Impact of vaccination status on the clinical course and outcomes of acute COVID-19 period: data from the international registry "Dynamics Analysis of Comorbidities in SARS-CoV-2 Survivors" (AKTIV-4)

G. P. Arutyunov, Ekaterina Iosifovna Tarlovskaya, A. G. Arutyunov, Поляков Дмитрий Сергеевич, Yu. M. Lopatin, Anna I. Chesnikova, Лариса Александровна Балыкова, А. Р. Вайсберг, Albert S. Galyavich, Наталья Юрьевна Григорьева

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Vladimir B. Grinevich, И. В. Губарева, Ирина Владимировна Демко, Александр Вячеславович Жарков, Д. Н. Зайцев, ZULFIYA F. KIM, Коробка Вячеслав Леонидович, Наталья Викторовна Ларева, Е. В. Макарова, Svetlana V. Malchikova, Sergey Vladimirovich Nedogoda, А. Г. Обрезан, Arman Hovakimyan, S. V. Pereverzev, Марина Михайловна Петрова, И. Г. Починка, Константин Викторович Протасов, Проценко Денис Николаевич, Andrey P. Rebrov, Olesya A. Rubanenko, D. Yu. Ruzanov, Alla V. Svarovskaya, Н. М. Селезнева, Е. А. Смирнова, Akhmetzhan Sugraliyev, Olga V. Khlynova, Шапошник Игорь Иосифович, D. A. Schukarev, A. K. Abdrakhmanova, T.P. Abdualimov, Агафонов Александр Валерьевич, V. G. Hakobjanyan, Аллахкулиева Л. Н., Апаркина Алена Васильевна, Olga Yu. Barysheva, Т. И. Батлук, A. S. Batchayeva, R. A. Bashkinov, Ya. A. Belenikina, Бикушова Ирина Валерьевна, Aigerim Z. Botabekova, Светлана Николаевна Ботова, V. O. Bochkareva, G. A. Bykova, K. R. Vagapova, Vasilen Vasilev, Natalia N. Vezikova, K. Viktorov, V. V. Genkel, A. I. Girivenko, O. P. Girich, Е. С. Годунко, Natalia V. Gordeeva, Elizaveta Gordeychuk, Е. И. Горшенина, E. V. Grigoryeva, E. Yu. Gubareva, Igor Leonidovich Davydkin, Amangul Duisenova, Д. С. Евдокимов, Larisa S. Evdokimova, A. E. Zheldybayeva, Yu. D. Zimina, I. A. Zolotovskaya, E. Yu. Ivanchenko, A. K. Izhanova, M. V. Kazakovtseva, Sarkis Ghazaryan, M. K. Kaidarbek, I. A. Karetnikov, Нина Анатольевна Кароли, Darya S. Kaskaeva, E. S. Kim, Evgeny Vyacheslavovich Kozlov, V.I. Koliev, M. I. Kolyadich, D. Yu. Konstantinov, Е. А. Константинова, A. K. Konussova, A. V. Korobka, A. A. Korolev, N. B. Kosacheva, Yu. A. Kravchuk, А. Yu. Kraposhina, T. V. Kryukova, А. С. Кузнецова, K. V. Kuzmichev, O. Yu. Kuchiyash, Yu. I. Lebedeva, Т. М. Левина

Russian Journal of Cardiology, 2025

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DOI 10.15829/1560-4071-2025-6010

Data confidence 70 medium

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Abstract

Aim. To assess the effectiveness of vaccination against Omicron and Delta variants according to the international registry "Dynamics Analysis of Comorbidities in SARS-CoV-2 Survivors" (AKTIV-4).Material and methods. The AKTIV-4 registry included men and women over 18 years of age with a diagnosis of coronavirus disease 2019 (COVID-19) (oropharyngeal and nasopharyngeal swabs, SARS-CoV-2 antibody titers, typical computed tomography performance), undergoing hospital treatment. A total of 3543 patients from 25 medical centers in 7 countries (the Russian Federation, the Republic of Armenia, the Republic of Belarus, the Republic of Kazakhstan, the Kyrgyz Republic, the Republic of Moldova, and the Republic of Uzbekistan) were included in the AKTIV-4 registry.Results. The clinical status of patients from the AKTIV-4 registry was more severe than in the AKTIV-1 and AKTIV-2 registries. Patients in the AKTIV-4 registry were older than patients in the AKTIV-1 registry. The inhospital mortality rate in patients in the AKTIV-4 registry was higher (8,41%, p<0,001) than in the population of patients in the AKTIV-1 (7,60%) and AKTIV-2 (4,80%) registries. Of the 3543 patients included in AKTIV-4, 36% were vaccinated. Among the vaccines, Sputnik V (GamCOVID-Vac) was the leader in primary and repeated vaccination, used in 77,8% and 61,0%, respectively. In the population of unvaccinated patients, there were more patients with a high risk of an unfavorable prognosis than in the vaccinated as follows: older age, coronary artery disease, class 3-4 heart failure, atrial fibrillation, chronic kidney disease, and anemia. Unvaccinated patients had a higher volume of lung damage compared to vaccinated patients, and bacterial pneumonia and acute respiratory distress syndrome developed more often. Among those who died in hospital, unvaccinated patients predominated (89,14%). Inhospital mortality for unvaccinated patients was 9,9%, while for vaccinated ones — 3,3% (odds ratio (OR) 0,31 [0,20;0,45], p<0,001). In patients within 3, 4-6, and ≥7 months after vaccination, the mortality rate was 3,12% (OR 0,30 [0,16;0,51], p<0,001), 4,00% (OR 0,39 [0,20;0,67], p<0,001), and 2,96% (OR 0,29 [0,09;0,70], p<0,001). Inhospital mortality of vaccinated patients did not differ significantly depending on the type of vaccine.Conclusion. Vaccination, primarily with Sputnik V, is an independent predictor of survival in hospitalized COVID-19 patients and reduces the risk of death by 62% according to multivariate analysis.