![]() Receipt of an additional (ie, booster) dose of vaccine was associated with reduced odds of severe disease (aOR, 0.50 CI, 0.44-0.57).Ĭonclusions and Relevance In this nationwide, retrospective cohort of predominantly male US Veterans, we identified risk factors associated with severe disease despite vaccination. Immunocompromising conditions, including receipt of different classes of immunosuppressive medications (eg, leukocyte inhibitor: aOR, 2.80 95% CI, 2.39-3.28) or cytotoxic chemotherapy (aOR, 2.71 CI, 2.27-3.24) prior to breakthrough infection, or leukemias or lymphomas (aOR, 1.87 CI, 1.61-2.17) and chronic conditions associated with end-organ disease, such as heart failure (aOR, 1.74 CI, 1.61-1.88), dementia (aOR, 2.01 CI, 1.83-2.20), and chronic kidney disease (aOR, 1.59 CI, 1.49-1.69), were also associated with increased risk. The strongest association with risk of severe disease after vaccination was age, which increased among patients aged 50 years or older with an adjusted odds ratio (aOR) of 1.42 (CI, 1.40-1.44) per 5-year increase in age, such that patients aged 80 years or older had an aOR of 16.58 (CI, 13.49-20.37) relative to patients aged 45 to 50 years. Results Among 110 760 patients with infections following vaccination (97 614 men, mean age at vaccination, 60.8 years 26 953 Black, 11 259 Hispanic, and 71 665 White), 10 612 (9.6%) had severe COVID-19. Association between severe disease and exposures was estimated using logistic regression models. Severe disease was defined as hospitalization within 14 days of a positive SARS-CoV-2 diagnostic test and either blood oxygen level of less than 94%, receipt of supplemental oxygen or dexamethasone, mechanical ventilation, or death within 28 days. Main Outcomes and Measures Development of severe vs nonsevere SARS-CoV-2 infection. Data were collected from December 15, 2020, through February 28, 2022.Įxposures Demographic characteristics, comorbidities, immunocompromised status, and vaccination-related variables. Objective To characterize risk factors for severe COVID-19 disease in a vaccinated population.ĭesign, Setting, and Participants This nationwide, retrospective cohort study included US veterans who received a SARS-CoV-2 vaccination series and later developed laboratory-confirmed SARS-CoV-2 infection and were treated at US Department of Veterans Affairs (VA) hospitals. Importance With a large proportion of the US adult population vaccinated against SARS-CoV-2, it is important to identify who remains at risk of severe infection despite vaccination. ![]() Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.Subcohort of Patients With Urban Residence, Data and Analysis Subcohort of Patients With Rural Residence, Data and AnalysisĮTable 22. Subcohort of Patients Who Received the Moderna Vaccine, Data and AnalysisĮTable 21. Subcohort of Patients Who Received the Pfizer Vaccine, Data and AnalysisĮTable 20. Subcohorts During Delta and Omicron, Comparison of AnalysesĮTable 19. Subcohort During Omicron Period, Data and AnalysisĮTable 18. Subcohort During Delta Period, Data and AnalysisĮTable 17. Subcohorts of Female and Male, Comparison of AnalysesĮTable 16. Subcohort of Male Patients, Data and AnalysisĮTable 15. Subcohort of Female Patients, Data and AnalysisĮTable 14. Age Distributions of Male and Female PatientsĮTable 13. Subcohort of Nonimmunocompromised Patients Aged 65 Years or Older With No Booster, Data and AnalysisĮFigure. Subcohort of Nonimmunocompromised Patients Younger Than 65 Years With No Booster, Data and AnalysisĮTable 12. Subcohort of Patients Aged 50 or Older, Data and AnalysisĮTable 11. Subcohort of Nonimmunocompromised Patients, Data and AnalysisĮTable 10. Subcohort of Immunocompromised Patients, Analysis by Number of Medication ClassesĮTable 9. Immunosuppressive Medications Before and/or After VaccinationĮTable 8. Subcohort Immunocompromised, Data and AnalysisĮTable 7. Subcohorts, Data for Patients Younger and Older Than 50 Years, Analysis for Patients Younger Than 50 YearsĮTable 6. Full Cohort Data, 4 Levels of SeverityĮTable 5. Full Cohort, Data and Analysis, Univariable and MultivariableĮTable 4. List of Immunosuppressive Medications, With ClassificationĮTable 3.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |