Clinical Manifestations of COVID-19 Breakthrough Infections: A Systematic Review and Meta-Analysis.
Por:
Lee CJ, Woo W, Kim AY, Yon DK, Lee SW, Koyanagi A, Kim MS, KalthoumTizaoui, Dragioti E, Radua J, Lee S, Smith L and Il Shin J
Publicada:
1 sep 2022
Ahead of Print:
19 may 2022
Resumen:
OBJECTIVE: To provide a comparative meta-analysis and systematic review of the risk and clinical outcomes of COVID-19 infection between fully vaccinated and unvaccinated groups. METHODS: Eighteen studies of COVID-19 infections in fully vaccinated ("breakthrough infections") and unvaccinated individuals were reviewed from Medline/PubMed, Scopus, Embase, and Web of Science databases. The meta-analysis examined the summary effects and between-study heterogeneity regarding differences in the risk of infection, hospitalization, treatments, and mortality between vaccinated and unvaccinated individuals. RESULTS: The overall risk of infection was lower for the fully vaccinated compared to that of the unvaccinated (relative risk[RR] 0.20, 95% CI 0.19-0.21), especially for variants other than Delta (Delta: RR 0.29, 95% CI 0.13-0.65; other variants: RR 0.06, 95% CI 0.04-0.08). The risk of asymptomatic infection was not statistically significantly different between fully vaccinated and unvaccinated (RR 0.56, 95% CI 0.27-1.19). There were neither statistically significant differences in risk of hospitalization (RR 1.06, 95% CI 0.38-2.93), invasive mechanical ventilation (RR 1.65 ,95% CI 0.90-3.06), or mortality (RR 1.19, 95% CI 0.79-1.78). Conversely, the risk of supplemental oxygen during hospitalization was significantly higher for the unvaccinated (RR 1.40, 95% CI 1.08-1.82). CONCLUSIONS: Unvaccinated people were more vulnerable to COVID-19 infection than fully vaccinated for all variants. Once infected, there were no statistically significant differences in the risk of hospitalization, invasive mechanical ventilation, or mortality. Still, unvaccinated showed an increased need for oxygen supplementation. Further prospective analysis, including patients' risk factors, COVID-19 variants, and the utilized treatment strategies, would be warranted. This article is protected by copyright. All rights reserved.
Filiaciones:
Lee CJ:
Department of Biological and Chemical Sciences, New York Institute of Technology, Old Westbury, USA
Woo W:
Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Kim AY:
Division of Pediatric Cardiology, Department of Pediatrics, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
Yon DK:
Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
Lee SW:
Department of Data Science, Sejong University College of Software Convergence, Seoul, South Korea
Koyanagi A:
Parc Sanitari Sant Joan de Deu/CIBERSAM, Universitat de Barcelona, Fundacio Sant Joan de Deu, Sant Boi de Llobregat, Barcelona, Spain
ICREA, Pg. Lluís Companys 23, Barcelona, Spain
Kim MS:
Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
KalthoumTizaoui:
Laboratory of Microoranismes and Active Biomolecules, Sciences Faculty of Tunis, Tunis El Manar University, Tunis, Tunisia
Dragioti E:
Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, SE, 581 85, Linköping, Sweden
Radua J:
Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institute, Stockholm, Sweden
Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
Lee S:
Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Smith L:
Cambridge Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
Il Shin J:
Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
Green Accepted, Green Published
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