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Length of hospital stay and risk of intensive care admission and in-hospital death among COVID-19 patients in Norway : a register-based cohort study comparing patients fully vaccinated with an mRNA vaccine to unvaccinated patients

Whittaker, Robert ; Bråthen Kristofferson, Anja ; Valcarcel Salamanca, Beatriz ; Seppälä, Elina ; Golestani, Karan LU ; Kvåle, Reidar ; Watle, Sara Viksmoen and Buanes, Eirik Alnes (2022) In Clinical Microbiology and Infection 28(6). p.871-878
Abstract

OBJECTIVES: We estimated the length of stay (LoS) in hospital and the intensive care unit (ICU) and risk of admission to ICU and in-hospital death among COVID-19 patients ≥18 years in Norway who had been fully vaccinated with an mRNA vaccine (at least two doses or one dose and previous SARS-CoV-2 infection), compared to unvaccinated patients.

METHODS: Using national registry data, we analyzed SARS-CoV-2-positive patients hospitalized in Norway between 1 February and 30 November 2021, with COVID-19 as the main cause of hospitalization. We ran Cox proportional hazards models adjusting for vaccination status, age, sex, county of residence, regional health authority, date of admission, country of birth, virus variant, and underlying... (More)

OBJECTIVES: We estimated the length of stay (LoS) in hospital and the intensive care unit (ICU) and risk of admission to ICU and in-hospital death among COVID-19 patients ≥18 years in Norway who had been fully vaccinated with an mRNA vaccine (at least two doses or one dose and previous SARS-CoV-2 infection), compared to unvaccinated patients.

METHODS: Using national registry data, we analyzed SARS-CoV-2-positive patients hospitalized in Norway between 1 February and 30 November 2021, with COVID-19 as the main cause of hospitalization. We ran Cox proportional hazards models adjusting for vaccination status, age, sex, county of residence, regional health authority, date of admission, country of birth, virus variant, and underlying risk factors.

RESULTS: We included 716 fully vaccinated patients (crude overall median LoS: 5.2 days; admitted to ICU: 103 (14%); in-hospital death: 86 (13%)) and 2487 unvaccinated patients (crude overall median LoS: 5.0 days; admitted to ICU: 480 (19%); in-hospital death: 102 (4%)). In adjusted models, fully vaccinated patients had a shorter overall LoS in hospital (adjusted log hazard ratios (aHR) for discharge: 1.61, 95% CI: 1.24-2.08), shorter LoS without ICU (aHR: 1.27, 95% CI: 1.07-1.52), and lower risk of ICU admission (aHR: 0.50, 95% CI: 0.37-0.69) compared to unvaccinated patients. We observed no difference in the LoS in ICU or in risk of in-hospital death between fully vaccinated and unvaccinated patients.

DISCUSSION: Fully vaccinated patients hospitalized with COVID-19 in Norway have a shorter LoS and lower risk of ICU admission than unvaccinated patients. These findings can support patient management and ongoing capacity planning in hospitals.

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author
; ; ; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
keywords
COVID-19/epidemiology, Cohort Studies, Critical Care, Hospital Mortality, Hospitalization, Humans, Length of Stay, SARS-CoV-2/genetics, Vaccines, Synthetic, mRNA Vaccines
in
Clinical Microbiology and Infection
volume
28
issue
6
pages
871 - 878
publisher
Wiley-Blackwell
external identifiers
  • scopus:85126954374
  • pmid:35219807
ISSN
1469-0691
DOI
10.1016/j.cmi.2022.01.033
language
English
LU publication?
no
additional info
Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.
id
dba6a4cf-516b-46b7-8381-f94a3ef8bbc8
date added to LUP
2024-09-12 10:33:43
date last changed
2024-09-13 04:02:51
@article{dba6a4cf-516b-46b7-8381-f94a3ef8bbc8,
  abstract     = {{<p>OBJECTIVES: We estimated the length of stay (LoS) in hospital and the intensive care unit (ICU) and risk of admission to ICU and in-hospital death among COVID-19 patients ≥18 years in Norway who had been fully vaccinated with an mRNA vaccine (at least two doses or one dose and previous SARS-CoV-2 infection), compared to unvaccinated patients.</p><p>METHODS: Using national registry data, we analyzed SARS-CoV-2-positive patients hospitalized in Norway between 1 February and 30 November 2021, with COVID-19 as the main cause of hospitalization. We ran Cox proportional hazards models adjusting for vaccination status, age, sex, county of residence, regional health authority, date of admission, country of birth, virus variant, and underlying risk factors.</p><p>RESULTS: We included 716 fully vaccinated patients (crude overall median LoS: 5.2 days; admitted to ICU: 103 (14%); in-hospital death: 86 (13%)) and 2487 unvaccinated patients (crude overall median LoS: 5.0 days; admitted to ICU: 480 (19%); in-hospital death: 102 (4%)). In adjusted models, fully vaccinated patients had a shorter overall LoS in hospital (adjusted log hazard ratios (aHR) for discharge: 1.61, 95% CI: 1.24-2.08), shorter LoS without ICU (aHR: 1.27, 95% CI: 1.07-1.52), and lower risk of ICU admission (aHR: 0.50, 95% CI: 0.37-0.69) compared to unvaccinated patients. We observed no difference in the LoS in ICU or in risk of in-hospital death between fully vaccinated and unvaccinated patients.</p><p>DISCUSSION: Fully vaccinated patients hospitalized with COVID-19 in Norway have a shorter LoS and lower risk of ICU admission than unvaccinated patients. These findings can support patient management and ongoing capacity planning in hospitals.</p>}},
  author       = {{Whittaker, Robert and Bråthen Kristofferson, Anja and Valcarcel Salamanca, Beatriz and Seppälä, Elina and Golestani, Karan and Kvåle, Reidar and Watle, Sara Viksmoen and Buanes, Eirik Alnes}},
  issn         = {{1469-0691}},
  keywords     = {{COVID-19/epidemiology; Cohort Studies; Critical Care; Hospital Mortality; Hospitalization; Humans; Length of Stay; SARS-CoV-2/genetics; Vaccines, Synthetic; mRNA Vaccines}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{871--878}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Clinical Microbiology and Infection}},
  title        = {{Length of hospital stay and risk of intensive care admission and in-hospital death among COVID-19 patients in Norway : a register-based cohort study comparing patients fully vaccinated with an mRNA vaccine to unvaccinated patients}},
  url          = {{http://dx.doi.org/10.1016/j.cmi.2022.01.033}},
  doi          = {{10.1016/j.cmi.2022.01.033}},
  volume       = {{28}},
  year         = {{2022}},
}