A Report on the Relationship between Vaccination Status, Viral Loads and Patient Outcomes among Hospitalized Patients during the COVID-19 Omicron Variant’s Surge in Tehran, Iran

Shirin  Esmaeili; Arezoo  Salami Khaneshan; Parvaneh  Ebrahimi Alavijeh; Kiavash  Semnani; SeyedAhmad  SeyedAlinaghi; Marjan  Sohrabi

doi:10.18502/jimc.v9i2.21191

Shirin Esmaeili School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
Arezoo Salami Khaneshan Department of Infectious Diseases, Tehran University of Medical Sciences, Tehran, Iran
Parvaneh Ebrahimi Alavijeh Department of Infectious Diseases, Tehran University of Medical Sciences, Tehran, Iran
Kiavash Semnani School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
SeyedAhmad SeyedAlinaghi Iranian Research Center for HIV/AIDS, Tehran University of Medical Sciences, Tehran, Iran
Marjan Sohrabi Department of Infectious Diseases, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jimc.v9i2.21191

Keywords: Adult, COVID-19, Intensive care units, Iran, Humans, Length of stay, Prognosis, Vaccination, Vaccines, Viral load

Abstract

Background: The present study explored patient outcomes and factors possibly associated with these outcomes among patients hospitalized with severe COVID-19 during the Omicron variant’s surge in a tertiary care center in Tehran, Iran.

Methods: The study design was a retrospective observational study conducted on adults hospitalized with severe COVID-19 in a tertiary care center in Iran, from 22 December 2021 to 22 April 2022. Patients with major comorbidities were excluded. Demographics, Cycle threshold (Ct) value at diagnosis, and outcomes (length of stay, ICU admission, and mortality) were obtained from hospital archives. Vaccination status was retrieved from a national registry. The relationship between proposed prognostic factors and patient outcomes was analyzed.

Results: Data from 212 in-patients with severe COVID-19 was analyzed. Patients were aged 54.7±18.6 years old. 11.3% of patients were admitted to the ICU, and overall mortality was 14.1%. Average length of stay was 6.27 days. 70.8% of patients were fully vaccinated, and 11.3% had received a booster dose. Vaccination was associated with significantly less hospital stay (p=0.006), ICU admissions (p=0.018), and mortality (p=0.024). Higher viral burden was associated with mortality (p=0.01), but not ICU admission or longer stay.

Conclusion: The present study findings restate the protective role of vaccines against adverse outcomes of COVID-19 infection. However, an alarming rate of poor outcomes during the peak circulation of the Omicron variant was found – warranting further consideration.