Study estimates the elevated risks of COVID-19 breakthrough infection and hospitalization in fully vaccinated individuals with comorbidities

Earlier studies indicated that many illnesses such as diabetes, chronic kidney/lung disease, or conditions (like solid organ transplant or cancer) that lead to immunocompromised states result in a higher risk of hospitalization following infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the pathogen behind the ongoing coronavirus disease 2019 (COVID-19) pandemic. A recent report describes the risk of breakthrough COVID-19 and hospitalizations in this subgroup of people following vaccination.

Study: Risk of COVID-19 breakthrough infection and hospitalization in individuals with comorbidities. Image Credit: sdecoret/Shutterstock
Study: Risk of COVID-19 breakthrough infection and hospitalization in individuals with comorbidities. Image Credit: sdecoret/Shutterstock

This news article was a review of a preliminary scientific report that had not undergone peer-review at the time of publication. Since its initial publication, the scientific report has now been peer reviewed and accepted for publication in a Scientific Journal. Links to the preliminary and peer-reviewed reports are available in the Sources section at the bottom of this article. View Sources

Introduction

The use of booster doses of vaccination against COVID-19 has been avidly discussed given the continuing high rate of infection with this virus, following the emergence of the Omicron variant and its subvariants with extremely high transmissibility. Such boosters were offered in many countries because available evidence showed rapidly decreasing protective immunity after two doses of the vaccines being used at present.

Older adults with high-risk conditions, including those listed above, were prioritized for these boosters, but the degree of risk to younger people with the same indications is still unclear. One study in US veterans with such illnesses, mostly male, showed that nucleic acid vaccines led to a 95% reduction in infections. The current study, available on the medRxiv* preprint server, aimed to understand both the risk of breakthrough infection and severe outcomes in this population.

For this purpose, the investigators developed a platform to evaluate this risk, called the Truveta platform.

What did the study show?

The study included over 2 million people, classified into cohorts based on the presence of four different illnesses and one control cohort. Some individuals were therefore assigned to more than one cohort.

The results show that the highest risk of breakthrough infection is found in those with chronic lung disease, with a 43% increase in risk, and people with diabetes, who have a 30% increase.

However, when it comes to hospitalization, patients with chronic kidney disease had a more than doubled risk even though their risk of infection was lower than those in other groups. The risk was increased by 80% and 50% in those with diabetes and immunocompromised states, respectively.

What are the implications?

The results clearly show that breakthrough infection with the virus occurs to a larger extent among people with some underlying medical conditions than the controls. The greatest increase in risk over baseline is among those with diabetes, chronic lung disease, or chronic kidney disease, even after adjusting for age, sex, race, and ethnic origin. The reason for this higher risk could be the deterioration in the immune response as a result of these conditions.

Studies in unvaccinated individuals with these comorbidities have shown the same pattern. The results also corroborate an earlier report of reduced vaccine effectiveness in a population of US male veterans with a high prevalence of other underlying medical conditions.

A doubling of the odds for hospitalization compared to the vaccinated population confirms earlier findings that people with conditions known to produce impaired immunity fare worse when infected with the virus. This also underlines the need to protect these groups with booster vaccines.

Interestingly, the group with the lowest increase in breakthrough infection was that with immunocompromised states, compared to other comorbidities. This could mean they protected themselves more carefully by behavioral modifications like mask-wearing or social distancing than people in the other groups.

Again, people with chronic lung disease were most likely to be infected by breakthrough infections but least likely to be hospitalized. This group already had greater access to steroids, and supplemental oxygen before COVID-19 or the disease designation included an overly broad range of diseases, so it did not help identify the actual increase in risk due to this condition.

Further research must look at how the presence of multiple such illnesses interact to produce a higher risk of breakthrough infection and adverse outcomes following COVID-19. Such data will help individuals, agencies, and governments to make better recommendations about booster doses of the vaccination for such groups.

The findings of this study improve the evidence and support recommendations for people with comorbidities such as chronic kidney disease, chronic lung disease, diabetes or people who are immunocompromised to receive the primary vaccination sequence as well as a booster dose.”

This news article was a review of a preliminary scientific report that had not undergone peer-review at the time of publication. Since its initial publication, the scientific report has now been peer reviewed and accepted for publication in a Scientific Journal. Links to the preliminary and peer-reviewed reports are available in the Sources section at the bottom of this article. View Sources

Journal references:

Article Revisions

  • May 13 2023 - The preprint preliminary research paper that this article was based upon was accepted for publication in a peer-reviewed Scientific Journal. This article was edited accordingly to include a link to the final peer-reviewed paper, now shown in the sources section.
Dr. Liji Thomas

Written by

Dr. Liji Thomas

Dr. Liji Thomas is an OB-GYN, who graduated from the Government Medical College, University of Calicut, Kerala, in 2001. Liji practiced as a full-time consultant in obstetrics/gynecology in a private hospital for a few years following her graduation. She has counseled hundreds of patients facing issues from pregnancy-related problems and infertility, and has been in charge of over 2,000 deliveries, striving always to achieve a normal delivery rather than operative.

Citations

Please use one of the following formats to cite this article in your essay, paper or report:

  • APA

    Thomas, Liji. (2023, May 13). Study estimates the elevated risks of COVID-19 breakthrough infection and hospitalization in fully vaccinated individuals with comorbidities. News-Medical. Retrieved on October 06, 2024 from https://www.news-medical.net/news/20220502/Study-estimates-the-elevated-risks-of-COVID-19-breakthrough-infection-and-hospitalization-in-fully-vaccinated-individuals-with-comorbidities.aspx.

  • MLA

    Thomas, Liji. "Study estimates the elevated risks of COVID-19 breakthrough infection and hospitalization in fully vaccinated individuals with comorbidities". News-Medical. 06 October 2024. <https://www.news-medical.net/news/20220502/Study-estimates-the-elevated-risks-of-COVID-19-breakthrough-infection-and-hospitalization-in-fully-vaccinated-individuals-with-comorbidities.aspx>.

  • Chicago

    Thomas, Liji. "Study estimates the elevated risks of COVID-19 breakthrough infection and hospitalization in fully vaccinated individuals with comorbidities". News-Medical. https://www.news-medical.net/news/20220502/Study-estimates-the-elevated-risks-of-COVID-19-breakthrough-infection-and-hospitalization-in-fully-vaccinated-individuals-with-comorbidities.aspx. (accessed October 06, 2024).

  • Harvard

    Thomas, Liji. 2023. Study estimates the elevated risks of COVID-19 breakthrough infection and hospitalization in fully vaccinated individuals with comorbidities. News-Medical, viewed 06 October 2024, https://www.news-medical.net/news/20220502/Study-estimates-the-elevated-risks-of-COVID-19-breakthrough-infection-and-hospitalization-in-fully-vaccinated-individuals-with-comorbidities.aspx.

Comments

  1. Rodereck Azir Rodereck Azir United States says:

    1st of all the writer of this article is an OB-Gyn so I don't see how their experience is covid related. Secondly trying to state that vaccine have a 95% effectiveness against infections at this point is a pretty blatant lie considering the majority of the country is supposedly vaccinated at this point yet infections and death rates are the same or higher than years prevaccines. Pfizer had to be sued to put out the real information of their studies and pieces like this are another reason why the American people cannot trust your corrupt institutions.

  2. Anne Beal Anne Beal United States says:

    Shouldn't behavioral differences have been adjusted for? As an immunocompromised person (primary antibody deficiency) I infuse 10 gms of IgG subcu every 10 days and wear a mask when I go out. I would expect to have a decreased chance of a breakthrough infection.

  3. Aaron ennis Aaron ennis United States says:

    Any response posted is filtered.

The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
Post a new comment
Post

While we only use edited and approved content for Azthena answers, it may on occasions provide incorrect responses. Please confirm any data provided with the related suppliers or authors. We do not provide medical advice, if you search for medical information you must always consult a medical professional before acting on any information provided.

Your questions, but not your email details will be shared with OpenAI and retained for 30 days in accordance with their privacy principles.

Please do not ask questions that use sensitive or confidential information.

Read the full Terms & Conditions.

You might also like...
Mild COVID-19 disrupts brain connectivity and reduces memory function in adolescents and young adults