Presenting clinical symptoms of post-COVID-19 breakthrough infection: Predictors of mortality in a Middle Eastern population
Asma S. Albtoosh,
Randa Farah,
Khaled Al Oweidat,
Osama Mohammad Hussein,
Abdullah Ahmad Obeid,
Haitham Mounir Hamila,
Mousa Nizar Mousa Radwan,
Radi Feras Ahmad,
Hosam Marwan Masadeh,
Abdalla Ibrahim Hammad,
Ayman Mohammed Musleh,
Amal Ayman Fakhoury,
Farah Mahmoud Disi,
Yakoub Y.SH. Joudah,
Nathir Obeidat,
Keira P. Mason
Affiliations
Asma S. Albtoosh
Department of Respiratory and Sleep Medicine, Department of Internal Medicine, School of Medicine, The University of Jordan, Amman, Jordan
Randa Farah
Department of Internal Medicine, School of Medicine, The University of Jordan, Amman, Jordan; Corresponding author at: Department of Internal Medicine, School of Medicine, University of Jordan, PO Box 332, Amman 11941, Jordan.
Khaled Al Oweidat
Department of Respiratory and Sleep Medicine, Department of Internal Medicine, School of Medicine, The University of Jordan, Amman, Jordan
Osama Mohammad Hussein
School of Medicine, The University of Jordan, Amman 11942, Jordan
Abdullah Ahmad Obeid
Respiratory and Sleep Medicine, Al Basheer Hospital, Ministry of Health, Jordan
Haitham Mounir Hamila
School of Medicine, The University of Jordan, Amman 11942, Jordan
Mousa Nizar Mousa Radwan
School of Medicine, The University of Jordan, Amman 11942, Jordan
Radi Feras Ahmad
School of Medicine, The University of Jordan, Amman 11942, Jordan
Hosam Marwan Masadeh
School of Medicine, The University of Jordan, Amman 11942, Jordan
Abdalla Ibrahim Hammad
School of Medicine, The University of Jordan, Amman 11942, Jordan
Ayman Mohammed Musleh
School of Medicine, The University of Jordan, Amman 11942, Jordan
Amal Ayman Fakhoury
School of Medicine, The University of Jordan, Amman 11942, Jordan
Farah Mahmoud Disi
School of Medicine, The University of Jordan, Amman 11942, Jordan
Yakoub Y.SH. Joudah
School of Medicine, The University of Jordan, Amman 11942, Jordan
Nathir Obeidat
Department of Respiratory and Sleep Medicine, Department of Internal Medicine, School of Medicine, The University of Jordan, Amman, Jordan
Keira P. Mason
Department of Anesthesia, Boston Children’s Hospital, Boston, MA, USA
Objective: Breakthrough COVID-19 infections are common following immunisation with various types of vaccines. The patterns of infections have not been well established. We aimed to analyse the signs and symptoms of post vaccination infections in addition to the need for hospital admission, ER visit and supplemental oxygen in relation to age and gender. Methods: A cross-sectional cohort study was conducted in JUH from March 2021 to August 2022, we interviewed 1479 individuals who are >15 years of age and got a breakthrough infection. The statistical analysis was performed using STATA statistical software. Results: Out of the 1479 cases, 50.2 % and 69.4 % were females and less than 45 years of age respectively. Symptoms of cough, fever and headache were reported by nearly 50 % of the patients, while one-third complained of dyspnoea. We found that participants older than 45 years had worse clinical outcomes (P-value < 0.001). 13 deaths were identified in this study due to breakthrough infection, 92.3 % of them were older than 45 years (P-value < 0.001). Participants ≥45 years who experienced a breakthrough infection of COVID-19 were 0.7 times less likely to be females using adjusted logistic regression. Conclusion: This study indicates that despite more severe symptoms reported in younger patients, the major clinical outcomes were worse among older patients, which makes age a major risk for poor outcomes regardless of symptoms. Thus, older people should be evaluated carefully when presenting with mild symptoms of COVID-19 breakthrough infection. The study also confirms that there is no difference in the incidence of COVID-19 breakthrough infections between males and females. Prospective studies are needed to risk stratify COVID-19 breakthrough infections, which should take into account variants of the virus and comorbidities.
