Comprehensive statistical analysis reveals significant benefits of COVID-19 vaccination in hospitalized patients: propensity score, covariate adjustment, and feature importance by permutation

作者：Esther Moraes, Magda Carvalho Pires, Ana Clara Rodrigues da Costa, Aline Gabrielle Sousa Nunes, Caroline Lopes de Amorim, Euler Roberto Fernandes Manenti, Fernanda Barbosa Lucas, Fernanda d’Athayde Rodrigues, Fernando Anschau, Guilherme Fonseca, Giovanna Grünewald Vietta, Jessica Moreira, Karen Brasil Ruschel, Mônica Aparecida Costa, Pamela Andrea Alves Durães, Pedro Augusto Van Der Sand Germani, Priscilla Pereira dos Reis, Rochele Mosmann Menezes, Leonardo Rocha, Marcos André Gonçalves, Unaí Tupinambás, Milena Soriano Marcolino · 发表于：BMC Infectious Diseases · 年份：2024 · DOI：10.1186/s12879-024-09865-1 · 被引用次数：6 · 研究领域：SARS-CoV-2 and COVID-19 Research、Vaccine Coverage and Hesitancy、Immune responses and vaccinations

BACKGROUND: COVID-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. METHODS: This 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. RESULTS: From 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 ...