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

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

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Abstract

To characterize the epidemiological and clinical profile of individuals more likely to become infected by 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

Data from hospitalized COVID-19 patients who had been fully vaccinated and had a SARS-CoV-2 infection positive diagnosis were collected from the SIVEP-Gripe database (Influenza Epidemiological Surveillance Information System) from January 18, 2021 to September 15, 2021. Demographic data, clinical symptoms/signs 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 elderly ≥ 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, dyspnoea, 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 characterize the profile of hospitalized Brazilian patients with COVID-19 vaccine breakthrough infection and the risk factors for an unfavorable outcome. These data have made it possible to identify priority groups to receive a booster dose, in addition to not neglecting personal protection.

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  1. ScreenIT

    SciScore for 10.1101/2022.04.12.22273589: (What is this?)

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

    Table 1: Rigor

    EthicsIRB: This retrospective study is based on a publicly available database and did not directly involve patients, not requiring the approval of an ethics committee.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    All analyzes were performed using Python (version 3.7.12) and scipy statistical package (version 1.4.1).
    Python
    suggested: (IPython, RRID:SCR_001658)
    scipy
    suggested: (SciPy, RRID:SCR_008058)

    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:
    The main limitation was the inclusion of only hospitalized patients cases, as the SIVEP-Gripe database does not record data from outpatients. Therefore, we do not know the characteristics of unreported breakthrough infections that may be asymptomatic or mild.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    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

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2022.04.12.22273589v1 on medRxiv
  3. Version published to 10.26633/rpsp.2022.106