A multi-country analysis of COVID-19 hospitalizations by vaccination status

ISARIC Clinical Characterisation Group, Bronner P. Gonçalves*, Waasila Jassat, Joaquín Baruch, Madiha Hashmi, Amanda Rojek, Abhishek Dasgupta, Ignacio Martin-Loeches, Luis Felipe Reyes, Chiara Piubelli, Barbara Wanjiru Citarella, Christiana Kartsonaki, Benjamin Lefèvre, José W. López Revilla, Miles Lunn, Ewen M. Harrison, Moritz U.G. Kraemer, Sally Shrapnel, Peter Horby, Zeno BisoffiPiero L. Olliaro, Laura Merson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Downloads (Pure)

Abstract

Background: Individuals vaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), when infected, can still develop disease that requires hospitalization. It remains unclear whether these patients differ from hospitalized unvaccinated patients with regard to presentation, coexisting comorbidities, and outcomes.

Methods: Here, we use data from an international consortium to study this question and assess whether differences between these groups are context specific. Data from 83,163 hospitalized COVID-19 patients (34,843 vaccinated, 48,320 unvaccinated) from 38 countries were analyzed.

Findings: While typical symptoms were more often reported in unvaccinated patients, comorbidities, including some associated with worse prognosis in previous studies, were more common in vaccinated patients. Considerable between-country variation in both in-hospital fatality risk and vaccinated-versus-unvaccinated difference in this outcome was observed.

Conclusions: These findings will inform allocation of healthcare resources in future surges as well as design of longer-term international studies to characterize changes in clinical profile of hospitalized COVID-19 patients related to vaccination history.

Funding: This work was made possible by the UK Foreign, Commonwealth and Development Office and Wellcome (215091/Z/18/Z, 222410/Z/21/Z, 225288/Z/22/Z, and 220757/Z/20/Z); the Bill & Melinda Gates Foundation (OPP1209135); and the philanthropic support of the donors to the University of Oxford’s COVID-19 Research Response Fund (0009109). Additional funders are listed in the “acknowledgments” section.
Original languageEnglish
Pages (from-to)797-812.e2
Number of pages18
JournalMed
Volume4
Issue number11
Early online date21 Sept 2023
DOIs
Publication statusPublished - 10 Nov 2023

Bibliographical note

Acknowledgments:
This work was also funded by grants from the National Institute for Health Research (NIHR; award CO-CIN-01), the Medical Research Council (MRC; grant MC_PC_19059), and the NIHR Health Protection Research Unit (HPRU) in Emerging and Zoonotic Infections at the University of Liverpool in partnership with Public Health England (PHE) (award 200907), NIHR HPRU in Respiratory Infections at Imperial College London with PHE (award 200927), Liverpool Experimental Cancer Medicine Centre (grant C18616/A25153), NIHR Biomedical Research Centre at Imperial College London (award ISBRC-1215-20013), and NIHR Clinical Research Network providing infrastructure support; CIHR Coronavirus Rapid Research Funding Opportunity OV2170359 and the coordination in Canada by Sunnybrook Research Institute; funding by the Health Research Board of Ireland (CTN-2014-12); the Rapid European COVID-19 Emergency Response research (RECOVER) (H2020 project 101003589) and European Clinical Research Alliance on Infectious Diseases (ECRAID) (965313); Cambridge NIHR Biomedical Research Centre (award NIHR203312); a Research Council of Norway grant no. 312780 and a philanthropic donation from Vivaldi Invest A/S owned by Jon Stephenson von Tetzchner; the Comprehensive Local Research Networks (CLRNs), of which P.J.M.O. is an NIHR Senior Investigator (NIHR201385); Stiftungsfonds zur Förderung der Bekämpfung der Tuberkulose und anderer Lungenkrankheiten of the City of Vienna, project number APCOV22BGM; funding from Medical University of Vienna, Department of Anaesthesia, Intensive Care Medicine and Pain Medicine; Italian Ministry of Health “Fondi Ricerca corrente–L1P6” to IRCCS Ospedale Sacro Cuore–Don Calabria; Australian Department of Health grant (3273191); Gender Equity Strategic Fund at University of Queensland, Artificial Intelligence for Pandemics (A14PAN) at University of Queensland, the Australian Research Council Centre of Excellence for Engineered Quantum Systems (EQUS, CE170100009), the Prince Charles Hospital Foundation, Australia; a grant from foundation Bevordering Onderzoek Franciscus; the South Eastern Norway Health Authority and the Research Council of Norway; Institute of Cancer Research (ICR), National Institutes of Health (NIH) supported by the Ministry of Health Malaysia; and the US DoD Armed Forces Health Surveillance Division, Global Emerging Infectious Diseases Branch to the US Naval Medical ResearchUnit no. TWO (NAMRU-2) (Work Unit #: P0153_21_N2). These authors would like to thank Vysnova Partners, Inc., for the management of this research project. The Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit is funded by the Wellcome Trust; M.U.G.K. was supported by the Branco Weiss Fellowship, Google.org, the Oxford Martin School, the Rockefeller Foundation, and the European Union Horizon 2020 project MOOD (#874850). The contents of this publication are the sole responsibility of the authors and do not necessarily reflect the views of the European Commission.

The investigators acknowledge the support of the COVID clinical management team, AIIMS, Rishikesh, India; the COVID-19 Clinical Management team, Manipal Hospital Whitefield, Bengaluru, India; the Liverpool School of Tropical Medicine and the University of Oxford; Imperial NIHR Biomedical Research Centre; the dedication and hard work of the Norwegian SARS-CoV-2 study team; endorsement of the Irish Critical Care Clinical Trials Group, co-ordination in Ireland by the Irish Critical Care Clinical Trials Network at University College Dublin; and preparedness work conducted by the Short Period Incidence Study of Severe Acute Respiratory Infection.

This work uses data provided by patients and collected by the NHS as part of their care and support #DataSavesLives. The data used for this research were obtained from ISARIC4C. We are extremely grateful to the 2,648 frontline NHS clinical and research staff and volunteer medical students who collected these data in challenging circumstances and for the generosity of the patients and their families for their individual contributions in these difficult times. The COVID-19 Clinical Information Network (CO-CIN) data were collated by ISARIC4C Investigators. We also acknowledge the support of Jeremy J. Farrar and Nahoko Shindo.

Fingerprint

Dive into the research topics of 'A multi-country analysis of COVID-19 hospitalizations by vaccination status'. Together they form a unique fingerprint.

Cite this