Peculiarities of clinical and radiological parameters, indexes of systemic inflammation and immune status in vaccinated patients with COVID-19
Abstract. Since 2021, an active vaccination campaign against COVID-19 is performing worldwide.Mineeva E.S., Demko I.V., Sobko E.A., Kruglova O.S., Kudryavtsev Ya.I.
The aim: to evaluate clinical and radiological parameters, indexes of systemic inflammation and immune status in vaccinated patients with COVID-19.
Materials and methods. The study included 137 individuals. Group 1 consisted of patients with COVID-19 who received preventive vaccination (n=74). Group 2 included patients with COVID-19 who had not been vaccinated (n=63). All patients underwent general clinical examination, MSCT of chest organs, general and biochemical blood tests, interleukin 6, ferritin, procalcitonin, D-dimer, and immunogram assessment.
Results. In the group of unvaccinated patients, in a third of patients a volume of lung tissue damage equal to CT 3–4 was registered, while in group 1, CT values of 3–4 were observed in less than 25% of patients (p=0,038). Also in group 2, patients had a longer stay duration in the hospital, including that on oxygen support. In both groups, patients who required ICU treatment were registered, but in a greater percentage of cases this need occurred in non-immunized individuals. Among patients who did not undergo vaccination, death was observed in 25,00%; in the group of vaccinated patients, mortality rate was significantly lower – 6,45% (p=0,039). Indicators of systemic inflammation were higher than normal in both groups, but more evident changes were observed in unvaccinated patients. When assessing the immune status, dysfunction of T-cell component of immunity was found in a cohort of unvaccinated patients.
Conclusion. Vaccinated patients have a more favorable course of COVID-19 comparatively to unvaccinated patients, characterized by a less volume of lung tissue damage and less number of hospital bed days, including those on oxygen support. Vaccinated individuals are characterized by a more favorable prognosis of the disease: thus, the incidence of deaths was significantly more often recorded among patients of group 2nd. In both groups, the course of COVID-19 and the need for respiratory support were associated with indexes of systemic inflammation, volume of lung tissue damage, immune status and outcome of the disease.
Keywords
COVID-19
vaccination
viral pneumonia
antibodies
immunity
immunogram
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About the Authors
Elena S. Mineeva, postgraduate student of Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University of the Ministry of Healthcare of Russia, pulmonologist at Regional Clinical Hospital (Krasnoyarsk). Address: 660022, Krasnoyarsk, 1 Partizana Zheleznyaka St.E-mail: yelena.mineeva94@gmail.com
ORCID: https://orcid.org/0000-0003-4840-1498
Irina V. Demko, MD, professor of Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University of the Ministry of Healthcare of Russia, head of the pulmonary and allergological center of Regional clinical hospital (Krasnoyarsk). Address: 660022, Krasnoyarsk, 1 Partizana Zheleznyaka St.
E-mail:demko64@mail.ru
ORCID: https://orcid.org/0000-0001-8982-5292
Elena A. Sobko, MD, professor of Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University of the Ministry of Healthcare of Russia, head of the Department of allergology of Regional clinical hospital (Krasnoyarsk). Address: 660022, Krasnoyarsk, 1 Partizana Zheleznyaka St.
E-mail: sobko29@mail.ru
ORCID: https://orcid.org/0000-0002-9377-5213
Olga S. Kruglova, postgraduate student of Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University of the Ministry of Healthcare of Russia. Address: 660022, Krasnoyarsk, 1 Partizana Zheleznyaka St.
E-mail: kruglovaos95@gmail.com
ORCID: https://orcid.org/0000-0003-1041-6088
Yan I. Kudryavtsev, student of Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University of the Ministry of Healthcare of Russia. Address: 660022, Krasnoyarsk, 1 Partizana Zheleznyaka St.
E-mail: bYanKudryavtsev@yandex.ru
ORCID: https://orcid.org/0000-0001-8185-9623
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