Impact of vaccination in reducing Hospital expenses, Mortality and Average length of stay among COVID-19 patients – a retrospective cohort study from India

  1. Madhumathi Ramakrishnan
  2. Prakash Subbarayan

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Abstract

WHO listed vaccine hesitancy among the top 10 global threats to health and there are very few reports highlighting vaccine benefits against COVID-19. The aim of this study was to study the impact of vaccination on reducing the average length of stay (ALOS), intensive care unit (ICU) requirement, mortality and cost of the treatment among COVID-19 patients.

Methods

In this retrospective cohort study all the patients above 45 years who underwent treatment for COVID-19 were included. The data of patients treated pan India during the period March & April 2021 with the diagnosis of COVID-19, under health insurance cover, were extracted to study parameters like the ALOS, mortality, ICU requirement, total hospital expenses incurred and the vaccination status.

Results

Among 3820 patients with COVID-19, 3301 (86.4%) were unvaccinated while 519 (13.6%) were vaccinated. Among the unvaccinated the mean (s.d) ALOS was 7 days. Fourteen days after second dose of vaccination this was significantly less (p=0.01) at 4.9. The mean total hospital expense among the unvaccinated was Rs. 277850. Fourteen days after second dose of vaccination this was further less (p=0.001) at Rs. 217850. Among the unvaccinated population 291/3301 (8.8%) required ICU and this was significantly less (p=0.03) at 31/519 (6%) among the vaccinated. Among those who received two doses of vaccination it was further less at 1/33 (3%). The mortality among unvaccinated patients was 16/3301 (0.5%) while there was no mortality among the vaccinated. Among those who received two doses of vaccination there was a 66% relative risk reduction in ICU stay and 81% relative risk reduction in mortality.

Conclusions

There was a significant reduction in ALOS, ICU requirement, mortality & treatment cost in patients who had completed two doses of vaccination. These findings may be used in motivating public and promoting vaccination drive.

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    SciScore for 10.1101/2021.06.18.21258798: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    There are several limitations in this study. Being a retrospective cohort study, in analyzing vaccination status among COVID-19 patients, we were unable to comment on the incidence of disease among the vaccinated/ unvaccinated population. This study covers patients under health insurance cover who are treated in private settings, thus excluding a larger population treated at government hospitals. However it covers pan-India data and is likely to represent a national trend. Further this study focused only on those aged 45+ and happened during the early phase of vaccination when skepticism was high and vaccine penetration was low. This study included only hospitalized patients, while a larger proportion of milder cases post vaccination could have been treated as outpatient or at home care settings. This study also did not cover asymptomatic cases that could have happened post vaccination. While vaccination is known to reduce symptomatic disease, hospitalization and death, Tang et al [15] in a study showed that vaccination also reduced asymptomatic COVID-19. Further larger prospective studies are needed to see whether vaccination would also reduce transmissibility of the disease. In our study we did not have details of the strain that could have been responsible for the break through infection. Also it was difficult to assess the baseline immune status of the population that could have attributed to this. A recent study[16] from UK showed that 33% protection was noted after a si...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We found bar graphs of continuous data. We recommend replacing bar graphs with more informative graphics, as many different datasets can lead to the same bar graph. The actual data may suggest different conclusions from the summary statistics. For more information, please see Weissgerber et al (2015).

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  2. Version published to 10.1101/2021.06.18.21258798v1 on medRxiv