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Int J Infect Dis . Characteristics and Clinical Effectiveness of COVID-19 Vaccination in Hospitalized Patients in Omicron-dominated Epidemic Wave -

tetano

Editor, Senior Moderator
Int J Infect Dis


. 2023 Apr 20;S1201-9712(23)00529-5.
doi: 10.1016/j.ijid.2023.04.399. Online ahead of print.
Characteristics and Clinical Effectiveness of COVID-19 Vaccination in Hospitalized Patients in Omicron-dominated Epidemic Wave - A Nationwide Study in Japan


Hiromu Tanaka[SUP] 1 [/SUP], Shotaro Chubachi[SUP] 2 [/SUP], Takanori Asakura[SUP] 3 [/SUP], Ho Namkoong[SUP] 4 [/SUP], Shuhei Azekawa[SUP] 1 [/SUP], Shiro Otake[SUP] 1 [/SUP], Kensuke Nakagawara[SUP] 1 [/SUP], Takahiro Fukushima[SUP] 1 [/SUP], Ho Lee[SUP] 1 [/SUP], Mayuko Watase[SUP] 1 [/SUP], Kaori Sakurai[SUP] 1 [/SUP], Tatsuya Kusumoto[SUP] 1 [/SUP], Katsunori Masaki[SUP] 1 [/SUP], Hirofumi Kamata[SUP] 1 [/SUP], Makoto Ishii[SUP] 5 [/SUP], Naoki Hasegawa[SUP] 4 [/SUP], Yukinori Okada[SUP] 6 [/SUP], Ryuji Koike[SUP] 7 [/SUP], Yuko Kitagawa[SUP] 8 [/SUP], Akinori Kimura[SUP] 9 [/SUP], Seiya Imoto[SUP] 10 [/SUP], Satoru Miyano[SUP] 11 [/SUP], Seishi Ogawa[SUP] 12 [/SUP], Takanori Kanai[SUP] 13 [/SUP], Koichi Fukunaga[SUP] 1 [/SUP]



Affiliations

Abstract

Objectives: Coronavirus disease (COVID-19) was severe in the Delta variant-dominated epidemic wave (fifth wave) in Japan. The clinical characteristics and effectiveness of COVID-19 vaccination are not fully understood in the Omicron variant-dominated wave (sixth and seventh waves), especially in hospitalized patients. We investigated the relationship between vaccination and disease severity in the Omicron-dominated wave and compared these variant-dominated waves.
Methods: The nationwide COVID-19 database (Japan COVID-19 Task Force) was used to compare clinical characteristics and critical outcome in patients hospitalized from Delta (5[SUP]th[/SUP], N=735) vs Omicron-dominated waves (6[SUP]th[/SUP], N=495; 7[SUP]th[/SUP], N=128).
Results: Patients in the sixth and seventh waves had a lower incidence of critical outcomes and respiratory outcomes, and a higher incidence of bacterial infection, although the mortality rate did not differ significantly between waves. In the sixth and seventh waves, 138 (27.9%) and 29 (22.7%) COVID-19 patients were unvaccinated, respectively. Multivariable analysis adjusted with previously reported factors revealed that the proportion of 1) critical outcomes and 2) respiratory outcomes decreased in a frequency-dependent manner; 1) (the number of vaccinations): 1-2 times, aOR 0.37 (95% CI; 0.20-0.69); 3-4 times: aOR 0.25 (95% CI; 0.11-0.58), 2) 1-2 times, aOR 0.43 (95% CI; 0.27-0.66); 3-4 times: aOR 0.36 (95% CI; 0.21-0.60).
Conclusions: COVID-19 hospitalized patients with Omicron infections showed a lower incidence of critical outcomes than those with Delta infections, and COVID-19 vaccination may contribute to preventing respiratory failure.

Keywords: Delta; Disease outbreaks; Immunization; Inpatients; Omicron; SARS-CoV-2.
 
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