Journal of Infection and Public Health (Mar 2024)

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

  • 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 Mariani,
  • 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 Muheberimana,
  • Alessandro Giommi,
  • Rosaria Bianco,
  • Grazia Eliana Chitani,
  • Chiara Bobbio,
  • Irene De Matteis,
  • Angelo Bianchi Bonomi,
  • 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 Fracanzani,
  • Rosa Lombardi,
  • Annalisa Cespiati,
  • Matteo Cesari,
  • Tiziano Lucchi,
  • Marco Proietti,
  • Laura Calcaterra,
  • Clara Mandelli,
  • Carlotta Coppola,
  • Arturo Cerizza,
  • Antonio Maria Pesenti,
  • Giacomo Grasselli,
  • Alessandro Galazzi,
  • Alessandro Nobili.,
  • Mauro Tettamanti,
  • Igor Monti,
  • Alessia Antonella Galbussera,
  • 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 Guagnano,
  • 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

Journal volume & issue
Vol. 17, no. 3
pp. 467 – 473

Abstract

Read online

Background: 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. Methods: 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. Results: 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). Conclusions: 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.

Keywords