Vaccination against the SARS-CoV-2 in individuals with comorbidities

Aim. To assess post-vaccination period and the incidence of coronavirus disease 2019 (COVID-19) in comorbid individuals vaccinated and revaccinated against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Material and methods. The study was conducted within the prospective SATURN registry, which included individuals who received various revaccination regimens against the SARS-CoV-2 (homoand heterologous regimens) based on a combination of two vaccines (GamCOVID-Vac and CoviVac). A total of 200 respondents participated in the study, who were divided into 2 groups depending on the Charlson comorbidity index score. Group I included participants (n=172) with a score of 0-1, which implies a high percentage (99-96%) of survival in the next 10 years. Group II included participants (n=28) with a Charlson index score of 2-4, where the survival rate is significantly lower and varies from 90 to 53%.

Results. One year after vaccination (visit 3) and further in each of the groups, the anti-SARS-CoV-2 IgG level significantly exceeded the reference values (≥499 BAU/ml). The immunity durability was maintained throughout the entire follow-up period. The COVID-19 rate in the post-vaccination period (visit 3 and further) among the study participants varied from 0 to 50% of respondents in different groups (p>0,05). During the same time periods, according to the Hospital Anxiety and Depression Scale (HADS), the median of both anxiety and depression in each of the groups ranged from 0 to 7, which indicates the absence of severe symptoms of these conditions in most program participants. The prevalence of suband clinically pronounced depression did not differ between the groups at each visit. The incidence of clinical anxiety at visit 3 was significantly higher in the group of comorbid patients (16,7 vs 1,8%, p<0,05). However, during further follow-up in group II, there was not a single participant with clinical anxiety.

Conclusion. The use of Russian vaccines (Gam-COVID-Vac and CoviVac) is equally effective in each of the studied groups. There were no significant differences between them in COVID-19 incidence after vaccination/revaccination. When assessing the post-vaccination period, our attention was focused on the mental status of the participants. During one of the control visits at the revaccination stage (visit 3), the incidence of clinical anxiety in the group of comorbid patients (II) was higher. However, establishing the cause-and-effect relationships with other factors is currently difficult and requires further research.

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