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Factors determining COVID-19 pneumonia severity in a country with routine BCG vaccination
  • Kurtuluş Aksu,
  • Tuğba Naziroğlu,
  • Pinar Özkan
Kurtuluş Aksu
University of Health Sciences Atatürk Chest Diseases and Chest Surgery Education and Research Hospital
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Tuğba Naziroğlu
Pendik State Hospital
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Pinar Özkan
Pendik State Hospital
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Abstract

Background: Bacillus Calmette-Guérin (BCG) vaccination policies of countries are postulated to have effect on the course of coronavirus disease 2019 (COVID-19) pandemic. Methods: Retrospective cross-sectional study was conducted between March 11-June 10, 2020 in a chest clinic in a state hospital in Istanbul,Turkey. Adults with diagnosis of COVID-19 pneumonia confirmed with severe acute respiratory syndrome coronavirus 2 polymerase chain reaction positivity in a nasopharyngeal sample and pulmonary infiltrates in computed chest tomography were included consecutively. Sociodemographic characteristics, body-mass index, smoking status, comorbid diseases, income rates, and BCG-vaccination status were compared between severe and mild patients with COVID-19 pneumonia. Results: Study population consisted of 123 adults (mean age, 49.7 years [standard deviation, 13.3 years]; 82 (66.7%) male). The proportion of BCG-vaccinated cases was significantly lower among severe patients than mild patients with COVID-19 pneumonia (68.5% vs 88.2%; p=.026). Mean age (54.0 ± 11.5 years vs 38.3 ±10.7 years; p <.001), diabetes rate (32.6% vs 5.9%; p=.002) and low-income (84.3% vs 52.9% p<.001) are higher in patients with severe COVID-19 pneumonia than in patients with mild COVID-19 pneumonia. Multivariate logistic regression analysis showed that increasing age (odds ratio [OR], 1.112; 95% confidence interval [CI], 1.058 – 1.169; p<.001) and low income (OR, 3.369; 95% CI, 1.074 – 10.570; p =.037) are associated with severe COVID-19 pneumonia. Conclusion: Clinical data does not support that being vaccinated with BCG is associated with disease severity in COVID-19 pneumonia. Age and low-income are the major predictors for disease severity.

Peer review status:ACCEPTED

10 Jul 2020Submission Checks Completed
10 Jul 2020Assigned to Editor
21 Jul 2020Reviewer(s) Assigned
26 Jul 2020Review(s) Completed, Editorial Evaluation Pending
29 Jul 2020Editorial Decision: Revise Minor
30 Jul 20201st Revision Received
30 Jul 2020Review(s) Completed, Editorial Evaluation Pending
12 Aug 2020Editorial Decision: Accept