https://doi.org/10.4081/monaldi.2023.2771

Retrospective analysis of epidemiologic features and clinical course of COVID-19 patients and comparison between vaccinated and unvaccinated patients

Early Access
Submitted: September 6, 2023
Accepted: October 6, 2023
Published: October 19, 2023
COVID-19, COVID-19 vaccines, respiratory insufficiency, SARS-CoV-2
Abstract Views: 428
PDF_early view: 234
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Domenica Di Costanzo
domenica.dicostanzo@libero.it
https://orcid.org/0000-0003-0041-6471
Pneumology Department, Sant'Anna and San Sebastiano Hospital, Caserta, Italy.
Mariano Mazza
https://orcid.org/0000-0001-5259-1648
ASL Caserta, Distretto 23, Mondragone (CE), Italy.
Andreina Carbone
https://orcid.org/0000-0002-2190-7010
Cardiology Unit, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.
Anna Pratillo
Pneumology Department, Sant'Anna and San Sebastiano Hospital, Caserta, Italy.
Felice Di Perna
Pneumology Department, Sant'Anna and San Sebastiano Hospital, Caserta, Italy.
Vittoria Graziani
https://orcid.org/0009-0005-6643-8958
Pneumology Department, Sant'Anna and San Sebastiano Hospital, Caserta, Italy.
Cristina Casals Marin
https://orcid.org/0009-0009-1198-6833
Pneumology Department, Sant'Anna and San Sebastiano Hospital, Caserta, Italy.
Stefania Tartaglione
Pneumology Department, Sant'Anna and San Sebastiano Hospital, Caserta, Italy.
Antonio Ponticiello
https://orcid.org/0000-0002-7670-1167
Pneumology Department, Sant'Anna and San Sebastiano Hospital, Caserta, Italy.

At our Pneumology Department, we dealt with three waves of COVID-19 pandemics. The purpose of this study is to compare patients' epidemiological and clinical characteristics across waves and to assess the effect of vaccination on clinical presentation, course, and prognosis. From March 2020 to March 2022, a retrospective cohort study was conducted to compare patient characteristics. Based on the time of hospital admission, data from 456 patients were collected and divided into three groups (IW, IIW, and IIIW). In addition, we looked at the link between vaccination and clinical presentation and hospitalization outcome. The average age and comorbidities of patients increased, as did the worsening of respiratory conditions at admission (PaO2/FiO2 median 207 in IW, 95.5 in IIW, and 99 in IIIW). Continuous positive airway pressure (CPAP) was the primary respiratory support during the first wave, but an increase in the use of high flow nasal cannula and noninvasive ventilation was later observed, resulting in a higher hospital discharge rate and a lower intubation rate. Vaccinated patients had less severe COVID-19-related respiratory failure, a better clinical course, and a higher hospital discharge rate (71.4% in V-group vs 44.7% in NV-group, p<0.001). Patients' characteristics changed over the three waves, possibly due to virus mutations. The advancement of clinical and therapeutic management knowledge has contributed to a reduction in the severity of respiratory failure. The vaccination campaign improved the clinical course and reduced mortality.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
World Health Organization. Europe. Coronavirus disease (COVID-19) pandemic. Overview. Available from: https://www.who.int/europe/emergencies/situations/covid-19
Bhat SA, Singh G, Bhat WF, et al. Coronavirus disease-2019 and its current scenario – A review. Clinical eHealth 2021;4:67-73. DOI: https://doi.org/10.1016/j.ceh.2021.09.002
Gray WK, Navaratnam AV, Day J, et al. COVID-19 hospital activity and in-hospital mortality during the first and second waves of the pandemic in England: an observational study. Thorax 2022;77:1113-20. DOI: https://doi.org/10.1136/thoraxjnl-2021-218025
Hohl CM, Rosychuk RJ, Hau JP, et al. Correction to: Treatments, resource utilization, and outcomes of COVID-19 patients presenting to emergency departments across pandemic waves: an observational study by the Canadian COVID-19 Emergency Department Rapid Response Network (CCEDRRN). CJEM 2022;24:461-2. DOI: https://doi.org/10.1007/s43678-022-00314-z
Egoryan G, Yanez-Bello MA, Ozcekirdek EC, et al. Clinical characteristics and outcomes of the first two waves of the COVID-19 pandemic in a community hospital: a retrospective cohort study. IJID Reg 2022;3:1-7. DOI: https://doi.org/10.1016/j.ijregi.2022.02.001
Matsunaga N, Hayakawa K, Asai Y, et al. Clinical characteristics of the first three waves of hospitalised patients with COVID-19 in Japan prior to the widespread use of vaccination: a nationwide observational study. Lancet Reg Health West Pac 2022;22:100421. DOI: https://doi.org/10.1016/j.lanwpc.2022.100421
Gattinoni L, Chiumello D, Caironi P, et al. COVID-19 pneumonia: different respiratory treatments for different phenotypes? Intensive Care Med 2020;46:1099-102. DOI: https://doi.org/10.1007/s00134-020-06033-2
Istituto Superiore di Sanità. National COVID-19 vaccination plan. Available from: https://www.epicentro.iss.it/en/vaccines/covid-19-vaccination-plan
Radovanovic D, Pini S, Franceschi E, et al. Characteristics and outcomes in hospitalized COVID-19 patients during the first 28 days of the spring and autumn pandemic waves in Milan: An observational prospective study. Respir Med 2021;178:106323. DOI: https://doi.org/10.1016/j.rmed.2021.106323
Bensai S, Oldani S, Bertolovic L, et al. The second wave of COVID-19 in Italy: a cohort study in a Respiratory Semi-Intensive Care Unit. Rassegna Patol Apparato Respir 2022;37:33-40.
Zhang Y, Zhang H, Zhang W. SARS-CoV-2 variants, immune escape, and countermeasures. Front Med 2022;16:196-207. DOI: https://doi.org/10.1007/s11684-021-0906-x
Scialo F, Vitale M, Daniele A, et al. SARS-CoV-2: One year in the pandemic. What have we learned, the new vaccine era and the threat of SARS-CoV-2 variants. Biomedicines 2021;9:611. DOI: https://doi.org/10.3390/biomedicines9060611
Nigro E, D'Agnano V, Quarcio G, et al. Exploring the network between adipocytokines and inflammatory response in SARS-CoV-2 infection: a scoping review. Nutrients 2023;15:3806. DOI: https://doi.org/10.3390/nu15173806
D'Agnano V, Scialò F, Perna F, et al. Exploring the role of Krebs von den Lungen-6 in severe to critical COVID-19 patients. Life (Basel) 2022;12:1141. DOI: https://doi.org/10.3390/life12081141
Giacomelli A, Ridolfo AL, Pezzati L, et al. Mortality rates among COVID-19 patients hospitalised during the first three waves of the epidemic in Milan, Italy: A prospective observational study. PLoS One 2022;17:e0263548. DOI: https://doi.org/10.1371/journal.pone.0263548
Cosentino F, Moscatt V, Marino A, et al. Clinical characteristics and predictors of death among hospitalized patients infected with SARS-CoV-2 in Sicily, Italy: A retrospective observational study. Biomed Rep 2022;16:34. DOI: https://doi.org/10.3892/br.2022.1517
Tregoning JS, Flight KE, Higham SL, et al. Progress of the COVID-19 vaccine effort: viruses, vaccines and variants versus efficacy, effectiveness and escape. Nat Rev Immunol 2021;21:626-36. DOI: https://doi.org/10.1038/s41577-021-00592-1
Wack S, Patton T, Ferris LK. COVID-19 vaccine safety and efficacy in patients with immune-mediated inflammatory disease: Review of available evidence. J Am Acad Dermatol 2021;85:1274-84. DOI: https://doi.org/10.1016/j.jaad.2021.07.054
Baum U, Poukka E, Leino T, et al. High vaccine effectiveness against severe COVID-19 in the elderly in Finland before and after the emergence of Omicron. BMC Infect Dis 2022;22:816. DOI: https://doi.org/10.1186/s12879-022-07814-4
Atiquzzaman M, Zheng Y, Er L, et al. COVID-19 vaccine effectiveness in patients with non-dialysis-dependent chronic kidney diseases: findings from a population-based observational study from British Columbia, Canada. Kidney Int 2022;102:1420-3. DOI: https://doi.org/10.1016/j.kint.2022.08.027
Chi WY, Li YD, Huang HC, et al. COVID-19 vaccine update: vaccine effectiveness, SARS-CoV-2 variants, boosters, adverse effects, and immune correlates of protection. J Biomed Sci 2022;29:82. DOI: https://doi.org/10.1186/s12929-022-00853-8

How to Cite

Di Costanzo, Domenica, Mariano Mazza, Andreina Carbone, Anna Pratillo, Felice Di Perna, Vittoria Graziani, Cristina Casals Marin, Stefania Tartaglione, and Antonio Ponticiello. 2023. “Retrospective Analysis of Epidemiologic Features and Clinical Course of COVID-19 Patients and Comparison Between Vaccinated and Unvaccinated Patients”. Monaldi Archives for Chest Disease, October. https://doi.org/10.4081/monaldi.2023.2771.
Copyright (c) 2023 The Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.