Authors
Anderson E. Ikeokwu, Rebecca Lawrence, Egbaoghene D. Osieme, Khalifa M. Gidado, Cullen Guy, Oladejo Dolapo
Introduction
The COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in a significant number of cases and deaths worldwide. Vaccination is the most effective preventive measure against the disease. This study aimed to assess the mortality rates of COVID-19 patients in the United States and the effectiveness of Pfizer, Moderna and Johnson & Johnson vaccines in preventing mortality.
Methods
A systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-2020) guidelines. Studies comparing vaccinated and unvaccinated groups in terms of COVID-19 outcomes were considered. The primary outcome was mortality from Covid 19. A snowball search complemented PubMed, Cochrane, and Google Scholar databases. The data were extracted and pooled using a random-effects model. Pooled proportion estimates and risk ratios were calculated with 95% confidence intervals. The analysis was performed using Review Manager Software, and bias assessments were conducted using the Joanna Briggs Institute (JBI) Meta-Analysis tools. A GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) approach was employed to rate the quality of evidence for the mortality outcome, considering various factors including risk of bias, imprecision, inconsistency, indirectness, and publication bias.
Results
The meta-analysis included 7 articles with a total of 21,618,297 COVID-19 patients were included in the meta-analysis. Five studies had a low risk of bias for all domains. The risk of bias was unclear for some studies for each of the domains. The GRADE approach rates the quality of evidence of the clinical outcome. The assessment included addressing the risk of bias, imprecision, inconsistency, indirectness and publication bias. We considered the evidence to be low-quality. The odds ratio (OR) for mortality among unvaccinated patients compared to vaccinated patients was 2.46 (95% CI: 1.71-3.53), indicating that unvaccinated patients were 2.46 times more likely to die from COVID-19. The global impact of the COVID-19 pandemic on mortality and morbidity has been substantial. Vaccination has demonstrated a significant reduction in symptomatic infections and improved protection against severe disease. Fully vaccinated individuals experienced reduced critical illness, shorter hospital stays, and decreased mortality rates. Unvaccinated individuals faced higher risks, particularly in the context of the Delta variant. The severity of the disease was strongly linked to mortality rates, exacerbated by comorbidities. In alignment with previous studies, our meta-analysis revealed that unvaccinated COVID-19-infected patients were 2.46 times more likely to die than their vaccinated counterparts.
Conclusion
The findings of this study support the effectiveness of COVID-19 vaccination in reducing mortality among infected individuals. Unvaccinated patients had a significantly higher risk of mortality compared to vaccinated patients. Vaccination remains a crucial strategy to mitigate the severity of the disease and reduce mortality rates. Efforts should be made to address vaccine hesitancy and ensure widespread vaccine coverage. Also, emphasis should be placed on the necessity of racial equity in vaccination distribution as well as the need for diversity in clinical trials to guarantee the safety and effectiveness of vaccines and therapies.
References
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