Characteristics and risk of COVID-19-related death in fully vaccinated people in Scotland.
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ABSTRACT:
SUBMITTER: Grange Z
PROVIDER: S-EPMC8553268 | biostudies-literature | 2021 Nov
REPOSITORIES: biostudies-literature
Publications
Characteristics and risk of COVID-19-related death in fully vaccinated people in Scotland.
Grange Zoe Z Buelo Audrey A Sullivan Christopher C Moore Emily E Agrawal Utkarsh U Boukhari Khaled K McLaughlan Iain I Stockton Diane D McCowan Colin C Robertson Chris C Sheikh Aziz A Murray Josephine L K JLK
Lancet (London, England) 20211028 10313
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Project description:BackgroundBreakthrough coronavirus disease 2019 (COVID-19) may occur in fully vaccinated persons.MethodsWe assessed the clinical outcomes of breakthrough COVID-19 in fully vaccinated individuals.ResultsIn this cohort of 1395 persons (mean age, 54.3 years; 60% female; median body mass index, 30.7) who developed breakthrough COVID- 19, there were 107 (7.7%) who required hospitalization by day 28. Hospitalization was significantly associated with the number of medical comorbidities. Antispike monoclonal antibody treatment was significantly associated with a lower risk of hospitalization (odds ratio, 0.227; 95% confidence interval, 0.128-0.403; P < .001). The number needed to treat (NNT) to prevent 1 hospitalization was 225 among the lowest risk patient group compared with NNT of 4 among those with highest numbers of medical comorbidity.ConclusionsMonoclonal antibody treatment is associated with reduced hospitalization in vaccinated high-risk persons with mild to moderate COVID-19.
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Project description:IntroductionThis study aimed to examine the heterogeneity of the associations between social determinants and COVID-19 fully vaccinated rate.MethodsThis study proposes 3 multiscale dimensions of spatial process, including level of influence (the percentage of population affected by a certain determinant across the entire area), scalability (the spatial process of a determinant into global, regional, and local process), and specificity (the determinant that has the strongest association with the fully vaccinated rate). The multiscale geographically weighted regression was applied to the COVID-19 fully vaccinated rates in U.S. counties (N=3,106) as of October 26, 2021, and the analyses were conducted in May 2022.ResultsThe results suggest the following: (1) Percentage of Republican votes in the 2020 presidential election is a primary influencer because 84% of the U.S. population lived in counties where this determinant is found the most dominant; (2) Demographic compositions (e.g., percentages of racial/ethnic minorities) play a larger role than socioeconomic conditions (e.g., unemployment) in shaping fully vaccinated rates; (3) The spatial process underlying fully vaccinated rates is largely local.ConclusionsThe findings challenge the 1-size-fits-all approach to designing interventions promoting COVID-19 vaccination and highlight the importance of a place-based perspective in ecological health research.
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Project description:ImportanceAssociations have been found between COVID-19 and subsequent mental illness in both hospital- and population-based studies. However, evidence regarding which mental illnesses are associated with COVID-19 by vaccination status in these populations is limited.ObjectiveTo determine which mental illnesses are associated with diagnosed COVID-19 by vaccination status in both hospitalized patients and the general population.Design, setting, and participantsThis study was conducted in 3 cohorts, 1 before vaccine availability followed during the wild-type/Alpha variant eras (January 2020-June 2021) and 2 (vaccinated and unvaccinated) during the Delta variant era (June-December 2021). With National Health Service England approval, OpenSAFELY-TPP was used to access linked data from 24 million people registered with general practices in England using TPP SystmOne. People registered with a GP in England for at least 6 months and alive with known age between 18 and 110 years, sex, deprivation index information, and region at baseline were included. People were excluded if they had COVID-19 before baseline. Data were analyzed from July 2022 to June 2024.ExposureConfirmed COVID-19 diagnosis recorded in primary care secondary care, testing data, or the death registry.Main outcomes and measuresAdjusted hazard ratios (aHRs) comparing the incidence of mental illnesses after diagnosis of COVID-19 with the incidence before or without COVID-19 for depression, serious mental illness, general anxiety, posttraumatic stress disorder, eating disorders, addiction, self-harm, and suicide.ResultsThe largest cohort, the pre-vaccine availability cohort, included 18 648 606 people (9 363 710 [50.2%] female and 9 284 896 [49.8%] male) with a median (IQR) age of 49 (34-64) years. The vaccinated cohort included 14 035 286 individuals (7 308 556 [52.1%] female and 6 726 730 [47.9%] male) with a median (IQR) age of 53 (38-67) years. The unvaccinated cohort included 3 242 215 individuals (1 363 401 [42.1%] female and 1 878 814 [57.9%] male) with a median (IQR) age of 35 (27-46) years. Incidence of most outcomes was elevated during weeks 1 through 4 after COVID-19 diagnosis, compared with before or without COVID-19, in each cohort. Incidence of mental illnesses was lower in the vaccinated cohort compared with the pre-vaccine availability and unvaccinated cohorts: aHRs for depression and serious mental illness during weeks 1 through 4 after COVID-19 were 1.93 (95% CI, 1.88-1.98) and 1.49 (95% CI, 1.41-1.57) in the pre-vaccine availability cohort and 1.79 (95% CI, 1.68-1.90) and 1.45 (95% CI, 1.27-1.65) in the unvaccinated cohort compared with 1.16 (95% CI, 1.12-1.20) and 0.91 (95% CI, 0.85-0.98) in the vaccinated cohort. Elevation in incidence was higher and persisted longer after hospitalization for COVID-19.Conclusions and relevanceIn this study, incidence of mental illnesses was elevated for up to a year following severe COVID-19 in unvaccinated people. These findings suggest that vaccination may mitigate the adverse effects of COVID-19 on mental health.
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