Imaging shows post-vaccine breakthrough COVID-19 less severe
A study yesterday in Radiology used imaging to determine that breakthrough infections are less severe when a patient is fully vaccinated against COVID-19 compared with patients who are unvaccinated or partially vaccinated.
The study was based on images collected from the COVID-19 Korean Imaging Cohort for COVID-19 (KICC-19) from June to August 2021 of 761 hospitalized patients with COVID-19. Forty-seven patients (6.2%) were fully vaccinated (breakthrough infection), 127 were partially vaccinated (17%), and 587 (77%) were unvaccinated.
Initial chest x-rays showed no pneumonia in 75% of fully vaccinated patients with breakthrough infection, compared with 63% of unvaccinated patients. Computed tomography chest scans showed differing levels of severity based on vaccination status: The proportion of scans without pneumonia was 22% (71/326) in unvaccinated patients, 30% (19/64) in partially vaccinated patients, and 59% (13/22) in fully vaccinated patients.
"Mechanical ventilation and in-hospital death occurred only in the unvaccinated group," said senior study author Yeon Joo Jeong, MD, PhD, from the department of radiology and biomedical research institute at Pusan National University Hospital in Busan, South Korea, in a press release. "After adjusting for baseline clinical characteristics, analysis showed that fully vaccinated patients were at significantly lower risk of requiring supplemental oxygen and of [intensive care unit] admission than unvaccinated patients."
Feb 1 Radiology study
Feb 1 Radiological Society of North America press release
High BMI more strongly connected with COVID death in racial minorities
Body mass index (BMI) was more strongly associated with COVID-19–related death in racial minorities than among White patients, according to a study today in Nature Communications.
A team led by the University of Leicester in England examined the electronic health records and census and death data of 12.6 million adults older than 40 years who had a recorded BMI from January to December 2020.
Of 33,951 deaths, 0.29% each were of patients of Black or South Asian race, 0.27% were White, and 0.18% were of other races. BMI was tied to COVID-19 death in all races, but compared with White patients, the association was stronger in Black, South Asian, and other races (P < 0.001 for interaction).
For instance, at a BMI of 40 kg/m2 (obese), hazard ratios (HRs) for death among White, Black, South Asian, and other races were 1.73, 3.01, 5.25, and 3.89, respectively, relative to a BMI of 22.5 kg/m2 (healthy weight) in White patients.
At a low BMI of 20 kg/m2, the risk of COVID-19 death was similar in Black (HR, 0.95) and other minority patients (HR, 1.13), compared with White patients, and South Asian patients were at slightly higher risk (HR, 1.21). At a BMI of 40 kg/m2, the risk of COVID-19 death in Black, South Asian, and other minority groups relative to White patients widened to 1.74, 3.05, and 2.25, respectively.
The associations between race, obesity, and COVID-19 hospitalizations was similar to those of death, with 1.13% of Black and South Asians, 0.84% of other minority groups, and 0.76% of White patients needing hospital care.
The authors said that obesity may worsen COVID-19 outcomes by triggering a change in the role of inflammatory mediators produced by fat tissue, which leads to a pro-inflammatory state, predisposition to blood clots, exaggerated immune responses, and limited antibody responses.
In a University of Leicester press release, coauthor Kamlesh Khunti, MD, PhD, said the study "gives insights that will allow healthcare professionals and policy makers to put measures in place and create tailored plans to protect people from ethnic minority groups who are overweight or obese and thus try to reduce mortality."
Feb 2 Nat Commun study
Feb 2 University of Leicester press release