COVID-19 Vaccines Reduced Declines in Respiratory Parameters Among Health Care Workers

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Although vaccination proves effective against severe infections, its impact on respiratory function in mild cases remains uncertain, particularly among health care workers.

Health care professionals who were administered SARS-CoV-2 vaccinations demonstrated protection against respiratory parameter declines following recovery from COVID-19, underscoring the significance of COVID-19 vaccines for health care workers, according to a recent study.1

Severe cases of COVID-19 are characterized by lung damage. Additionally, some patients with COVID-19 develop long COVID, with persistent symptoms of chest pain and fatigue. Clinical results vary, and the extent of lasting lung damage is not completely comprehended. Although vaccination proves effective against severe infections, its impact on respiratory function in mild cases remains uncertain, particularly among health care workers (HCWs).

The retrospective study, published in the Journal of Occupational Medicine and Toxicology, sought to assess lung function among HCWs who experienced COVID-19 from 2020 to 2022, comparing their spirometric test outcomes before and after the pandemic, considering their vaccination status. The researchers examined the association between SARS-CoV-2 infection and changes in lung function parameters for 2020, 2021, and 2022 as well as the protective effect of SARS-CoV-2 vaccination on forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FVC/FEV1 ratio, and peak expiratory flow rates (PEFR).

Researchers enrolled 321 HBWs who underwent health surveillance visits at the Policlinic of Rome Tor Vergata between 2019 and 2023, where they were given annual spirometric tests to assess fitness to work. To assess changes in respiratory function that could be attributed to COVID-19, the researchers compared tests collected in the 6 months prior to March 2020 with those performed in the 6 months following September 2022. Data on SARS-CoV-2 infection were collected from an occupational health database. During the pandemic, the workers were tested for COVID-19 via nasopharyngeal swab every 15 days, the results of which were added to a database. The regular testing also meant that the researchers could account for all symptomatic and asymptomatic COVID-19 cases.

Of the enrolled HCWs, 5 were excluded from the study for severe infector or comorbid respiratory conditions (asthma and chronic obstructive pulmonary disorder). The mean (SD) age was 48.85 (10.63). Among the population, 55.1% (n = 177) had a recognized COVID-19 infection in the examined period and 95.0% (n = 305) received a SARS-CoV-2 vaccination, of whom 124 (40.7%) developed a breakthrough infection after receiving at least 1 vaccine dose.

A statistically significant difference in FVC was observed between infected and non-infected subjects in 2020 and 2021 (P < .05), but not in 2022 (P = .88). The analysis revealed that the decrease in FVC was significantly lower in subjects who had been vaccinated before infection (P < .05).

The study concluded that subclinical SARS-CoV-2 infections in 2020 and 2021 adversely affected respiratory parameters (FVC and FEV1), but vaccination mitigated these effects. Even in healthy individuals with prior infections, respiratory changes were observed, with vaccination providing protection, particularly against FVC decline.

The analysis had some limitations, including the limited sample size, notable heterogeneity in the number of COVID-19 cased within the sample over different years, and the dependence on subjective symptom assessment and the exclusion of objective data, such as spirometric indices. However, a strength of the study was that the study period allowed the monitoring of COVID-19 cases and the impact of vaccination throughout the alpha, beta, and delta SARS-CoV-2 variant surges.

“Certainly, further studies are required to extend the follow-up period, allowing for a better evaluation of the significance of the reductions in spirometric indices recorded by us, which are still in the subclinical phase,” the authors noted. “Our work demonstrates the effectiveness of the vaccination campaign in preventing unfavorable outcomes on functional indices, a factor to consider in defining vaccination strategies for populations at higher risk of infection, such as healthcare workers.”

This article originally appeared on AJMC.

Reference
1. Ippoliti L, Coppeta L, Somma G, et al. Pulmonary function assessment after COVID-19 in vaccinated healthcare workers. J Occup Med Toxicol. Published online December 15, 2023. doi:10.1186/s12995-023-00400-7
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