key: cord-0745573-o6jt8vp9
authors: Egan, C.; Turtle, L.; Thorpe, M.; Harrison, E. M.; Semple, M. G.; Docherty, A. B.
title: Hospital admission for symptomatic COVID‐19 and impact of vaccination: analysis of linked data from the Coronavirus Clinical Information Network and the National Immunisation Management Service
date: 2022-02-18
journal: Anaesthesia
DOI: 10.1111/anae.15677
sha: 629eb828817c477bd42f01cd50888fde944f24fb
doc_id: 745573
cord_uid: o6jt8vp9

nan

SARS-CoV-2 vaccines administered in the UK are highly effective in preventing hospitalisation and death from COVID-19 [1] . Patients with immunocompromise are less likely to be able to mount a satisfactory immunological response to the vaccine and therefore may remain at higher risk of moderate-to-severe COVID-19 [2] . Understanding the reasons and risk-factors for admission will provide insight into strategies for future vaccination. This study aimed to characterise the hospitalised vaccinated population and identify the effect of the relationship between vaccination status and immunocompetence on hospital mortality using the prospective observational cohort recruited from the UK Coronavirus Clinical Information Network (CO-CIN).

ISARIC4C/CO-CIN collected data on hospitalised patients with COVID-19 in the UK since February 2020 [3] .

The National Immunisation Management Service contains vaccine type and date of first and/or second vaccination since the COVID-19 vaccination programme started in the UK on 8 December 2020. We linked data in CO-CIN and the National Immunisation Management Service and restricted our population to adults admitted to hospital with symptomatic polymerase chain reaction (PCR)-positive SARS-CoV-2 infection with at least 28 days of follow-up. This is a complete case analysis. Patients with re-infection were removed from this analysis. We categorised patients into the following three groups: no virus immunityunvaccinated patients and patients experiencing symptoms ≤ 20 days after first vaccination dose [4] ; first dose failure - Table 1) .

After adjustment, vaccination reduced the odds of mortality in patients admitted to hospital ( Fig. 1 and online Supporting Information Figure S3 ). Immunocompromised patients had consistently higher odds of mortality compared with immunocompetent patients (Fig. 1) , and there was a significant interaction between vaccination status and immunocompromise (p = 0.001).

since the vaccination programme began in the UK have not been vaccinated, and for those who have received a vaccine, most admissions occurred within 3 weeks of the first dose before the vaccine would be expected to be effective (see online Supporting Information Figure S1 ). It is important to highlight to the general population that there is a lag between receiving a vaccination and developing the immunity required to prevent hospitalisation or death, as awareness may alter postvaccination behaviour. We found that vaccination generally 

Additional supporting information may be found online via the journal website. 

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The authors acknowledge the data linkages undertaken by N. Tarbatt and N. Abbotts (NHS England). This work is supported by grants from the NIHR, the MRC and by

University of Edinburgh, Edinburgh, UK