Fully Vaccinated and Boosted Patients Requiring Hospitalization for COVID-19

There were four fatalities among 65 fully vaccinated and boosted (FV&B) COVID-19 patients at an acute-care hospital system in Southeastern Michigan. In the FV&B cohort that required ICU-level care (n=11), 7 (63.6%) were male with a median age of 71 (66.5, 76.5). 5 (45.5%) were vaccinated with three consecutive Pfizer immunizations, 4 (36.4%) received three doses of the Moderna vaccine, and 2 (18.2%) received two Janssen vaccines. 4 (36.4%) died, 3 (27.2%) were discharged to a Skilled Nursing Facility (SNF), and 2 (18.2%) were discharged home.


This data was collected between August 12th, 2021 and December 6th, 2021, for 4,571 patients with a primary diagnosis of COVID-19 who required inpatient treatment at an acute-care hospital system in Southeastern Michigan.


Of the 4,571 encounters requiring hospitalization, 65(1.4%) were FV&B and 2,935(64%) were UV Despite older age (median 74 vs 58 years old), higher rate of pre-existing ESRD (18.5% vs 1.8%), higher proportion of immunocompromised state (32.3% vs 10.4%).


Despite a significantly higher baseline risk in the vaccinated & boosted group (Elixhauser 16 vs 8 (p <0.001)), there was a trend toward lower in-hospital mortality (7.7% vs 12.1%; p=0.38) among FV&B patients. Other severe outcomes followed this same trend, with 7.7% of FV&B vs 11.1% UV patients needing mechanical ventilation and 4.6% vs 10.6% of patients needing vasopressors in each group, respectively (p=0.5 and 0.17). 

As COVID-19 continues to spread, larger expansive trials are needed to further identify risk factors for severe outcomes among the FV&B population.


REFERENCE

Nicholas Mielke, Steven Johnson, Amit Bahl,
Boosters reduce in-hospital mortality in patients with COVID-19: An observational cohort analysis,
The Lancet Regional Health - Americas,
Volume 8,
2022,
100227,
ISSN 2667-193X,
https://doi.org/10.1016/j.lana.2022.100227.
(https://www.sciencedirect.com/science/article/pii/S2667193X22000448)

Fully Vaccinated and Boosted Patients Requiring Hospitalization for COVID-19: an Observational Cohort Analysis
Nicholas Mielke, Steven Johnson, Amit Bahl
medRxiv 2022.01.05.22268626; doi: https://doi.org/10.1101/2022.01.05.22268626

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