, Li H, You H, et al. Effectiveness of inactivated COVID-19 vaccines against mild disease, pneumonia, and severe disease among persons infected with SARS-CoV-2 Omicron variant: real-world study in Jilin Province, China. Emerg Microbes Infect, 2023, 12(1): 2149935.
15.	Gao B, He L, Bao Y, et al. Repeated vaccination of inactivated SARS-CoV-2 vaccine dampens neutralizing antibodies against Omicron variants in breakthrough infection. Cell Res, 2023, 33(3): 258-261.
16.	Caramelo F, Ferreira N, Oliveiros B. Estimation of risk factors for COVID-19 mortality-preliminary results. MedRxiv, 2020: 2020.02. 24.20027268.
17.	Albitar O, Ballouze R, Ooi JP, et al. Risk factors for mortality among COVID-19 patients. Diabetes Res Clin Pract, 2020, 166: 108293.
18.	Zhang J, Wang X, Jia X, et al. Risk factors for disease severity, unimprovement, and mortality in COVID-19 patients in Wuhan, China. Clin Microbiol Infect, 2020, 26(6): 767-772.
19.	Jordan RE, Adab P, Cheng KK. COVID-19: risk factors for severe disease and death. BMJ, 2020, 368: m1198.
20.	魏瑷琳, 李依川, 顾永林, 等. 广安奥密克戎的流行特征与临床预后. 中国胸心血管外科临床杂志, 2023, 30(7): 970-975.
21.	王海峰, 李亚飞, 潘静静, 等. ≥60岁老年人群感染不同新冠病毒变异株临床症状及严重程度分析. 中国公共卫生, 2022, 38(8): 968-974.
22.	Zhang Z, Guo L, Huang L, et al. Distinct disease severity between children and older adults with coronavirus disease 2019 (COVID-19): impacts of ACE2 expression, distribution, and lung progenitor cells. Clin Infect Dis, 2021, 73(11): e4154-e4165.
23.	Bastolla U, Chambers P, Abia D, et al. Is COVID-19 severity associated with ACE2 degradation. Front Drug Dis, 2022, 1: 789710.
24.	Takahashi T, Ellingson MK, Wong P, et al. Sex differences in immune responses that underlie COVID-19 disease outcomes. Nature, 2020, 588(7837): 315-320.
25.	Junqueira C, Crespo Â, Ranjbar S, et al. FcγR-mediated SARS-CoV-2 infection of monocytes activates inflammation. Nature, 2022, 606(7914): 576-584.
26.	Gebhard C, Regitz-Zagrosek V, Neuhauser HK, et al. Impact of sex and gender on COVID-19 outcomes in Europe. Biol Sex Differ, 2020, 11(1): 29.
27.	Li J, He X, Yuan Yuan None, et al. Meta-analysis investigating the relationship between clinical features, outcomes, and severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia. Am J Infect Control, 2021, 49(1): 82-89.

1. Viana R, Moyo S, Amoako DG, et al. Rapid epidemic expansion of the SARS-CoV-2 Omicron variant in southern Africa. Nature, 2022, 603(7902): 679-686.
2. Tracking of VOC Omicron. Global initiative of sharing all influenza data (GISAID). 2022.
3. Ren SY, Wang WB, Gao RD, et al. Omicron variant (B. 1.1. 529) of SARS-CoV-2: mutation, infectivity, transmission, and vaccine resistance. World J Clin Cases, 2022, 10(1): 1-11.
4. Veneti L, Bøås H, Kristoffersen AB, et al. Reduced risk of hospitalisation among reported COVID-19 cases infected with the SARS-CoV-2 Omicron BA. 1 variant compared with the Delta variant, Norway, December 2021 to January 2022. Euro Surveill, 2022, 27(4): 2200077.
5. Cheung PH, Chan CP, Jin DY. Lessons learned from the fifth wave of COVID-19 in Hong Kong in early 2022. Emerg Microbes Infect, 2022, 11(1): 1072-1078.
6. Garcia-Del-Barco D, Risco-Acevedo D, Berlanga-Acosta J, et al. Revisiting pleiotropic effects of type Ⅰ interferons: rationale for its prophylactic and therapeutic use against SARS-CoV-2. Front Immunol, 2021, 12: 655528.
7. Andrews N, Stowe J, Kirsebom F, et al. COVID-19 vaccine effectiveness against the Omicron (B. 1.1. 529) variant. N Engl J Med, 2022, 386(16): 1532-1546.
8. Buchan SA, Chung H, Brown KA, et al. Estimated effectiveness of COVID-19 vaccines against Omicron or Delta symptomatic infection and severe outcomes. JAMA Netw Open, 2022, 5(9): e2232760.
9. 新型冠状病毒感染诊疗方案(试行第十版). 江苏中医药, 2023, 55(2): 后插1-后插5.
10. 赵建楠, 宋洋, 王英, 等. 奥密克戎BA. 1变异株在全球的流行和刺突蛋白的进化分析. 病毒学报, 2023, 39(3): 609-619.
11. Fu Y, Zhao J, Wei X, et al. Effectiveness and cost-effectiveness of inactivated vaccine to address COVID-19 pandemic in China: evidence from randomized control trials and real-world studies. Front Public Health, 2022, 10: 917732.
12. Huang Z, Xu S, Liu J, et al. Effectiveness of inactivated and Ad5-nCoV COVID-19 vaccines against SARS-CoV-2 Omicron BA. 2 variant infection, severe illness, and death. BMC Med, 2022, 20(1): 400.
13. Li M, Liu Q, Wu D, et al. Association of COVID-19 vaccination and clinical severity of patients infected with Delta or Omicron variants - China, May 21, 2021-February 28, 2022. China CDC Wkly, 2022, 4(14): 293-297.
14. Xu H, Li H, You H, et al. Effectiveness of inactivated COVID-19 vaccines against mild disease, pneumonia, and severe disease among persons infected with SARS-CoV-2 Omicron variant: real-world study in Jilin Province, China. Emerg Microbes Infect, 2023, 12(1): 2149935.
15. Gao B, He L, Bao Y, et al. Repeated vaccination of inactivated SARS-CoV-2 vaccine dampens neutralizing antibodies against Omicron variants in breakthrough infection. Cell Res, 2023, 33(3): 258-261.
16. Caramelo F, Ferreira N, Oliveiros B. Estimation of risk factors for COVID-19 mortality-preliminary results. MedRxiv, 2020: 2020.02. 24.20027268.
17. Albitar O, Ballouze R, Ooi JP, et al. Risk factors for mortality among COVID-19 patients. Diabetes Res Clin Pract, 2020, 166: 108293.
18. Zhang J, Wang X, Jia X, et al. Risk factors for disease severity, unimprovement, and mortality in COVID-19 patients in Wuhan, China. Clin Microbiol Infect, 2020, 26(6): 767-772.
19. Jordan RE, Adab P, Cheng KK. COVID-19: risk factors for severe disease and death. BMJ, 2020, 368: m1198.
20. 魏瑷琳, 李依川, 顾永林, 等. 广安奥密克戎的流行特征与临床预后. 中国胸心血管外科临床杂志, 2023, 30(7): 970-975.
21. 王海峰, 李亚飞, 潘静静, 等. ≥60岁老年人群感染不同新冠病毒变异株临床症状及严重程度分析. 中国公共卫生, 2022, 38(8): 968-974.
22. Zhang Z, Guo L, Huang L, et al. Distinct disease severity between children and older adults with coronavirus disease 2019 (COVID-19): impacts of ACE2 expression, distribution, and lung progenitor cells. Clin Infect Dis, 2021, 73(11): e4154-e4165.
23. Bastolla U, Chambers P, Abia D, et al. Is COVID-19 severity associated with ACE2 degradation. Front Drug Dis, 2022, 1: 789710.
24. Takahashi T, Ellingson MK, Wong P, et al. Sex differences in immune responses that underlie COVID-19 disease outcomes. Nature, 2020, 588(7837): 315-320.
25. Junqueira C, Crespo Â, Ranjbar S, et al. FcγR-mediated SARS-CoV-2 infection of monocytes activates inflammation. Nature, 2022, 606(7914): 576-584.
26. Gebhard C, Regitz-Zagrosek V, Neuhauser HK, et al. Impact of sex and gender on COVID-19 outcomes in Europe. Biol Sex Differ, 2020, 11(1): 29.
27. Li J, He X, Yuan Yuan None, et al. Meta-analysis investigating the relationship between clinical features, outcomes, and severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia. Am J Infect Control, 2021, 49(1): 82-89.

Chinese Journal of Evidence-Based Medicine

Analysis of the relationship of COVID-19 vaccination and critical cases of inpatients infected with Omicron variants

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