Factors determining COVID-19 pneumonia severity in a country with routine BCG vaccination #MMPMID32813879
Aksu K; Naziroglu T; Ozkan P
Clin Exp Immunol 2020[Nov]; 202 (2): 220-225 PMID32813879show ga
BACKGROUND: The impact of countries' bacillus Calmette-Guerin (BCG) vaccination policies on the course of coronavirus disease (COVID-19) outbreak is a curiosity. In this study, the relationship between BCG vaccination status and severity of COVID-19 pneumonia and the factors affecting disease severity were investigated. METHODS: A retrospective cross-sectional study was conducted between March and June 2020 in patients diagnosed with COVID-19 pneumonia, confirmed by severe acute respiratory syndrome coronavirus-2 polymerase chain reaction positivity in a nasopharyngeal sample and pulmonary infiltrates in computed chest tomography, in a state hospital in Istanbul, Turkey. Socio-demographic features, body mass index, smoking status, concomitant diseases, income rates and BCG vaccination status of subjects were analyzed. RESULT: The study population comprised 123 adults with COVID-19 pneumonia [mean age = 49.7 years, standard deviation = 13.3 years; 82 (66.7%) male]. While the rate of cases vaccinated with BCG is lower (68.5 versus 88.2%, P = 0.026), mean age (54.0 +/- 11.5 years versus 38.3 +/- 10.7 years; P < 0.001), diabetes (32.6 versus 5.9%, P = 0.002) and low income (84.3 versus 52.9%, P < 0.001) are higher in patients with severe disease compared to those with mild disease. According to multivariate analysis increasing age [odds ratio (OR) = 1.119; 95% confidence interval (CI) = 1.062-1.178, P < 0.001] and low income (OR = 3.209; 95% CI = 1.008-10.222, P = 0.049) are associated with severe disease in COVID-19 pneumonia. CONCLUSION: This study reveals that BCG vaccination is not associated with disease severity in COVID-19 pneumonia. Age and low income are the main determinants of severe COVID-19 pneumonia.
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Clin+Exp+Immunol 2020 ; 202 (2): 220-225
