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Clin Exp Immunol . Factors determining COVID-19 pneumonia severity in a country with routine BCG vaccination

tetano

Editor, Senior Moderator
Clin Exp Immunol


. 2020 Aug 19.
doi: 10.1111/cei.13507. Online ahead of print.
Factors determining COVID-19 pneumonia severity in a country with routine BCG vaccination


Kurtuluş Aksu[SUP] 1 [/SUP], Tuğba Naziroğlu[SUP] 2 [/SUP], Pınar ?zkan[SUP] 2 [/SUP]



Affiliations

Abstract

Background: The impact of countries' Bacillus Calmette-Gu?rin (BCG) vaccination policies on the course of coronavirus disease (COVID-19) outbreak is a curiosity. In this study, the relationship between BCG vaccination status and severity of COVID-19 pneumonia and the factors affecting disease severity were investigated.
Methods: A retrospective cross-sectional study was conducted between March-June 2020 in patients diagnosed with COVID-19 pneumonia, confirmed by severe acute respiratory syndrome coronavirus-2 polymerase chain reaction positivity in a nasopharyngeal sample and pulmonary infiltrates in computed chest tomography, in a state hospital in Istanbul, Turkey. Sociodemographic features, body mass index, smoking status, concomitant diseases, income rates, and BCG vaccination status of subjects were analyzed.
Results: Study population consisted of 123 adults with COVID-19 pneumonia (mean age, 49.7 years [standard deviation, 13.3 years]; 82 (66.7%) male). While the rate of cases vaccinated with BCG is lower (68.5% vs 88.2%; p=.026), the mean age (54.0 ? 11.5 years vs 38.3 ?10.7 years; p <.001), diabetes (32.6% vs 5.9%; p=.002) and low income (84.3% vs 52.9% p<.001) are higher in patients with severe disease compared to those with mild disease. According to multivariate analysis increasing age (odds ratio [OR], 1.119; 95% confidence interval [CI], 1.062 - 1.178; p<.001) and low income (OR, 3.209; 95% CI, 1.008 - 10.222; p =.049) are associated with severe disease in COVID-19 pneumonia.
Conclusion: This study reveals that BCG vaccination is not associated with disease severity in COVID-19 pneumonia. Age and low income are the main determinants of severe COVID-19 pneumonia.

Keywords: Bacillus Calmette-Gu?rin; COVID-19; SARS-CoV-2; diabetes mellitus; hypertension; income; severity; smoking.
 
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