BACKGROUND: Individuals vaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), when infected, can still develop disease that requires hospitalization. It remains unclear whether these patients differ from hospitalized unvaccinated patients with regard to presentation, coexisting comorbidities, and outcomes.

METHODS: Here, we use data from an international consortium to study this question and assess whether differences between these groups are context specific. Data from 83,163 hospitalized COVID-19 patients (34,843 vaccinated, 48,320 unvaccinated) from 38 countries were analyzed.

FINDINGS: While typical symptoms were more often reported in unvaccinated patients, comorbidities, including some associated with worse prognosis in previous studies, were more common in vaccinated patients. Considerable between-country variation in both in-hospital fatality risk and vaccinated-versus-unvaccinated difference in this outcome was observed.

CONCLUSIONS: These findings will inform allocation of healthcare resources in future surges as well as design of longer-term international studies to characterize changes in clinical profile of hospitalized COVID-19 patients related to vaccination history.

FUNDING: This work was made possible by the UK Foreign, Commonwealth and Development Office and Wellcome (215091/Z/18/Z, 222410/Z/21/Z, 225288/Z/22/Z, and 220757/Z/20/Z); the Bill & Melinda Gates Foundation (OPP1209135); and the philanthropic support of the donors to the University of Oxford's COVID-19 Research Response Fund (0009109). Additional funders are listed in the "acknowledgments" section.

Cite as

Gonçalves, B., Jassat, W., Baruch, J., Hashmi, M., Rojek, A., Dasgupta, A., Martin-Loeches, I., Reyes, L., Piubelli, C., Citarella, B., Kartsonaki, C., Lefèvre, B., Lopez-Revilla, J., Lunn, M., Harrison, E., Kraemer, M., Shrapnel, S., Horby, P., Bisoffi, Z., Olliaro, P., Merson, L. & ISARIC Clinical Characterisation Group 2023, 'A multi-country analysis of COVID-19 hospitalizations by vaccination status', Med. https://doi.org/10.1016/j.medj.2023.08.005

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Last updated: 03 May 2024
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