Clinical characteristics and outcomes of vaccinated patients hospitalised with SARS-CoV-2 breakthrough infection: Multi-IPV, a multicentre study in Northern Italy

• DOI: 10.1016/j.jiph.2023.12.026
• Publication Date: 2024-01-17T02:00:12Z
• Authors: Andrea Lombardi; Simone Villa; Marta Colaneri; Giovanni Scaglione; Francesca Bai; Benedetta Varisco; Valeria Bono; Antonio Vena; Chiara Dentone; Chiara Russo; Mauro Tettamanti; Giulia Renisi; Giulia Viero; Cecilia Azzarà; Marco Mantero; Flora Peyvandi; Matteo Bassetti; Giulia Marchetti; Antonio Muscatello; Alessandro Nobili; Andrea Gori; Alessandra Bandera; Silvano Bosari; Luigia Scudeller; Giuliana Fusetti; Laura Rusconi; Silvia Dell’Orto; Daniele Prati; Luca Valenti; Silvia Giovannelli; Maria Manunta; Giuseppe Lamorte; Francesca Ferarri; Andrea Gori.; Alessandra Bandera; Antonio Muscatello; Davide Mangioni; Laura Alagna; Giorgio Bozzi; Andrea Lombardi.; Riccardo Ungaro; Giuseppe Ancona; Marco Mussa; Bianca Veronica M...; Matteo Bolis; Nathalie Iannotti; Serena Ludovisi; Agnese Comelli; Giulia Renisi; Simona Biscarini; Valeria Castelli; Emanuele Palomba; Marco Fava; Carlo Alberto Peri; Paola Saltini; Giulia Viero; Teresa Itri; Valentina Ferroni; Valeria Pastore; Roberta Massafra; Arianna Liparoti; Toussaint Muheber...; Alessandro Giommi; Rosaria Bianco; Grazia Eliana Chi...; Chiara Bobbio; Irene De Matteis; Angelo Bianchi Bo...; Flora Peyvandi; Roberta Gualtierotti; Barbara Ferrari; Raffaella Rossio; Nadia Boasi; Erica Pagliaro; Costanza Massimo; Michele De Caro; Andrea Giachi; Nicola Montano; Barbara Vigone; Chiara Bellocchi; Angelica Carandina; Elisa Fiorelli; Valerie Melli; Eleonora Tobaldini; Francesco Blasi; Stefano Aliberti; Maura Spotti; Leonardo Terranova; Sofia Misuraca; Alice D’Adda; Silvia Della Fiore; Marta Di Pasquale; Marco Mantero.; Martina Contarini; Margherita Ori; Letizia Morlacchi; Valeria Rossetti; Andrea Gramegna; Maria Pappalettera; Mirta Cavallini; Agata Buscemi; Marco Vicenzi; Irena Rota; Giorgio Costantino; Monica Solbiati; Ludovico Furlan; Marta Mancarella; Giulia Colombo; Giorgio Colombo; Alice Fanin; Mariele Passarella; Valter Monzani; Ciro Canetta; Angelo Rovellini; Laura Barbetta; Filippo Billi; Christian Folli; Silvia Accordino; Diletta Maira; Cinzia Maria Hu; Irene Motta; Natalia Scaramellini; Anna Ludovica Fra...; Rosa Lombardi; Annalisa Cespiati; Matteo Cesari; Tiziano Lucchi; Marco Proietti; Laura Calcaterra; Clara Mandelli; Carlotta Coppola; Arturo Cerizza; Antonio Maria Pes...; Giacomo Grasselli; Alessandro Galazzi; Alessandro Nobili.; Mauro Tettamanti; Igor Monti; Alessia Antonella...; Ernesto Crisafulli; Domenico Girelli; Alessio Maroccia; Daniele Gabbiani; Fabiana Busti; Alice Vianello; Marta Biondan; Filippo Sartori; Paola Faverio; Alberto Pesci; Stefano Zucchetti; Paolo Bonfanti; Marianna Rossi; Ilaria Beretta; Anna Spolti; Sergio Harari; Davide Elia; Roberto Cassandro; Antonella Caminati; Francesco Cipollone; Maria Teresa Guag...; Damiano D’Ardes; Ilaria Rossi; Francesca Vezzani; Antonio Spanevello; Francesca Cherubino; Dina Visca; Marco Contoli; Alberto Papi; Luca Morandi; Nicholas Battistini; Guido Luigi Moreo; Pasqualina Iannuzzi; Daniele Fumagalla; Sara Leone
• Keywords: Adult; COVID-19 Vaccines; Breakthrough Infections; SARS-CoV-2; Breakthrough infection, SARS-COV-2, vaccination; Vaccination; COVID-19; SARS-COV-2; Infectious and parasitic diseases; RC109-216; Vaccination; Breakthrough infection; SARS-COV-2;; Breakthrough infection; 03 medical and health sciences; Italy; Breakthrough infection; SARS-COV-2; Vaccination;; Humans; Hospital Mortality; Public aspects of medicine; RA1-1270; 0305 other medical science; Breakthrough infection; SARS-COV-2; Vaccination; Retrospective Studies

Despite the well-known efficacy of anti-COVID-19 vaccines in preventing morbidity and mortality, several vaccinated individuals are diagnosed with SARS-CoV-2 breakthrough infection, which might require hospitalisation. This multicentre, observational, and retrospective study aimed to investigate the clinical characteristics and outcomes of vaccinated vs. non-vaccinated patients, both hospitalised with SARS-CoV-2 infection in 3 major hospitals in Northern Italy.Data collection was retrospective, and paper and electronic medical records of adult patients with a diagnosed SARS-CoV-2 infection were pseudo-anonymised and analysed. Vaccinated and non-vaccinated individuals were manually paired, using a predetermined matching criterion (similar age, gender, and date of hospitalisation). Demographic, clinical, treatment, and outcome data were compared between groups differing by vaccination status using Pearson's Chi-square and Mann-Whitney tests. Moreover, multiple logistic regression analyses were performed to assess the impact of vaccination status on ICU admission or intra-hospital mortality.Data from 360 patients were collected. Vaccinated patients presented with a higher prevalence of relevant comorbidities, like kidney replacement therapy or haematological malignancy, despite a milder clinical presentation at the first evaluation. Non-vaccinated patients required intensive care more often than their vaccinated counterparts (8.8% vs. 1.7%, p = 0.002). Contrariwise, no difference in intra-hospital mortality was observed between the two groups (19% vs. 20%, p = 0.853). These results were confirmed by multivariable logistic regressions, which showed that vaccination was significantly associated with decreased risk of ICU admission (aOR=0.172, 95%CI: 0.039-0.542, p = 0.007), but not of intra-hospital mortality (aOR=0.996, 95%CI: 0.582-1.703, p = 0.987).This study provides real-world data on vaccinated patients hospitalised with COVID-19 in Northern Italy. Our results suggest that COVID-19 vaccination has a protective role in individuals with higher risk profiles, especially regarding the need for ICU admission. These findings contribute to our understanding of SARS-CoV-2 infection outcomes among vaccinated individuals and emphasise the importance of vaccination in preventing severe disease, particularly in those countries with lower first-booster uptake rates.