Clinical and laboratory features of COVID-19 in the vaccinated patients and the patients after previous illness

Olga Riaba; Olga Golubovska

doi:10.32345/USMYJ.1(152).2025.38-46

Olga Riaba Infectious Diseases Department, O.O. Bogomolets National Medical University Bogomolets National Medical University, Kyiv, Ukraine https://orcid.org/0000-0003-4573-6858
Olga Golubovska Infectious Diseases Department, O.O. Bogomolets National Medical University Bogomolets National Medical University, Kyiv, Ukraine https://orcid.org/0000-0003-3455-8718

DOI: https://doi.org/10.32345/USMYJ.1(152).2025.38-46

Keywords: COVID-19; C-Reactive Protein; Diagnosis; Disease Progression; Lymphopenia; Pneumonia; Respiratory Insufficiency

Abstract

patients with COVID-19 can have a wide range of clinical manifestations: from generalized intoxication and respiratory symptoms to complaints from other organs and systems. The severity of the disease primarily depends on the age of the patients, the presence of comorbidities, and the susceptibility of the body to a particular variant of the SARS-CoV-2 virus. Vaccination and pre-infection provide a period of immune protection against reinfection. However, it has been reported that patients who have been vaccinated or have had COVID-19 can get sick in the same way as non-immune individuals. The aim of our study was to analyze and compare clinical and laboratory features of the course of coronavirus disease 2019 among hospitalized vaccinated patients who contracted COVID-19 for the first time and hospitalized unvaccinated patients who had previously contracted COVID-19, which was confirmed by laboratory tests. The study included 220 hospitalized patients who were divided into two groups: vaccinated patients who had no history of confirmed COVID-19 (n=129) and unvaccinated patients who had previously contracted COVID-19 (n=91). Results: unvaccinated patients who had history of confirmed COVID-19 had a more pronounced clinical picture of the disease; absolute lymphopenia was significantly more common in patients with severe and critical course in both study groups (p=0,0001); mean C-reactive protein values were statistically significantly different between patients of both groups with moderate, severe and critical course of COVID-19, and were the highest ones in patients with critical course who died (p=0,0001).

References

Hu B, Guo H, Zhou P, Shi ZL. Characteristics of SARS-CoV-2 and COVID-19. Nat Rev Microbiol. 2021 Mar;19(3):141-154. DOI: 10.1038/s41579-020-00459-7. Epub 2020 Oct 6. Erratum in: Nat Rev Microbiol. 2022 May;20(5):315. DOI: 10.1038/s41579-022-00711-2.

WHO. Coronavirus Disease 2019 (COVID-19) Situation Report -51 SITUATION IN NUMBERS Total and New Cases in Last 24 Hours [Internet]. 2020 Mar. Available from: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200311-sitrep-51-covid-19.pdf?sfvrsn=1ba62e57_10.

World Health Organization. Statement on the Fifteenth Meeting of the International Health Regulations (2005) Emergency Committee regarding the Coronavirus Disease (COVID-19) Pandemic [Internet]. www.who.int. 2023. Available from: https://www.who.int/news/item/05-05-2023-statement-on-the-fifteenth-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-coronavirus-disease-(covid-19)-pandemic.

Umakanthan S, Sahu P, Ranade AV, Bukelo MM, Rao JS, Abrahao-Machado LF, Dahal S, Kumar H, Kv D. Origin, transmission, diagnosis and management of coronavirus disease 2019 (COVID-19). Postgrad Med J. 2020 Dec;96(1142):753-758. DOI: 10.1136/postgradmedj-2020-138234.

Majumder J, Minko T. Recent Developments on Therapeutic and Diagnostic Approaches for COVID-19. AAPS J. 2021 Jan 5;23(1):14. DOI: 10.1208/s12248-020-00532-2.

Safiabadi Tali SH, LeBlanc JJ, Sadiq Z, Oyewunmi OD, Camargo C, Nikpour B, Armanfard N, Sagan SM, Jahanshahi-Anbuhi S. Tools and Techniques for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)/COVID-19 Detection. Clin Microbiol Rev. 2021 May 12;34(3):e00228-20. DOI: 10.1128/CMR.00228-20.

Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, Liu L, Shan H, Lei CL, Hui DSC, Du B, Li LJ, Zeng G, Yuen KY, Chen RC, Tang CL, Wang T, Chen PY, Xiang J, Li SY, Wang JL, Liang ZJ, Peng YX, Wei L, Liu Y, Hu YH, Peng P, Wang JM, Liu JY, Chen Z, Li G, Zheng ZJ, Qiu SQ, Luo J, Ye CJ, Zhu SY, Zhong NS; China Medical Treatment Expert Group for Covid-19. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020 Apr 30;382(18):1708-1720. DOI: 10.1056/NEJMoa2002032.

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 Feb 15;395(10223):497-506. DOI: 10.1016/S0140-6736(20)30183-5. Epub 2020 Jan 24. Erratum in: Lancet. 2020 Feb 15;395(10223):496. DOI: 10.1016/S0140-6736(20)30252-X.

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, Xiang H, Cheng Z, Xiong Y, Zhao Y, Li Y, Wang X, Peng Z. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020 Mar 17;323(11):1061-1069. DOI: 10.1001/jama.2020.1585. Erratum in: JAMA. 2021 Mar 16;325(11):1113. DOI: 10.1001/jama.2021.2336.

Giacomelli A, Pezzati L, Conti F, Bernacchia D, Siano M, Oreni L, Rusconi S, Gervasoni C, Ridolfo AL, Rizzardini G, Antinori S, Galli M. Self-reported Olfactory and Taste Disorders in Patients With Severe Acute Respiratory Coronavirus 2 Infection: A Cross-sectional Study. Clin Infect Dis. 2020 Jul 28;71(15):889-890. DOI: 10.1093/cid/ciaa330.

Struyf T, Deeks JJ, Dinnes J, Takwoingi Y, Davenport C, Leeflang MM, Spijker R, Hooft L, Emperador D, Dittrich S, Domen J, Horn SRA, Van den Bruel A; Cochrane COVID-19 Diagnostic Test Accuracy Group. Signs and symptoms to determine if a patient presenting in primary care or hospital outpatient settings has COVID-19 disease. Cochrane Database Syst Rev. 2020 Jul 7;7(7):CD013665. DOI: 10.1002/14651858.CD013665. Update in: Cochrane Database Syst Rev. 2021 Feb 23;2:CD013665. DOI: 10.1002/14651858.CD013665.pub2.

da Rosa Mesquita R, Francelino Silva Junior LC, Santos Santana FM, Farias de Oliveira T, Campos Alcântara R, Monteiro Arnozo G, Rodrigues da Silva Filho E, Galdino Dos Santos AG, Oliveira da Cunha EJ, Salgueiro de Aquino SH, Freire de Souza CD. Clinical manifestations of COVID-19 in the general population: systematic review. Wien Klin Wochenschr. 2021 Apr;133(7-8):377-382. DOI: 10.1007/s00508-020-01760-4.

Vetter P, Vu DL, L'Huillier AG, Schibler M, Kaiser L, Jacquerioz F. Clinical features of covid-19. BMJ. 2020 Apr 17;369:m1470. DOI: 10.1136/bmj.m1470.

CDC. Underlying Conditions and the Higher Risk for Severe COVID-19 [Internet]. COVID-19. 2024. Available from: https://www.cdc.gov/covid/hcp/clinical-care/underlying-conditions.html.

Tartof SY, Xie F, Yadav R, Wernli KJ, Martin ET, Belongia EA, Gaglani M, Zimmerman RK, Talbot HK, Thornburg N, Flannery B; US Flu VE Network Investigators. Prior SARS-CoV-2 infection and COVID-19 vaccine effectiveness against outpatient illness during widespread circulation of SARS-CoV-2 Omicron variant, US Flu VE network. Influenza Other Respir Viruses. 2023 May;17(5):e13143. DOI: 10.1111/irv.13143.

Vitale J, Mumoli N, Clerici P, De Paschale M, Evangelista I, Cei M, Mazzone A. Assessment of SARS-CoV-2 Reinfection 1 Year After Primary Infection in a Population in Lombardy, Italy. JAMA Intern Med. 2021 Oct 1;181(10):1407-1408. DOI: 10.1001/jamainternmed.2021.2959.

Matuchansky C. Protection against SARS-CoV-2 after Vaccination and Previous Infection. N Engl J Med. 2022 Jun 30;386(26):2534. DOI: 10.1056/NEJMc2205618.