COVID-19 patients' clinical profile and outcome with respect to their vaccination status: A prospective observational multicentre cohort study during third wave in Western India

Indian J Med Microbiol. 2023 Jan-Feb:41:28-32. doi: 10.1016/j.ijmmb.2022.12.004. Epub 2022 Dec 27.

Abstract

Purpose: To understand the benefits of COVID-19 vaccination (Covishield, Covaxin) on clinical features and outcome of COVID-19 during the third wave in India.

Materials and methods: The primary study aim was to describe the clinical profile and outcome of COVID-19 regarding their vaccination and to identify risk factors for disease progression in vaccinated patients. This was a prospective observational multicentric study of COVID-19 attended by Infectious Disease physicians during January 15, 2022 to February 15, 2022. Adult patients with positive RT-PCR or rapid antigen test for COVID-19 were enrolled. Patient received treatment as per local institutional protocol. Chi square test for categorical and Mann Whitney test for continuous variables were applied for the analysis. Logistic regression was used to calculate adjusted odds ratios.

Results: A total of 788 patients were included in analysis out of 883 enrolled patients from 13 centers across Gujarat. By the end of two weeks' follow up, 22 patients (2.8%) had expired. The Median age of subjects was 54 years, with a (55.8%) male. 90% of the subjects were vaccinated, majority (77%) of them had received 2 doses of vaccine with Covishield (659, 93%). Mortality among the non-vaccinated was significantly (11.4%) higher than vaccinated (1.8%). Logistic regression analysis showed numbers of comorbidities (p ​= ​0.027), baseline higher WBC count (p ​= ​0.02), higher NLR (p ​= ​0.016), and Ct value (p ​= ​0.046) were associated with mortality while vaccination was associated with survival (p ​= ​0.001). The factors associated with mortality among vaccinated were age, comorbidities, baseline higher WBC, NLR, and CRP.

Conclusions: Omicron variant was associated with mild symptoms. Clinical and laboratory risk factors for getting severe disease with Omicron variant were the same with previous SARS CoV-2 strain. Two doses of vaccine protect people against severe disease and death. Age, comorbidities, baseline leucocytosis, high NLR, elevated CRP are the risk factors for poor outcome in vaccinated patients.

Keywords: COVID-19; CVID-19 vaccine; Covaxin; Covishield; Omicron; SARS CoV-2.

Publication types

  • Observational Study
  • Multicenter Study

MeSH terms

  • Adult
  • COVID-19 Vaccines
  • COVID-19*
  • ChAdOx1 nCoV-19
  • Cohort Studies
  • Female
  • Humans
  • India
  • Male
  • Middle Aged
  • SARS-CoV-2

Substances

  • BBV152 COVID-19 vaccine
  • COVID-19 Vaccines
  • ChAdOx1 nCoV-19

Supplementary concepts

  • SARS-CoV-2 variants