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Association between influenza vaccination and hospitalisation or all-cause mortality in people with COVID-19: a retrospective cohort study

Association between influenza vaccination and hospitalisation or all-cause mortality in people with COVID-19: a retrospective cohort study
Association between influenza vaccination and hospitalisation or all-cause mortality in people with COVID-19: a retrospective cohort study

Introduction recent evidence suggests that influenza vaccination may offer protection against COVID-19 severity. Our aim was to quantify the association between influenza vaccination status and risk of hospitalisation or all-cause mortality in people diagnosed with COVID-19. 

Methods: a retrospective cohort study using routinely collected health records from patients registered to a General Practitioner (GP) practice in South West England within the Electronic Care and Health Information Analytics database. The cohort included 6921 people with COVID-19 during the first wave of the pandemic (1 January-31 July 2020). Data on influenza vaccination, hospitalisation and all-cause mortality were ascertained through linked clinical and demographic records. We applied propensity score methods (stabilised inverse probability of treatment weight) to quantify the association between influenza vaccination status and COVID-19 outcomes (hospitalisation or all-cause mortality). 

Results: 2613 (38%) participants received an influenza vaccination between 1 January 2019 and COVID-19 diagnosis. Receipt of influenza vaccination was associated with a significantly lower odds of hospitalisation or all-cause mortality (adjusted OR: 0.85, 95% CI 0.75 to 0.97, p=0.02), and 24% reduced odds of all-cause mortality (adjusted OR: 0.76, 95% CI 0.64 to 0.90). 

Discussion: influenza vaccination was associated with a 15%-24% lower odds of severe COVID-19 outcomes. The current UK influenza vaccination programme needs urgent expansion as an integral component of the ongoing response plans to the COVID-19 pandemic.

COVID-19, infection control, innate immunity, respiratory infection
2052-4439
Wilcox, Christopher R.
e2c4c36a-e2e5-43a5-9fd6-7198cc15dd53
Islam, Nazrul
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Dambha-Miller, Hajira
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Wilcox, Christopher R.
e2c4c36a-e2e5-43a5-9fd6-7198cc15dd53
Islam, Nazrul
e5345196-7479-438f-b4f6-c372d2135586
Dambha-Miller, Hajira
58961db5-31aa-460e-9394-08590c4b7ba1

Wilcox, Christopher R., Islam, Nazrul and Dambha-Miller, Hajira (2021) Association between influenza vaccination and hospitalisation or all-cause mortality in people with COVID-19: a retrospective cohort study. BMJ Open Respiratory Research, 8 (1), [2020000857]. (doi:10.1136/bmjresp-2020-000857).

Record type: Article

Abstract

Introduction recent evidence suggests that influenza vaccination may offer protection against COVID-19 severity. Our aim was to quantify the association between influenza vaccination status and risk of hospitalisation or all-cause mortality in people diagnosed with COVID-19. 

Methods: a retrospective cohort study using routinely collected health records from patients registered to a General Practitioner (GP) practice in South West England within the Electronic Care and Health Information Analytics database. The cohort included 6921 people with COVID-19 during the first wave of the pandemic (1 January-31 July 2020). Data on influenza vaccination, hospitalisation and all-cause mortality were ascertained through linked clinical and demographic records. We applied propensity score methods (stabilised inverse probability of treatment weight) to quantify the association between influenza vaccination status and COVID-19 outcomes (hospitalisation or all-cause mortality). 

Results: 2613 (38%) participants received an influenza vaccination between 1 January 2019 and COVID-19 diagnosis. Receipt of influenza vaccination was associated with a significantly lower odds of hospitalisation or all-cause mortality (adjusted OR: 0.85, 95% CI 0.75 to 0.97, p=0.02), and 24% reduced odds of all-cause mortality (adjusted OR: 0.76, 95% CI 0.64 to 0.90). 

Discussion: influenza vaccination was associated with a 15%-24% lower odds of severe COVID-19 outcomes. The current UK influenza vaccination programme needs urgent expansion as an integral component of the ongoing response plans to the COVID-19 pandemic.

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Accepted/In Press date: 9 January 2021
Published date: 4 March 2021
Additional Information: Funding Information: Funding HD-M is a National Institute for Health Research (NIHR) funded Academic Clinical Lecturer at the University of Southampton and has received NIHR School of Primary Care Research (SPCR) funding to support her COVID-19 work (SPCR2014-10043). CW is an NIHR-funded Academic Clinical Fellow at the University of Southampton. Open access funding for publication of this article was provided by the University of Southampton. NI received salary support from the Nuffield Department of Population Health at the University of Oxford. Publisher Copyright: © 2021 BMJ. All rights reserved. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
Keywords: COVID-19, infection control, innate immunity, respiratory infection

Identifiers

Local EPrints ID: 450512
URI: http://eprints.soton.ac.uk/id/eprint/450512
ISSN: 2052-4439
PURE UUID: cadde401-0134-4456-bac4-3a4fd28e0be9
ORCID for Nazrul Islam: ORCID iD orcid.org/0000-0003-3982-4325
ORCID for Hajira Dambha-Miller: ORCID iD orcid.org/0000-0003-0175-443X

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Date deposited: 02 Aug 2021 16:30
Last modified: 18 Mar 2024 04:07

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Author: Nazrul Islam ORCID iD

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