Factors determining COVID‐19 pneumonia severity in a country with routine BCG vaccination. (17th September 2020)

• Record Type: Journal Article
• Authors: Aksu, K.; Naziroğlu, T.; Özkan, P.
• Is Part Of: Clinical and experimental immunology. Volume 202:Number 2(2020)
• Page Start: 220
• Page End: 225
• Publication Date: 2020-09-17
• Subjects: bacillus Calmette–Guérin -- COVID‐19 -- diabetes mellitus -- hypertension -- income -- SARS‐CoV‐2 -- severity -- smoking; Immunopathology -- Periodicals; 616.079
• DOI: 10.1111/cei.13507
• Languages: English
• ISSNs: 0009-9104

Abstract

Summary: Background: The impact of countries' bacillus Calmette–Guérin (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. Abstract : Sociodemographic features, body mass index, smoking status, concomitant diseases, income rates, and BCG vaccination status of subjects were analyzed in 123 patients diagnosed with COVID‐19 pneumonia in a state hospital in Istanbul, Turkey. 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.