Gam-COVID-Vac, EpiVacCorona, and CoviVac effectiveness against lung injury during Delta and Omicron variant surges in St. Petersburg, Russia: a test-negative case-control study

Anton Barchuk, Anna Bulina, Mikhail Cherkashin, Natalia Berezina, Tatyana Rakova, Darya Kuplevatskaya, Dmitriy Skougarevskiy, Artemiy Okhotin, Anton Barchuk, Anna Bulina, Mikhail Cherkashin, Natalia Berezina, Tatyana Rakova, Darya Kuplevatskaya, Dmitriy Skougarevskiy, Artemiy Okhotin

Abstract

Background: Monitoring vaccine effectiveness (VE) remains a priority for epidemiological research throughout the COVID-19 pandemic. VE against infection declines with the emergence of new SARS-CoV-2 variants of concern (VOC), but VE against the severe disease remains high. Therefore, we aimed to estimate the effectiveness of COVID-19 vaccines used in Russia against lung injury during Delta and Omicron VOC surges.

Methods: We designed a case-control study (test-negative design) to estimate VE against any (any volume of involved lung parenchyma) and severe (>50% of involved parenchyma) lung injury detected on computer tomography and associated with COVID-19 between October 1, 2021-April 28, 2022 (Delta VOC dominance period followed by Omicron dominance period). We included the data of patients with symptomatic confirmed SARS-CoV-2 infection referred to the low-dose computer tomography triage centres.

Results: Among 23996 patients in the primary analysis, 13372 (55.7%) had any lung injury, and 338 (1.4%) had severe lung injury. The adjusted for age, sex and triage centre VE estimates against any lung injury were 56% (95% confidence interval 54-59) for two-dose Gam-COVID-Vac (Sputnik V), 71% (68-74) for three-dose Gam-COVID-Vac (booster), 2% (-27 to 24) for EpiVacCorona, and 46% (37-53) for CoviVac. VE estimates against severe lung injury were 76% (67-82) for two-dose Gam-COVID-Vac (Sputnik V), 87% (76-93) for three-dose Gam-COVID-Vac, 36% (-63 to 75) for EpiVacCorona, and 80% (45-92) for CoviVac.

Conclusions: Gam-COVID-Vac remained effective against lung injury associated with COVID-19 during Delta and Omicron VOC surges, and one Gam-COVID-Vac booster could be seen as an appropriate option after a two-dose regimen. CoviVac was also effective against lung injury. EpiVacCorona use in population-based vaccination should be halted until effectiveness and efficacy evidence is provided. Trial registration The joint study of COVID-19 vaccine effectiveness in St. Petersburg was registered at ClinicalTrials.gov (NCT04981405, date of registration-August 4, 2021).

Trial registration: ClinicalTrials.gov NCT04981405 NCT00498140.

Keywords: COVID-19; Case–control study; Lung injury; SARS-CoV-2; Vaccine effectiveness.

Conflict of interest statement

Anton Barchuk reports personal fees from AstraZeneca, MSD, and Biocad outside the submitted work. Other authors have no competing interest or competing interests to declare.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Study flowchart based on the primary outcome
Fig. 2
Fig. 2
Patients dynamics and proportion of patients with any lung injury through the study period October 2021–April 2022 (dashed vertical line marks the start of the Omicron surge)

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