Clinical and Imaging Characteristics of SARS-CoV-2 Breakthrough Infection in Hospitalized Immunocompromised Patients

被引:1
作者
Lee, Jong Eun [1 ,10 ,11 ]
Kim, Jinwoo [2 ]
Hwang, Minhee [3 ,4 ]
Kim, Yun-Hyeon [5 ]
Chung, Myung Jin [6 ,7 ]
Jeong, Won Gi [8 ,9 ]
Jeong, Yeon Joo [2 ]
机构
[1] Chonnam Natl Univ Hosp, Dept Radiol, Gwangju, South Korea
[2] Pusan Natl Univ, Sch Med, Res Inst Convergence Biomed Sci & Technol, Dept Radiol,Yangsan Hosp, 20 Geumo Ro, Yangsan 50612, South Korea
[3] Pusan Natl Univ, Pusan Natl Univ Hosp, Sch Med, Dept Radiol, Busan, South Korea
[4] Biomed Res Inst, Busan, South Korea
[5] Chonnam Natl Univ, Chonnam Natl Univ Hosp, Med Sch, Dept Radiol & Biomed Engn, Gwangju, South Korea
[6] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Radiol, Seoul, South Korea
[7] Sungkyunkwan Univ, Ctr Imaging Sci, Sch Med, Samsung Med Ctr, Seoul, South Korea
[8] Chonnam Natl Univ, Hwasun Hosp, Dept Radiol, Hwasun, South Korea
[9] Chonnam Natl Univ, Med Sch, Hwasun, South Korea
[10] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Radiol, Seoul, South Korea
[11] Univ Ulsan, Res Inst Radiol, Coll Med, Asan Med Ctr, Seoul, South Korea
关键词
COVID-19; Breakthrough infections; Immunocompromised host; Computed tomography; Treatment outcome; COVID-19; OUTCOMES;
D O I
10.3348/kjr.2023.0992
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Objective: To evaluate the clinical and imaging characteristics of SARS-CoV-2 breakthrough infection in hospitalized immunocompromised patients in comparison with immunocompetent patients. Materials and Methods: This retrospective study analyzed consecutive adult patients hospitalized for COVID-19 who received at least one dose of the SARS-CoV-2 vaccine at two academic medical centers between June 2021 and December 2022. Immunocompromised patients (with active solid organ cancer, active hematologic cancer, active immune-mediated inflammatory disease, status post solid organ transplantation, or acquired immune deficiency syndrome) were compared with immunocompetent patients. Multivariable logistic regression analysis was performed to evaluate the effect of immune status on severe clinical outcomes (in-hospital death, mechanical ventilation, or intensive care unit admission), severe radiologic pneumonia (>= 25% of lung involvement), and typical CT pneumonia. Results: Of 2218 patients (mean age, 69.5 +/- 16.1 years), 274 (12.4%), and 1944 (87.6%) were immunocompromised an immunocompetent, respectively. Patients with active solid organ cancer and patients status post solid organ transplantation had significantly higher risks for severe clinical outcomes (adjusted odds ratio = 1.58 [95% confidence interval {CI}, 1.01- 2.47], P = 0.042; and 3.12 [95% CI, 1.47-6.60], P = 0.003, respectively). Patient status post solid organ transplantation and patients with active hematologic cancer were associated with increased risks for severe pneumonia based on chest radiographs (2.96 [95% CI, 1.54-5.67], P = 0.001; and 2.87 [95% CI, 1.50-5.49], P = 0.001, respectively) and for typical CT pneumonia (9.03 [95% CI, 2.49-32.66], P < 0.001; and 4.18 [95% CI, 1.70-10.25], P = 0.002, respectively). Conclusion: Immunocompromised patients with COVID-19 breakthrough infection showed an increased risk of severe clinical outcome, severe pneumonia based on chest radiographs, and typical CT pneumonia. In particular, patients status post solid organ transplantation was specifically found to be associated with a higher risk of all three outcomes than hospitalized immunocompetent patients.
引用
收藏
页码:481 / 492
页数:12
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