tetano
Editor, Senior Moderator
Radiology
. 2022 Feb 1;213072.
doi: 10.1148/radiol.213072. Online ahead of print.
Imaging and Clinical Features of COVID-19 Breakthrough Infections: A Multicenter Study
Jong Eun Lee[SUP] #[/SUP][SUP] 1 [/SUP], Minhee Hwang[SUP] #[/SUP][SUP] 2 [/SUP], Yun-Hyeon Kim[SUP] 1 [/SUP], Myungjin Chung[SUP] 3 [/SUP], Byeonghak Sim[SUP] 4 [/SUP], Kum Ju Chae[SUP] 5 [/SUP], Jin Young Yoo[SUP] 6 [/SUP], Yeon Joo Jeong[SUP] 2 [/SUP]
Affiliations
Abstract
Background Since vaccines against coronavirus disease 2019 (COVID-19) became available, rare breakthrough infections have been reported despite their high efficacies. Purpose To evaluate the clinical and imaging characteristics of COVID-19 breakthrough infections and compare them with those of unvaccinated COVID-19 patients. Materials and Methods In this retrospective multicenter cohort study, we analyzed data from three centers of patients (aged ≥ 18 years) registered in an open data repository for COVID-19 between June and August 2021. Hospitalized patients with baseline chest radiograph were divided into three groups according to their vaccination status. Differences between clinical and imaging features were analyzed using Pearson's chi-square test, Fisher's exact test, and analysis of variance (ANOVA). Univariable and multivariable logistic regression analyses were used to evaluate associations between clinical factors, including vaccination status, and clinical outcomes. Results Of the 761 hospitalized patients with COVID-19, the mean age was 47 years, 385 (51%) were women; Forty seven patients (6.2%) were fully vaccinated (breakthrough infection), 127 were partially vaccinated (17%), and 587 (77%) were unvaccinated. 412 (54%) of the patients underwent chest CT scans during hospitalization. Of patients with CT, the proportions of CT scans without pneumonia was 22% (71/326) of unvaccinated patients, 30% (19/64) of partially vaccinated patients, and 59% (13/22) of fully vaccinated patients (P <.001). Fully vaccinated status was associated with a lower risk of requiring supplemental oxygen than unvaccinated patients (odds ratio [OR], 95% confidence interval [CI]; 0.24, 0.09-0.64, p=.005) as well as lower risk of intensive care unit (ICU) admission (OR, 95% CI; 0.08, 0.09-0.78, p=.02.) Conclusion Patients with COVID-19 breakthrough infections had a significantly higher proportion of CT scans without pneumonia compared to unvaccinated patients. Vaccinated patients with breakthrough infections had lower likelihood of requiring supplemental oxygen or ICU admission. See also the editorial by Schiebler and Bluemke.
. 2022 Feb 1;213072.
doi: 10.1148/radiol.213072. Online ahead of print.
Imaging and Clinical Features of COVID-19 Breakthrough Infections: A Multicenter Study
Jong Eun Lee[SUP] #[/SUP][SUP] 1 [/SUP], Minhee Hwang[SUP] #[/SUP][SUP] 2 [/SUP], Yun-Hyeon Kim[SUP] 1 [/SUP], Myungjin Chung[SUP] 3 [/SUP], Byeonghak Sim[SUP] 4 [/SUP], Kum Ju Chae[SUP] 5 [/SUP], Jin Young Yoo[SUP] 6 [/SUP], Yeon Joo Jeong[SUP] 2 [/SUP]
Affiliations
- PMID: 35103535
- DOI: 10.1148/radiol.213072
Abstract
Background Since vaccines against coronavirus disease 2019 (COVID-19) became available, rare breakthrough infections have been reported despite their high efficacies. Purpose To evaluate the clinical and imaging characteristics of COVID-19 breakthrough infections and compare them with those of unvaccinated COVID-19 patients. Materials and Methods In this retrospective multicenter cohort study, we analyzed data from three centers of patients (aged ≥ 18 years) registered in an open data repository for COVID-19 between June and August 2021. Hospitalized patients with baseline chest radiograph were divided into three groups according to their vaccination status. Differences between clinical and imaging features were analyzed using Pearson's chi-square test, Fisher's exact test, and analysis of variance (ANOVA). Univariable and multivariable logistic regression analyses were used to evaluate associations between clinical factors, including vaccination status, and clinical outcomes. Results Of the 761 hospitalized patients with COVID-19, the mean age was 47 years, 385 (51%) were women; Forty seven patients (6.2%) were fully vaccinated (breakthrough infection), 127 were partially vaccinated (17%), and 587 (77%) were unvaccinated. 412 (54%) of the patients underwent chest CT scans during hospitalization. Of patients with CT, the proportions of CT scans without pneumonia was 22% (71/326) of unvaccinated patients, 30% (19/64) of partially vaccinated patients, and 59% (13/22) of fully vaccinated patients (P <.001). Fully vaccinated status was associated with a lower risk of requiring supplemental oxygen than unvaccinated patients (odds ratio [OR], 95% confidence interval [CI]; 0.24, 0.09-0.64, p=.005) as well as lower risk of intensive care unit (ICU) admission (OR, 95% CI; 0.08, 0.09-0.78, p=.02.) Conclusion Patients with COVID-19 breakthrough infections had a significantly higher proportion of CT scans without pneumonia compared to unvaccinated patients. Vaccinated patients with breakthrough infections had lower likelihood of requiring supplemental oxygen or ICU admission. See also the editorial by Schiebler and Bluemke.