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Hospitalized Patients With Severe Coronavirus Disease 2019 During the Omicron Wave in Israel: Benefits of a Fourth Vaccine Dose.
- Source :
-
Clinical Infectious Diseases . 2/1/2023, Vol. 76 Issue 3, pe234-e239. 6p. - Publication Year :
- 2023
-
Abstract
- Background Waning immunity and an increased incidence of coronavirus disease 2019 (COVID-19) during the Omicron outbreak led the Israeli Ministry of Health to recommend a fourth vaccine dose for high-risk individuals. In this study, we assessed its effect for hospitalized patients with severe breakthrough COVID-19. Methods In this multicenter cohort study of hospitalized adults with severe COVID-19 in Israel, from 15 to 31 January 2022, cases were divided according to the number of vaccinations received. Poor outcome was defined as mechanical ventilation or in-hospital death and was compared between 3- and 4-dose vaccinees using logistic regression. Results Included were 1049 patients, median age 80 years. Among them, 394 were unvaccinated, 386 and 88 had received 3 or 4 doses, respectively. The 3-dose group was older, included more males, and immunosuppressed patients but with similar outcomes, 49% vs 51% compared with unvaccinated patients (P =.72). Patients who received 4 doses were similarly older and immunosuppressed but had better outcomes compared with unvaccinated patients, 34% vs 51% (P <.01). We examined independent predictors for poor outcome in patients who received either 3 or 4 doses a median of 161 days or 14 days before diagnosis, respectively. Receipt of the fourth dose was associated with protection (odds ratio, 0.51; 95% confidence interval,.3–.87), as was remdesivir. Male sex, chronic renal failure, and dementia were associated with poor outcomes. Conclusions Among hospitalized patients with severe breakthrough COVID-19, a recent fourth dose was associated with significant protection against mechanical ventilation or death compared with 3 doses. [ABSTRACT FROM AUTHOR]
- Subjects :
- *PREVENTION of epidemics
*RESEARCH
*CHRONIC kidney failure
*COVID-19
*GENETIC mutation
*CONFIDENCE intervals
*COVID-19 vaccines
*ANTIVIRAL agents
*IMMUNOSUPPRESSION
*TREATMENT effectiveness
*ARTIFICIAL respiration
*HOSPITAL mortality
*SEX distribution
*HOSPITAL care
*DEMENTIA
*DESCRIPTIVE statistics
*LOGISTIC regression analysis
*VACCINATION status
*ODDS ratio
*DATA analysis software
*LONGITUDINAL method
Subjects
Details
- Language :
- English
- ISSN :
- 10584838
- Volume :
- 76
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- Clinical Infectious Diseases
- Publication Type :
- Academic Journal
- Accession number :
- 161829708
- Full Text :
- https://doi.org/10.1093/cid/ciac501