COVID-19 Vaccine Effectiveness Against Hospitalizations and Severe Outcomes in Kosovo, 2022–2024: A Test-Negative Case–Control Study

IF 4.2 4区医学 Q1 INFECTIOUS DISEASES

Influenza and Other Respiratory Viruses Pub Date : 2025-09-08 DOI:10.1111/irv.70152

Besfort Kryeziu, Sandra Cohuet, Ariana Kalaveshi-Osmani, Zana Kaçaniku-Deva, Pranvera Kaçaniku-Gunga, Iris Finci, Miguel Angel Sanchez, James Humphreys, Naser Ramadani, Edita Haxhiu, Kostas Danis, Angela M. C. Rose, Isme Humolli, Mark A. Katz

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Abstract

Background

Few studies have evaluated COVID-19 vaccine effectiveness (VE) in middle-income countries, particularly in eastern Europe. We aimed to estimate COVID-19 VE against SARS-CoV-2-confirmed hospitalizations and severe outcomes in Kosovo.

Methods

We conducted a test-negative case–control study using data from Kosovo's severe acute respiratory infection (SARI) sentinel surveillance system from January 2022 to June 2024. We enrolled adult patients aged ≥ 18 years hospitalized with SARI. From all patients, we collected clinical data, vaccination history, and a nasopharyngeal specimen, which was tested for SARS-CoV-2 using RT-PCR. SARS-CoV-2-positive patients were cases; those testing negative were controls. We estimated VE overall and against severe outcomes (requiring oxygen, intensive care admission, or in-hospital death) using logistic regression, adjusting for age, sex, and comorbidities, calculating VE as (1–adjusted odds ratio) × 100.

Results

We included 564 SARI patients; 218 (39%) tested positive for SARS-CoV-2. Overall, 24% of SARI patients had received at least one COVID-19 vaccine dose in the previous 12 months. VE against SARS-CoV-2-confirmed SARI hospitalization among all adults was 72% (95% CI: 30%–89%) at 14–179-day postvaccination, and 26% (95% CI: −33%–59%) at 180–364 days. In adults ≥ 60 years, VE was 52% (95% CI:−31%–82%) at 14–179-day postvaccination, and −36% (95% CI: −190%–36%) at 180–364 days. VE against severe outcomes was 67% (95% CI: −14%–91%) at 14–179 days, and 17% (95% CI:−111%–67%) at 180–364 days.

Conclusions

Our findings suggest that COVID-19 vaccination in Kosovo offered substantial protection against hospitalization and severe outcomes within 6 months, though confidence intervals were wide for some subgroups. Effectiveness waned after 6 months, highlighting the need for periodic booster doses.

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2022-2024年科索沃COVID-19疫苗对住院治疗的有效性和严重后果：一项检测阴性的病例对照研究

很少有研究评估了中等收入国家，特别是东欧国家的COVID-19疫苗有效性。我们的目的是估计COVID-19与科索沃确诊的sars - cov -2住院和严重后果之间的关系。方法利用2022年1月至2024年6月科索沃严重急性呼吸道感染（SARI）哨点监测系统的数据，开展了一项检测阴性病例对照研究。我们招募了年龄≥18岁的SARI住院成人患者。我们收集了所有患者的临床资料、疫苗接种史和鼻咽标本，并使用RT-PCR对其进行了SARS-CoV-2检测。sars - cov -2阳性患者为病例；检测呈阴性者为对照。我们使用逻辑回归，调整年龄、性别和合并症，计算VE为（1校正优势比）× 100，对总体VE和严重结局（需要氧气、重症监护住院或院内死亡）进行了估计。结果纳入564例SARI患者；218人（39%）SARS-CoV-2检测呈阳性。总体而言，24%的急性呼吸道感染患者在过去12个月内至少接种了一剂COVID-19疫苗。接种疫苗后14 - 179天，所有成年人中sars - cov -2确诊的SARI住院率为72% (95% CI: 30%-89%)， 180-364天为26% （95% CI: - 33%-59%）。在≥60岁的成人中，疫苗接种后14 - 179天VE为52% (95% CI: - 31%-82%)， 180-364天VE为- 36% （95% CI: - 190%-36%）。在14-179天，严重结局的VE为67% (95% CI: - 14%-91%)，在180-364天，VE为17% （95% CI: - 111%-67%）。我们的研究结果表明，在科索沃，COVID-19疫苗接种对6个月内住院和严重后果提供了实质性保护，尽管某些亚组的置信区间很宽。6个月后有效性减弱，强调需要定期加强剂量。

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来源期刊

Influenza and Other Respiratory Viruses 医学-病毒学

CiteScore

7.20

自引率

4.50%

发文量

120

审稿时长

6-12 weeks

期刊介绍： Influenza and Other Respiratory Viruses is the official journal of the International Society of Influenza and Other Respiratory Virus Diseases - an independent scientific professional society - dedicated to promoting the prevention, detection, treatment, and control of influenza and other respiratory virus diseases. Influenza and Other Respiratory Viruses is an Open Access journal. Copyright on any research article published by Influenza and Other Respiratory Viruses is retained by the author(s). Authors grant Wiley a license to publish the article and identify itself as the original publisher. Authors also grant any third party the right to use the article freely as long as its integrity is maintained and its original authors, citation details and publisher are identified.