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 Nov 11:9:100456.
doi: 10.1016/j.ejro.2022.100456. eCollection 2022.

COVID-19 Vaccination reduced pneumonia severity

Noriaki Wada  1 , Yi Li  2 , Takuya Hino  3 , Staci Gagne  1 , Vladimir I Valtchinov  1 , Elizabeth Gay  4 , Mizuki Nishino  1 , Bruno Madore  1 , Charles R G Guttmann  5 , Sheila Bond  6 , Kousei Ishigami  3 , Gary M Hunninghake  1   4 , Bruce D Levy  4 , Kenneth M Kaye  6 , David C Christiani  7   8 , Hiroto Hatabu  1
Affiliations

COVID-19 Vaccination reduced pneumonia severity

Noriaki Wada et al. Eur J Radiol Open. .

Abstract

Purpose: To investigate the effect of vaccinations and boosters on the severity of COVID-19 pneumonia on CT scans during the period of Delta and Omicron variants.

Methods: Retrospectively studied were 303 patients diagnosed with COVID-19 between July 2021 and February 2022, who had obtained at least one CT scan within 6 weeks around the COVID-19 diagnosis (-2 to +4 weeks). The severity of pneumonia was evaluated with a 6-point scale Pneumonia Score. The association between demographic and clinical data and vaccination status (booster/additional vaccination, complete vaccination and un-vaccination) and the difference between Pneumonia Scores by vaccination status were investigated.

Results: Of 303 patients (59.4 ± 16.3 years; 178 females), 62 (20 %) were in the booster/additional vaccination group, 117 (39 %) in the complete vaccination group, and 124 (41 %) in the unvaccinated group. Interobserver agreement of the Pneumonia Score was high (weighted kappa score = 0.875). Patients in the booster/additionally vaccinated group tended to be older (P = 0.0085) and have more underlying comorbidities (P < 0.0001), and the Pneumonia Scores were lower in the booster/additionally vaccinated [median 2 (IQR 0-4)] and completely vaccinated groups [median 3 (IQR 1-4)] than those in the unvaccinated group [median 4 (IQR 2-4)], respectively (P < 0.0001 and P < 0.0001, respectively). A multivariable linear analysis adjusted for confounding factors confirmed the difference.

Conclusion: Vaccinated patients, with or without booster/additional vaccination, had milder COVID-19 pneumonia on CT scans than unvaccinated patients during the period of Delta and Omicron variants. This study supports the efficacy of the vaccine against COVID-19 from a radiological perspective.

Keywords: COVID-19; COVID-19, coronavirus disease 2019; CT; DAD, diffuse alveolar damage; GGO, ground-glass opacity; Lung; OP, organizing pneumonia; Pneumonia; RT-PCR, reverse transcription-polymerase chain reaction; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; Vaccination; mRNA, messenger ribonucleic acid.

PubMed Disclaimer

Conflict of interest statement

M.N. reports research grant to the institution from Merck, Canon Medical Systems, AstraZeneca, and Daiichi Sankyo; and consulting fees from Daiichi Sankyo and AstraZeneca, outside the submitted work. C.R.G.G. reports stock ownership of GSK, Roche, and Novartis, outside the submitted work. G.M.H. reports consulting fees from Boehringer Ingelheim, Gerson Lehrman Group, and Chugai Pharmaceuticals, outside the submitted work. B.D.L reports grants or contacts from NIH, Pieris Pharmaceuticals, SRA, and Sanofi; royalties or licenses from Propeller Health; consulting fees from AstraZeneca, NControl, Cartesian, Novartis, Gossamer Bio, and Thetis Pharmaceuticals; participation on a data safety monitoring board or advisory board from NIAID; and stock or stock options from Entrinsic Biosciences and Nocion Therapeutics, outside the submitted work. H.H. reports grants or contracts from Canon Medical Systems Inc and Konica-Minolta Inc; and consulting fees from Canon Medical Systems Inc and Mitsubishi Chemical Co, outside the submitted work. The other authors have no conflicts of interest to be disclosed related to this article.

Figures

Fig. 1
Fig. 1
Flowchart of study selection based on inclusion and exclusion criteria.
Fig. 2
Fig. 2
Histogram of the interval of time between diagnosis and CT with Pneumonia Score.
Fig. 3
Fig. 3
Comparison of Pneumonia Scores for each vaccination group.
Fig. 4
Fig. 4
Representative cases for Pneumonia Score 1–5 A. Pneumonia Score 1. 39-year-old woman with hypertension, who had booster or additional vaccination. The time from last vaccination to COVID-19 diagnosis was 4.7 months. Initial CT was performed five days after diagnosis. Subtle GGOs were confirmed in right lower lobe. B. Pneumonia Score 2. 55-year-old woman with asthma, who had complete vaccination series. The time from last vaccination to COVID-19 diagnosis was 6 months. Initial CT scan was performed one day after diagnosis. Focal GGOs and parenchymal consolidation were confirmed in right upper lobe. C. Pneumonia Score 3. 62-year-old woman with a history of lung cancer treatment, who had complete vaccination series. The time from last vaccination to COVID-19 diagnosis was 4.7 months. CT performed eight days after diagnosis showed multifocal bilateral parenchymal consolidation and GGOs, which is consistent with non-extensive OP pattern. Follow- up CT about 2 months later showed that the consolidation and GGOs have mostly resolved. D. Pneumonia Score 4. 29-year-old man without any comorbidities, who had no vaccination. CT performed on the same day of COVID-19 diagnosis showed multifocal and extensive GGOs or consolidations accompanying focal spared areas, which is consistent with extensive OP pattern. E. Pneumonia Score 5. 69-year-old man with hypertension, who had no vaccination. CT performed on the same day of COVID-19 diagnosis showed diffuse and extensive consolidations and GGOs predominantly in dependent lung region accompanying focal spared areas in right lower lobe, which is consistent with DAD pattern. GGOs, ground-glass opacities; OP, organizing pneumonia; DAD, diffuse alveolar damage.
See this image and copyright information in PMC

References

    1. Baden L.R., El Sahly H.M., Essink B., Kotloff K., Frey S., Novak R., Diemert D., Spector S.A., Rouphael N., Creech C.B., McGettigan J., Khetan S., Segall N., Solis J., Brosz A., Fierro C., Schwartz H., Neuzil K., Corey L., Gilbert P., Janes H., Follmann D., Marovich M., Mascola J., Polakowski L., Ledgerwood J., Graham B.S., Bennett H., Pajon R., Knightly C., Leav B., Deng W., Zhou H., Han S., Ivarsson M., Miller J., Zaks T. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. N. Engl. J. Med. 2021;384(5):403–416. doi: 10.1056/NEJMoa2035389. (for the COVE Study Group) - DOI - PMC - PubMed
    1. Dagan N., Barda N., Kepten E., Miron O., Perchik S., Katz M.A., Hernan M.A., Lipsitch M., Reis B., Balicer R.D. BNT162b2 mRNA Covid-19 vaccine in a nationwide mass vaccination setting. N. Engl. J. Med. 2021;384(15):1412–1423. doi: 10.1056/NEJMoa2101765. - DOI - PMC - PubMed
    1. Butt A.A., Omer S.B., Yan P., Shaikh O.S., Mayr F.B. SARS-CoV-2 vaccine effectiveness in a high-risk national population in a real-world setting. Ann. Intern. Med. 2021;174(10):1404–1408. doi: 10.7326/M21-1577. - DOI - PMC - PubMed
    1. Johnson A.G., Amin A.B., Ali A.R., Hoots B., Cadwell B.L., Arora S., Avoundjian T., Awofeso A.O., Barnes J., Bayoumi N.S., Busen K., Chang C., Cima M., Crockett M., Cronquist A., Davidson S., Davis E., Delgadillo J., Dorabawila V., Drenzek C., Eisenstein L., Fast H.E., Gent A., Hand J., Hoefer D., Holtzman C., Jara A., Jones A., Kamal-Ahmed I., Kangas S., Kanishka F., Kaur R., Khan S., King J., Kirkendall S., Klioueva A., Kocharian A., Kwon F.Y., Logan J., Lyons B.C., Lyons S., May A., McCormick D., Mshi E., Mendoza L., Milroy A., O’Donnell M., Pike S., Pogosjans A., Saupe J., Sell E., Smith D.M., Sosin E., Stanislawski M.K., Steele M., Stephenson A., Stout K., Strand B.P., Tilakaratne K., Turner H., Vest S., Warner C., Wiedeman A., Zaldivar B.J., Silk H.M., Scobie COVID-19 incidence and death rates among unvaccinated and fully vaccinated adults with and without booster doses during periods of delta and omicron variant emergence – 25 U.S. Jurisdictions, April 4-December 25, 2021. MMWR Morb. Mortal. Wkly. Rep. 2022;71(4):132–138. doi: 10.15585/mmwr.mm7104e2. - DOI - PMC - PubMed
    1. Lauring A.S., Tenforde M.W., Chappell J.D., Gaglani M., Ginde A.A., McNeal T., Ghamande S., Douin D.J., Talbot H.K., Casey J.D., Mohr N.M., Zepeski A., Shapiro N.I., Gibbs K.W., Files D.C., Hager D.N., Shehu A., Prekker M.E., Erickson H.L., Exline M.C., Gong M.N., Mohamed A., Johnson N.J., Srinivasan V., Steingrub J.S., Peltan I.D., Brown S.M., Martin E.T., Monto A.S., Khan A., Hough C.L., Busse L.W., Ten Lohuis C.C., Duggal A., Wilson J.G., Gordon A.J., Qadir N., Chang S.Y., Mallow C., Rivas C., Babcock H.M., Kwon J.H., Halasa N., Grijalva C.G., Rice T.W., Stubblefield W.B., Baughman A., Womack K.N., Rhoads J.P., Lindsell C.J., Hart K.W., Zhu Y., Adams K., Schrag S.J., Olson S.M., Kobayashi M., Verani J.R., Patel M.M., Self W.H. On behalf of Influenza and Other Viruses in the Acutely Ill (IVY) Network, Clinical severity of, and effectiveness of mRNA vaccines against, covid-19 from omicron, delta, and alpha SARS-CoV-2 variants in the United States: prospective observational study. BMJ. 2022;376 doi: 10.1136/bmj-2021-069761. - DOI - PMC - PubMed