Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Aug 18:46:e106.
doi: 10.26633/RPSP.2022.106. eCollection 2022.

Profile of Brazilian inpatients with COVID-19 vaccine breakthrough infection and risk factors for unfavorable outcome

Matheus A S de Jesus  1 , Natália S Hojo-Souza  2 , Thiago R de Moraes  1 , Daniel L Guidoni  3 , Fernanda S H de Souza  3
Affiliations

Profile of Brazilian inpatients with COVID-19 vaccine breakthrough infection and risk factors for unfavorable outcome

Matheus A S de Jesus et al. Rev Panam Salud Publica. .

Abstract
in English, Spanish, Portuguese

Objective: To characterize the epidemiological and clinical profile of individuals more likely to become infected with SARS-CoV-2 after the fully vaccination schedule in order to profile priority groups to receive a booster dose in situations of vaccine doses shortage as well as for maintenance of personal protective care.

Methods: This cross-sectional study used data from hospitalized COVID-19 patients aged ≥18 years, who had been fully vaccinated and had a SARS-CoV-2 infection positive diagnosis collected from the SIVEP-Gripe database (Influenza Epidemiological Surveillance Information System) from January 18, 2021 to September 15, 2021. Demographic data, clinical symptoms and preexisting medical conditions (comorbidities) were analyzed. The primary outcome was in-hospital death.

Results: The majority of hospitalized patients with vaccine breakthrough infection were ≥60 years old, male, with critical or severe COVID-19. The fatality rate was extremely high (50.27%) and more pronounced in elderly groups. The most prevalent symptoms were cough, dyspnea, respiratory distress, and low blood oxygen saturation. The most frequent comorbidities were heart disease and diabetes. High fatality rates were observed among patients admitted to the intensive care units (72.88%) and those who required invasive mechanical ventilation (87.82%). The main risk factors for an unfavorable outcome were older age, respiratory compromise, inactivated virus vaccine immunization, and preexisting medical conditions.

Conclusions: We characterized the profile of hospitalized Brazilian patients with COVID-19 vaccine breakthrough infection and the risk factors for an unfavorable outcome. These data allow to identify priority groups to receive a booster dose and to continue using personal protection.

Objetivo: Caracterizar el perfil clínico y epidemiológico de las personas con mayores probabilidades de contraer la infección por el SARS-CoV-2 luego de tener el esquema completo de vacunación, con el fin de definir los grupos de prioridad para la aplicación de la dosis de refuerzo en situaciones de escasez de dosis de vacunación, así como para el mantenimiento de los equipos de protección personal.

Métodos: En este estudio transversal se emplearon datos de pacientes mayores de 18 años hospitalizados con COVID-19 que habían recibido la pauta completa de vacunación y tenían un diagnóstico positivo de infección por SARS-CoV-2, recabados de la base de datos SIVEP-Gripe (Sistema de Información de Vigilancia Epidemiológica de la Gripe) en el periodo comprendido entre el 18 de enero del 2021 y el 15 de septiembre del 2021. Se analizaron datos demográficos, síntomas clínicos y trastornos médicos preexistentes (comorbilidades). El resultado primario fue la muerte hospitalaria.

Resultados: La mayoría de los pacientes vacunados hospitalizados fueron varones mayores de 60 años con infección crítica o grave por el virus de la COVID-19. La tasa de letalidad fue extremadamente elevada (50,27 %) y más pronunciada en los grupos de edad avanzada. Los síntomas más prevalentes fueron tos, disnea, dificultad respiratoria y baja saturación de oxígeno en sangre. Las comorbilidades más frecuentes fueron las cardiopatías y la diabetes. Se observaron altas tasas de letalidad entre los pacientes ingresados en las unidades de cuidados intensivos (72,88 %) y los que necesitaron ventilación mecánica invasiva (87,82 %). Los principales factores de riesgo para un resultado desfavorable fueron la edad avanzada, dificultades respiratorias, inmunización con vacunas de virus inactivados y trastornos médicos preexistentes.

Conclusiones: Se caracterizaron el perfil de los pacientes brasileños vacunados hospitalizados con COVID-19 por infección irruptiva de vacuna y los factores de riesgo de un resultado desfavorable. Estos datos permiten identificar los grupos de prioridad para recibir la dosis de refuerzo y continuar utilizando protección personal.

Objetivo: Caracterizar o perfil epidemiológico e clínico dos indivíduos mais propensos a se infectar com SARS-CoV-2 após o esquema vacinal completo, a fim de traçar o perfil dos grupos prioritários para receberem uma dose de reforço em situações de escassez de doses vacinais, bem como para manutenção dos cuidados de proteção individual.

Métodos: Este estudo transversal utilizou dados de pacientes hospitalizados com COVID-19 com idade ≥18 anos, esquema vacinal completo e diagnóstico positivo de infecção por SARS-CoV-2, coletados do banco de dados SIVEP-Gripe (Sistema de Informação da Vigilância Epidemiológica da Gripe) de 18 de janeiro a 15 de setembro de 2021. Foram analisados dados demográficos, sintomas clínicos e problemas médicos preexistentes (comorbidades). O desfecho primário foi óbito intra-hospitalar.

Resultados: A maioria dos pacientes hospitalizados com infecção devido a escape vacinal tinha ≥60 anos, era do sexo masculino e tinha um quadro de COVID-19 grave ou gravíssimo. A letalidade foi extremamente alta (50,27%) e mais pronunciada nos grupos de pessoas idosas. Os sintomas mais prevalentes foram tosse, dispneia, desconforto respiratório e baixa saturação de oxigênio no sangue. As comorbidades mais frequentes foram cardiopatia e diabetes. Altas taxas de letalidade foram observadas entre os pacientes internados em unidades de terapia intensiva (72,88%) e os que precisaram de ventilação mecânica invasiva (87,82%). Os principais fatores de risco para um desfecho desfavorável foram idade avançada, comprometimento respiratório, imunização com vacina de vírus inativado e problemas médicos preexistentes.

Conclusões: Caracterizamos o perfil dos pacientes brasileiros hospitalizados com infecção por COVID-19 devido a escape vacinal e os fatores de risco para desfecho desfavorável. Esses dados permitem identificar grupos prioritários para receber dose de reforço e continuar os cuidados de proteção individual.

Keywords: Brazil; COVID-19 vaccines; SARS-CoV-2; risk factors.

PubMed Disclaimer

Figures

FIGURE 1.
FIGURE 1.. Study population
FIGURE 2.
FIGURE 2.. Hospitalizations among patients with COVID-19 between epidemiological weeks 2021-3 and 2021-37 according to the vaccination status (n=687 865)
FIGURE 3.
FIGURE 3.. Disease severity and outcomes according to vaccine type for patients with breakthrough infection (n=29 369)
See this image and copyright information in PMC

References

    1. World Health Organization [Accessed October 16, 2020];Who announces covid-19 outbreak a pan demic. 2020 Available from: https://www.euro.who.int/en/health-topics/health-emergencies/coronavirus....
    2. World Health Organization. Who announces covid-19 outbreak a pan demic; 2020. [Accessed October 16, 2020]. Available from: https://www.euro.who.int/en/health-topics/health-emergencies/coronavirus....
    1. World Health Organization [Accessed November 19, 2021];Coronavirus (COVID-19) Dashboard. 2021 Available from: https://covid19.who.int/
    2. World Health Organization. Coronavirus (COVID-19) Dashboard; 2021. [Accessed November 19, 2021]. Available from: https://covid19.who.int/.
    1. Our World in Data Coronavirus Pandemic. [Accessed November 23, 2021];Vaccinations. 2021 Available from: https://ourworldindata.org/covid-vaccinations.
    2. Our World in Data. Coronavirus Pandemic. Vaccinations; 2021. [Accessed November 23, 2021]. Available from: https://ourworldindata.org/covid-vaccinations.
    1. Liu Q, Qin C, Liu M, Liu J. Effectiveness and safety of SARS-CoV-2 vaccine in real-world studies: a systematic review and meta-analysis. Infect Dis Poverty. 2021;10(1):1–15. - PMC - PubMed
    2. Liu Q, Qin C, Liu M, Liu J. Effectiveness and safety of SARS-CoV-2 vaccine in real-world studies: a systematic review and meta-analysis. Infect Dis Poverty. 2021;10(1):1-15. - PMC - PubMed
    1. Birhane M, Bressler S, Chang G, Clark T, Dorough L, Fischer M, et al. COVID-19 Vaccine Breakthrough Infections Reported to CDC—United States, January 1–April 30, 2021. MMWR Morb Mortal Wkly Rep. 2021;70(21):792–793. - PMC - PubMed
    2. Birhane M, Bressler S, Chang G, Clark T, Dorough L, Fischer M, et al. COVID-19 Vaccine Breakthrough Infections Reported to CDC—United States, January 1–April 30, 2021. MMWR Morb Mortal Wkly Rep. 2021;70(21):792-3. - PMC - PubMed