Lack of full COVID-19 vaccination raises risk for nonrespiratory features in all variants

Key takeaways:

• Nonrespiratory features of COVID-19 occurred in more individuals without complete vaccination.
• Omicron or delta variants in combination with incomplete vaccination meant a heightened likelihood for mortality.

WASHINGTON — Those with incomplete COVID-19 vaccination faced elevated risk for nonrespiratory features, such as fever and tachycardia, according to research presented at the American Thoracic Society International Conference.

Shannon Cotton

“Our study involving 65,000 people underscore the benefits of vaccination,” Shannon Cotton, BSN, RN, CCRN, ICU nurse at UC San Diego Health and nursing science PhD student at Sue and Bill Gross School of Nursing at University of California, Irvine, told Healio. “Our research adds to the growing body of evidence to support the recommendation of vaccination from health care providers, especially against the backdrop of pandemic fatigue among the general public and the need for additional boosters on potentially a yearly basis.”

Cotton and colleagues assessed patients in the University of California Health COVID Research Data Set (UC CORDS) who contracted COVID-19 to see how different SARS-CoV-2 variants change the prevalence of nonrespiratory features and mortality in those with full vaccination (n = 7,997) and those without full vaccination (n = 55,573).

According to the abstract, researchers used the CDC data tracker in this retrospective study to classify variants: founder (n = 3,465), alpha (n = 26,274), delta (n = 7,786) and omicron (n = 27,633).

Additionally, several organ systems — such as cardiovascular, endocrine and metabolic, gastrointestinal, immunological, neurological, lower respiratory and upper respiratory — were charted to observe which are affected by certain COVID-19 variants.

In all evaluated variants and both types of vaccinated individuals, the most frequent feature was fever, but individuals not fully vaccinated showed “significantly higher” fever with delta and omicron infections (P = .001 for both).

Individuals without full vaccination and an omicron infection also had increased cardiac features, with tachycardia occurring frequently in these individuals and those lacking full vaccination with the delta variant, according to the release.

COVID-19 features of diabetes and GERD were similar to fever in that they were seen in all variants and occurred in both fully vaccinated and non-fully vaccinated individuals.

“We were very surprised to find that fever was the most common feature across all variants,” Cotton told Healio. “Additionally, it was interesting to see the data showing that for nearly every symptom, effects were worse in the nonvaccinated group. These findings are aligned with other studies that show the benefits of vaccination likely extend beyond reducing death, but also lessening the severity of symptoms.”

In terms of mortality, the omicron or delta variants in combination with not being fully vaccinated were each linked to a heightened odds for mortality (OR = 1.96; P < .01 and OR = 1.64; P = .052, respectively), according to the abstract.

“We believe that future studies should focus on prospective data, specifically in patients with post-acute sequelae of COVID-19 [PASC] or long-COVID linking features of variants to symptoms of PASC,” Cotton told Healio. “We firmly believe this can help guide clinicians in the care and treatment of patients with PASC.”

Reference:

• Fever found to be most common non-respiratory feature of SARS-Cov-2 infection. https://www.thoracic.org/about/newsroom/press-releases/conference/resources/sars-covid-2-and-fever.pdf. Published May 23, 2023. Accessed May 23, 2023.