Munigela A, Sowpati DT, M S, Banu S, Siva AB, V JK, Nutalapati C, Vishnubhotla R, Kulkarni A, Mukherjee P, Zaveri L, Rao GV, Tallapaka KB, Reddy DN, Ara S, Avadhanula S, Bollu H, Jandhyala SK, Kulkarni O, Methuku V, Nurkurthy SP, Undamatla V, Verma S, Vodapalli A, Vemula K, Kanna J, Dharavath K, Maity B, Gujjarlapudi D, Yelamanchili S. Clinical outcomes in Covishield (ChAdOx1) and Covaxin (BBV-152) vaccinated individuals hospitalized with the Delta variant (B.1.617.2).
IJID Regions 2022;
5:104-110. [PMID:
36090517 PMCID:
PMC9444261 DOI:
10.1016/j.ijregi.2022.08.016]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 08/29/2022] [Accepted: 08/31/2022] [Indexed: 11/03/2022]
Abstract
The Delta variant of severe acute respiratory syndrome coronavirus-2 is the predominant variant causing breakthrough infections in India.
Disease severity was significantly lower in vaccinated individuals.
Mortality reduced by >50% in fully vaccinated (two doses) individuals.
Vaccinated individuals had higher antibody levels and lower inflammatory markers.
Vaccinated deceased individuals mounted a minimal antibody response.
Background
Covishield (ChAdOx) and Covaxin (BBV-152) are the mainstream vaccines against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) used in India and a few other countries.
Objective
To assess the clinical outcomes of patients hospitalized with coronavirus disease 2019 (COVID-19) who had been vaccinated with either Covishield or Covaxin.
Methods
This prospective, single-centre, observational cohort study of 1160 patients hospitalized with COVID-19 was conducted between April and June 2021. Severity of disease at admission and during hospitalization, requirement for intensive care unit (ICU) admission and ventilatory support, inflammatory markers (C-reactive protein, ferritin, lactate dehydrogenase, D-dimer), neutralizing antibody levels and mortality were assessed in vaccinated and unvaccinated patients.
Results
More than 90% of patients in this study harboured the Delta variant (Pango lineage B.1.617.2) of SARS-CoV-2. Severity of disease at admission and during hospitalization (3.44% vs 7.51%; P=0.0032) and requirement for ICU admission and ventilatory support (2.83% vs 5.86%; P=0.0154) were significantly lower in vaccinated patients compared with unvaccinated patients. Vaccinated patients also had significantly (P<0.0001) higher antibody levels and lower inflammatory marker levels compared with unvaccinated patients. A subset of vaccinated, deceased patients mounted minimal antibody response [‘non-responders’: 4.53 (standard deviation 1.40) AU/mL].
Conclusion
These results demonstrate the effectiveness of Covishield and Covaxin against severe disease in patients hospitalized with COVID-19 with breakthrough infections caused by the Delta variant. Strategies targeting non-responders are desirable to minimize morbidity and mortality.
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