tetano
Editor, Senior Moderator
Open Forum Infect Dis
. 2022 Mar 7;9(5)
fac116.
doi: 10.1093/ofid/ofac116. eCollection 2022 May.
Risk Factors Associated With Hospitalization and Death in COVID-19 Breakthrough Infections
Geehan Suleyman[SUP] 1 2 [/SUP], Raef Fadel[SUP] 3 [/SUP], Indira Brar[SUP] 1 2 [/SUP], Rita Kassab[SUP] 3 [/SUP], Rafa Khansa[SUP] 3 [/SUP], Nicholas Sturla[SUP] 3 [/SUP], Ayman Alsaadi[SUP] 3 [/SUP], Katie Latack[SUP] 4 [/SUP], Joseph Miller[SUP] 5 [/SUP], Robert Tibbetts[SUP] 6 [/SUP], Linoj Samuel[SUP] 6 [/SUP], George Alangaden[SUP] 1 2 [/SUP], Mayur Ramesh[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Characterizations of coronavirus disease 2019 (COVID-19) vaccine breakthrough infections are limited. We aim to characterize breakthrough infections and identify risk factors associated with outcomes.
Methods: This was a retrospective case series of consecutive fully vaccinated patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a multicenter academic center in Southeast Michigan, between December 30, 2020, and September 15, 2021.
Results: A total of 982 patients were identified; the mean age was 57.9 years, 565 (59%) were female, 774 (79%) were White, and 255 (26%) were health care workers (HCWs). The median number of comorbidities was 2; 225 (23%) were immunocompromised. BNT162b2 was administered to 737 (75%) individuals. The mean time to SARS-CoV-2 detection was 135 days. The majority were asymptomatic or exhibited mild to moderate disease, 154 (16%) required hospitalization, 127 (13%) had severe-critical illness, and 19 (2%) died. Age (odds ratio [OR], 1.14; 95% CI, 1.04-1.07; P < .001), cardiovascular disease (OR, 3.02; 95% CI, 1.55-5.89; P = .001), and immunocompromised status (OR, 2.57; 95% CI, 1.70-3.90; P < .001) were independent risk factors for hospitalization. Additionally, age (OR, 1.06; 95% CI, 1.02-1.11; P = .006) was significantly associated with mortality. HCWs (OR, 0.15; 95% CI, 0.05-0.50; P = .002) were less likely to be hospitalized, and prior receipt of BNT162b2 was associated with lower odds of hospitalization (OR, 0.436; 95% CI, 0.303-0.626; P < .001) and/or death (OR, 0.360; 95% CI, 0.145-0.898; P = .029).
Conclusions: COVID-19 vaccines remain effective at attenuating disease severity. However, patients with breakthrough infections necessitating hospitalization may benefit from early treatment modalities and COVID-19-mitigating strategies, especially in areas with substantial or high transmission rates.
Keywords: COVID-19; breakthrough infections; hospitalizations; outcomes.
. 2022 Mar 7;9(5)
fac116.doi: 10.1093/ofid/ofac116. eCollection 2022 May.
Risk Factors Associated With Hospitalization and Death in COVID-19 Breakthrough Infections
Geehan Suleyman[SUP] 1 2 [/SUP], Raef Fadel[SUP] 3 [/SUP], Indira Brar[SUP] 1 2 [/SUP], Rita Kassab[SUP] 3 [/SUP], Rafa Khansa[SUP] 3 [/SUP], Nicholas Sturla[SUP] 3 [/SUP], Ayman Alsaadi[SUP] 3 [/SUP], Katie Latack[SUP] 4 [/SUP], Joseph Miller[SUP] 5 [/SUP], Robert Tibbetts[SUP] 6 [/SUP], Linoj Samuel[SUP] 6 [/SUP], George Alangaden[SUP] 1 2 [/SUP], Mayur Ramesh[SUP] 1 [/SUP]
Affiliations
- PMID: 35437511
- PMCID: PMC8903475
- DOI: 10.1093/ofid/ofac116
Abstract
Background: Characterizations of coronavirus disease 2019 (COVID-19) vaccine breakthrough infections are limited. We aim to characterize breakthrough infections and identify risk factors associated with outcomes.
Methods: This was a retrospective case series of consecutive fully vaccinated patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a multicenter academic center in Southeast Michigan, between December 30, 2020, and September 15, 2021.
Results: A total of 982 patients were identified; the mean age was 57.9 years, 565 (59%) were female, 774 (79%) were White, and 255 (26%) were health care workers (HCWs). The median number of comorbidities was 2; 225 (23%) were immunocompromised. BNT162b2 was administered to 737 (75%) individuals. The mean time to SARS-CoV-2 detection was 135 days. The majority were asymptomatic or exhibited mild to moderate disease, 154 (16%) required hospitalization, 127 (13%) had severe-critical illness, and 19 (2%) died. Age (odds ratio [OR], 1.14; 95% CI, 1.04-1.07; P < .001), cardiovascular disease (OR, 3.02; 95% CI, 1.55-5.89; P = .001), and immunocompromised status (OR, 2.57; 95% CI, 1.70-3.90; P < .001) were independent risk factors for hospitalization. Additionally, age (OR, 1.06; 95% CI, 1.02-1.11; P = .006) was significantly associated with mortality. HCWs (OR, 0.15; 95% CI, 0.05-0.50; P = .002) were less likely to be hospitalized, and prior receipt of BNT162b2 was associated with lower odds of hospitalization (OR, 0.436; 95% CI, 0.303-0.626; P < .001) and/or death (OR, 0.360; 95% CI, 0.145-0.898; P = .029).
Conclusions: COVID-19 vaccines remain effective at attenuating disease severity. However, patients with breakthrough infections necessitating hospitalization may benefit from early treatment modalities and COVID-19-mitigating strategies, especially in areas with substantial or high transmission rates.
Keywords: COVID-19; breakthrough infections; hospitalizations; outcomes.