Document Type : Original Article
Authors
- Maryam Edalatifard 1
- Nooshin Jalili 2
- Shalaleh Aghaei 3
- Niloofar Khoshnam Rad 1
- Manijeh Jozpanahi 4
- Besharat Rahimi 1
- Zohre Naderi 5
- Somaye Rezaian 6
- Zahra Habibi Dastenaei 7
- Sara Soltan Mohammadi 1
- Alireza Saheb Ekhtiari 8
- Nima Bahram 8
- Hajar Beigy 9
- Mohamadjavad Malekmohamadi 10
- Mohammad Rezaian 11
1 Thoracic Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
2 Department of Internal Medicine, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.
3 Student Research Committee, Zanjan University of Medical Sciences, Zanjan, Iran.
4 Department of Infectious Diseases, Vali-e-Asr Hospital, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.
5 Department of Internal Medicine, Isfahan University of Medicine Sciences, Isfahan, Iran.
6 Department of Internal Medicine, Alborz University of Medicine Sciences, Alborz, Iran.
7 Development Unit, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran.
8 Vali-e-Asr Hospital, Zanjan University of Medical Sciences, Zanjan, Iran.
9 Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
10 Student Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran.
11 Department of Toxicology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran.
Abstract
Introduction:
Vaccination against SARS-CoV-2 is seen as a cornerstone of pandemic control efforts. As there are limited data on the efficacy of vaccination in Iran against the Omicron variant, we aimed to explore the effects of vaccination on clinical outcomes in hospitalized adult patients.
Methods:
We conducted a prospective, multi-center observational study in five tertiary hospitals across Iran. Adult patients with confirmed COVID-19 by PCR were followed until discharge or death. Patients were compared based on their COVID-19 vaccination history (unvaccinated, partially vaccinated, or fully vaccinated). The primary outcome was COVID-19-related mortality; and the secondary outcomes were ICU admission and length of hospital stay.
Results:
Of the 813 hospitalized patients, 211 (26.0%) were unvaccinated, 296 (36.4%) were partially vaccinated, and 306 (37.6%) were fully vaccinated. The overall mortality rate was 14.5%. Mortality was highest in unvaccinated patients (18.0%), compared to partially vaccinated (14.8%) and fully vaccinated patients (11.7%). The difference across these groups was not statistically significant (p=0.13); however, pooling all vaccinated patients showed a significantly lower mortality compared with unvaccinated individuals (13.1% vs. 18.0%, p=0.04). Logistic regression analysis revealed that advanced age (p=0.003), malignancy (p=0.001), patchy ground-glass opacities (p=0.048), and higher percentage of lung involvement (p<0.001) were independent predictors of mortality.
Conclusions:
In this multicenter cohort study, real-world evidence from Iran suggests that COVID-19 vaccination was associated with lower in-hospital mortality during the Omicron wave, with the most favorable outcomes observed in patients who had received three vaccine doses.
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