ArticleBMC infectious diseases2024
Comprehensive statistical analysis reveals significant benefits of COVID-19 vaccination in hospitalized patients: propensity score, covariate adjustment, and feature importance by permutation.
Article in BMC infectious diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Comparison between the characteristics and outcomes of patients hospitalized for COVID-19 in three waves of the pandemic: a retrospective analysis.Infectious diseases of poverty · 2025Article
- Factors Associated with Prolonged Mechanical Ventilation and 30-Day Mortality in Intubated COVID-19 Patients with Invasive Fungal Infections: A Retrospective Observational Study.Tropical medicine and infectious disease · 2025Article
- Unraveling relevant cross-waves pattern drifts in patient-hospital risk factors among hospitalized COVID-19 patients using explainable machine learning methods.BMC infectious diseases · 2025Article
- Vaccine-Preventable Conditions: Disparities in Hospitalizations Affecting Rural Communities in the Southeast United States.International journal of environmental research and public health · 2025Article
- Early Elevated Inflammatory Markers in SARS-CoV-2 Vaccinated Patients Are Associated with Reduced Mortality, Morbidity, and Lung Injury.Life (Basel, Switzerland) · 2024Article
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Authors and funding
22 authors.
Funding
Abstract
backgroundCOVID-19 vaccines effectively prevent infection and hospitalization. However, few population-based studies have compared the clinical characteristics and outcomes of patients hospitalized for COVID-19 using advanced statistical methods. Our objective is to address this evidence gap by comparing vaccinated and unvaccinated patients hospitalized for COVID-19.
methodsThis retrospective cohort included adult COVID-19 patients admitted from March 2021 to August 2022 from 27 hospitals. Clinical characteristics, vaccination status, and outcomes were extracted from medical records. Vaccinated and unvaccinated patients were compared using propensity score analyses, calculated based on variables associated with vaccination status and/or outcomes, including waves. The vaccination effect was also assessed by covariate adjustment and feature importance by permutation.
resultsFrom the 3,188 patients, 1,963 (61.6%) were unvaccinated and 1,225 (38.4%) were fully vaccinated. Among these, 558 vaccinated individuals were matched with 558 unvaccinated ones. Vaccinated patients had lower rates of mortality (19.4% vs. 33.3%), invasive mechanical ventilation (IMV-18.3% vs. 34.6%), noninvasive mechanical ventilation (NIMV-10.6% vs. 22.0%), intensive care unit admission (ICU-32.0% vs. 44.1%) vasoactive drug use (21.1% vs. 32.6%), dialysis (8.2% vs. 14.7%) hospital length of stay (7.0 vs. 9.0 days), and thromboembolic events (3.9% vs.7.7%), p < 0.05 for all. Risk-adjusted multivariate analysis demonstrated a significant inverse association between vaccination and in-hospital mortality (adjusted odds ratio [aOR] = 0.42, 95% confidence interval [CI]: 0.31-0.56; p < 0.001) as well as IMV (aOR = 0.40, 95% CI: 0.30-0.53; p < 0.001). These results were consistent in all analyses, including feature importance by permutation.
conclusionVaccinated patients admitted to hospital with COVID-19 had significantly lower mortality and other severe outcomes than unvaccinated ones during the Delta and Omicron waves. These findings have important implications for public health strategies and support the critical importance of vaccination efforts, particularly in low-income countries, where vaccination coverage remains suboptimal.
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