Course of COVID-19-associated pneumonia in patients vaccinated against COVID-19


DOI: https://dx.doi.org/10.18565/therapy.2022.10.14-20

Lysenko M.A., Poteshkina N.G., Ibragimova A.M., Krylova N.S., Kovalevskaya E.A., Karasev A.A., Svanadze A.M.

1) N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow; 2) City Clinical Hospital No. 52 of the Department of Healthcare of Moscow
Abstract. In the context of the COVID-19 pandemic, vaccination has shown high efficiency in reducing the rate of hospitalization and mortality rate of patients.
The aim of the study was a complex estimation of the course of COVID-19-associated pneumonia in patients vaccinated against COVID-19.
Material and methods. 220 patients with COVID-19-associated pneumonia were examined. The main group (I) consisted of patients vaccinated against COVID-19 (n=110, including 57 male persons, mean age 64,6±12,0 years), the comparison group (II) consisted of not vaccinated against COVID-19 patients (n=110, including 56 male persons, mean age 64,8±12,8 years). Estimation of clinical, laboratory and instrumental data of patients in both groups was carried out twice: on the 10±3rd day (groups I10, II10) and on the 17±3rd day from the onset of symptoms (groups I17, II17).
Results. On the 10±3rd day from the onset of symptoms, vaccinated patients were characterized by a milder clinical status, as was proved by significant differences in the scores of the SHOX-COVID scale (4 [4; 6] in group I10 vs 5 [4; 7] in II10, p=0,042) and SpO2 (95±3% in I10 vs 94±3% in II10, p=0.037). When assessing laboratory data in the group of vaccinated patients, the level of lymphocytes was higher (1,2±0,8 × 109/l versus 0,9±0,4 × 109/l, p=0,004), the level of LDH was lower (284,5±103,9 U/L vs 321,6±121,1 U/L, p=0,016) and AST (30,9 [24,2–41,1] U/L vs 38,2 [29,2–50,9] U/L, p=0,002). When comparing the volume of pulmonary parenchyma damage, there were no significant differences between the groups: 1 [1; 2] in I10 vs 2 [1; 2] in II10, p=0,317. On the 17±3rd day from the onset of symptoms, there was a difference between the groups in SpO2 level: 97 [96; 98] % vs 96 [95; 98] %, p=0,003. When comparing the dynamics of laboratory parameters, in group I, a higher level of lymphocytes remained (1,3 [0,8; 1,9] × 109/l in I17 vs 1,0 [0,7; 1,5] × 109/l in II17, p=0,009). The stage of pneumonia according to MSCT of thoracic region was significantly lower in group I, in contrast to group II: 1 [1; 2] versus 2 [1; 2], p=0,024,
Conclusion. In fully vaccinated against COVID-19 patients, the course of COVID-19-associated pneumonia was characterized by less severe clinical manifestations, the absence of lymphopenia and, in dynamics, a smaller amount of pulmonary parenchyma damage.

Literature


1. World Health Organization. WHO Coronavirus (COVID-19) Dashboard. URL: https://covid19.who.int/ (date of access – 24.04.2022).


2. Tsimafeyeu I., Volkova M., Alekseeva G. et al. Safety and preliminary efficacy of the Gam-COVID-Vac vaccine and outcomes of SARS-CoV-2 infection in Russian patients with genitourinary malignancies. J Hematol Oncol. 2021; 14(1): 192. https://dx.doi.org/10.1186/s13045-021-01205-z.


3. Lopez Bernal J., Andrews N., Gower C. et. al. Effectiveness of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines on covid-19 related symptoms, hospital admissions, and mortality in older adults in England: Test negative case-control study. BMJ. 2021; 373: n1088. https://dx.doi.org/10.1136/bmj.n1088.


4. Baden L.R., El Sahly H.M., Essink B. et al. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. N Engl J Med. 2021; 384(5): 403–16. https://dx.doi.org/10.1056/NEJMoa2035389.


5. Polack F.P., Thomas S.J., Kitchin N. et al. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. N Engl J Med. 2020; 383(27): 2603–15. https://dx.doi.org/10.1056/NEJMoa2034577.


6. Hall V.J., Foulkes S., Saei A. et al. COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): A prospective, multicentre, cohort study. Lancet. 2021; 397(10286): 1725–35. https://dx.doi.org/10.1016/S0140-6736(21)00790-X.


7. Perry M., Gravenor M.B., Cottrell S. et al. COVID-19 vaccine uptake and effectiveness in adults aged 50 years and older in Wales UK: A 1.2m population data-linkage cohort approach. Hum Vaccin Immunother. 2022; 18(1): 2031774. https://dx.doi.org/10.1080/21645515.2022.2031774.


8. Haas E.J., Angulo F.J., McLaughlin J.M. et al. Impact and effectiveness of mRNA BNT162b2 vaccine against SARS-CoV-2 infections and COVID-19 cases, hospitalisations, and deaths following a nationwide vaccination campaign in Israel: An observational study using national surveillance data. Lancet. 2021; 397(10287): 1819–29. https://dx.doi.org/10.1016/S0140-6736(21)00947-8.


9. Abhilash K.P.P., Mathiyalagan P., Krishnaraj V.R.K. et al. Impact of prior vaccination with Covishield TM and Covaxin® on mortality among symptomatic COVID-19 patients during the second wave of the pandemic in South India during April and May 2021: A cohort study. Vaccine. 2022; 40(13): 2107–13. https://dx.doi.org/10.1016/j.vaccine.2022.02.023.


10. Seo W.J., Kang J., Kang H.K. et al. Impact of prior vaccination on clinical outcomes of patients with COVID-19. Emerg Microbes Infect. 2022; 11(1): 1316–24. https://dx.doi.org/10.1080/22221751.2022.2069516.


11. Johnson K.W., Patel S., Thapi S. et al. Association of reduced hospitalizations and mortality among COVID-19 vaccinated patients with heart failure. J Card Fail. 2022; 28(9): 1475–79. https://dx.doi.org/10.1016/j.cardfail.2022.05.008.


12. Kirsebom F.C.M., Andrews N., Stowe J. et al. COVID-19 vaccine effectiveness against the omicron (BA.2) variant in England. Lancet Infect Dis. 2022; 22(7): 931–33. https://dx.doi.org/10.1016/S1473-3099(22)00309-7.


13. Brosh-Nissimov T., Orenbuch-Harroch E., Chowers M. et al. BNT162b2 vaccine breakthrough: clinical characteristics of 152 fully vaccinated hospitalized COVID-19 patients in Israel. Clin Microbiol Infect. 2021; 27(11): 1652–57. https://dx.doi.org/10.1016/j.cmi.2021.06.036.


14. Kale P., Gupta E., Bihari C. et al. Vaccine breakthrough infections by SARS-CoV-2 variants after ChAdOx1 nCoV-19 vaccination in healthcare workers. Vaccines (Basel). 2021; 10(1): 54. https://dx.doi.org/10.3390/vaccines10010054.


15. Временные методические рекомендации «Профилактика, диагностика и лечение новой коронавирусной инфекции (COVID-19)». Версия 14 от 27.12.2021. Минздрав России. Доступ: https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/059/041/original/%D0%92%D0%9C%D0%A0_COVID-19_V14_27-12-2021.pdf (дата обращения – 01.12.2022). [Interim guidelines «Prevention, diagnosis and treatment of a new coronavirus infection (COVID-19)». Version 14 of 12/27/2021. Ministry of Healthcare of Russia. URL: https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/059/041/original/%D0%92%D0%9C%D0%A0_COVID-19_V14_27-12-2021.pdf (date of access – 01.12.2022) (In Russ.)].


16. Teran-Tinedo J.R., Gonzalez-Rubio J., Najera A. et al. Clinical characteristics and respiratory care in hospitalized vaccinated SARS-CoV-2 patients. EClinicalMedicine. 2022; 48: 101453. https://dx.doi.org/10.1016/j.eclinm.2022.101453.


17. Линец Ю.П., Артюхов С.В., Казанцев А.Н. с соавт. Течение Covid-19 у вакцинированных пациентов. Журнал им. Н.В. Склифосовского «Неотложная медицинская помощь». 2021; 10(4): 636–641. [Linets Y.P., Artyukhov S.V., Kazantsev A.N. et al. COVID-19 course in vaccinated patients. Zhurnal imeni N.V. Sklifosovskogo «Neotlozhnaya meditsinskaya pomoshch’» = Russian Sklifosovsky Journal of «Emergency Medical Care». 2021; 10(4): 636–641 (In Russ.)]. https://dx.doi.org/10.23934/2223-9022-2021-10-4-636-641. EDN: HVZKXY.


About the Autors


Maryana A. Lysenko, Dr. med. habil., professor of the Department of general therapy, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, chief physician of City Clinical Hospital No. 52 of the Department of Healthcare of Moscow. Address: 123182, Moscow, 3 Pekhotnaya Str. E-mail: lysenkoma@zdrav.mos.ru. ORCID: https://orcid.org/0000-0002-2636-2558
Natalia G. Poteshkina, Dr. med. habil., professor, head of the Department of general therapy, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, director of the University clinic of general therapy of City Clinical Hospital No. 52 of the Department of Healthcare of Moscow. Address: 123182, Moscow, 3 Pekhotnaya Str. E-mail: nat-pa@yandex.ru. ORCID: https://orcid.org/0000-0001-9803-2139
Aishat M. Ibragimova, postgraduate student of the Department of general therapy, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, general practitioner at the 6th Therapeutic Department of City Clinical Hospital No. 52 of the Department of Healthcare of Moscow. Address: 123182, Moscow, 3 Pekhotnaya Str. E-mail: ayshaibr9393@gmail.com. ORCID: https://orcid.org/0000-0001-6963-9185
Natalya S. Krylova, PhD in Medicine, associate professor of the Department of general therapy, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, doctor at the Department of ultrasound and functional diagnostics of City Clinical Hospital No. 52 of the Department of Healthcare of Moscow. Address: 123182, Moscow, 3 Pekhotnaya Str. E-mail: krylova_n@list.ru.
ORCID: https://orcid.org/0000-0003-0310-0771
Elena A. Kovalevskaya, PhD in Medicine, associate professor of the Department of general therapy, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, head of the Department of cardiology of City Clinical Hospital No. 52 of the Department of Healthcare of Moscow. Address: 123182, Moscow, 3 Pekhotnaya Str. E-mail: tolyaaa@mail.ru. ORCID: https://orcid.org/0000-0002-0787-4347
Anton A. Karasev, postgraduate student of the Department of general therapy, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, general practitioner at the 4th Therapeutic Department of City Clinical Hospital No. 52 of the Department of Healthcare of Moscow. Address: 123182, Moscow, 3 Pekhotnaya Str. E-mail: akara95_2010@mail.ru. ORCID: https://orcid.org/0000-0002-3863-6755
Anna M. Svanadze, PhD in Medicine, associate professor of the Department of general therapy, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, doctor at the Department of ultrasound and functional diagnostics of City Clinical Hospital No. 52 of the Department of Healthcare of Moscow. Address: 123182, Moscow, 3 Pekhotnaya Str.
ORCID:https://orcid.org/0000-0003-0566-663Xhttps://orcid.org/0000-0003-0566-663X


Similar Articles


Бионика Медиа