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Medical professionals given SARS-CoV-2 vaccinations demonstrate protection against respiratory declines after recovery from COVID-19, underscoring the importance of COVID-19 vaccines for healthcare workers, according to a recent study.
Severe cases of COVID-19 are characterized by lung damage. Additionally, some patients with COVID-19 develop prolonged COVID, with persistent symptoms of chest pain and fatigue. Clinical outcomes vary and the extent of permanent lung damage is not fully understood. Although vaccination has been shown to be effective against severe infections, its impact on respiratory function in mild cases remains uncertain, particularly among healthcare workers (HCWs).
The retrospective study published in Journal of Occupational Medicine and Toxicology, sought to assess lung function among healthcare workers who survived COVID-19 from 2020 to 2022, comparing their spirometry test results before and after the pandemic, taking into account their vaccination status. The researchers investigated the relationship 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).
The researchers included 321 HBWs who underwent health surveillance visits at Rome’s Tor Vergata Polyclinic between 2019 and 2023, where they were given annual spirometry tests to assess fitness for work. To assess changes in respiratory function that could be attributed to COVID-19, the researchers compared tests collected in the 6 months before March 2020 with those performed in the 6 months after September 2022. The data for SARS-CoV-2 infection were collected from an occupational medicine database. During the pandemic, workers were tested for COVID-19 by nasopharyngeal swab every 15 days, the results of which were added to a database. Regular testing also meant researchers could account for all symptomatic and asymptomatic cases of COVID-19.
Of the included healthcare workers, 5 were excluded from the study due to severe infectious or comorbid respiratory conditions (asthma and chronic obstructive pulmonary disease). The mean (SD) age was 48.85 (10.63). Among the population, 55.1% (n = 177) had a recognized infection with COVID-19 during the study period and 95.0% (n = 305) received vaccination against SARS-CoV-2, of which 124 (40.7% ) developed a breakthrough infection after receiving at least 1 dose of vaccine.
A statistically significant difference in FVC was observed between infected and uninfected subjects in 2020 and 2021 (P < .05), but not in 2022 (P = 0.88). The analysis revealed that the reduction in FVC was significantly lower in subjects who had been vaccinated before infection (P < 0.05).
The study concluded that subclinical SARS-CoV-2 infections in 2020 and 2021 adversely affected respiratory parameters (FVC and FEV1), but vaccination moderated these effects. Even in healthy individuals with previous infections, respiratory changes have been observed, with vaccination conferring protection, particularly against a reduction in FVC.
The analysis had some limitations, including the limited sample size, notable heterogeneity in the number of COVID-19 cases in the sample across years, and reliance on subjective assessment of symptoms and exclusion of objective data such as spirometric indices. However, the strength of the study was that the study period allowed observation of the incidence of COVID-19 and the impact of vaccination across the alpha, beta, and delta variants of SARS-CoV-2.
“Further studies are certainly needed to extend the follow-up period, allowing a better assessment of the significance of the reductions in spirometric indices recorded by us, which are still in the subclinical phase,” the authors note. “Our work demonstrates the effectiveness of a vaccination campaign in preventing adverse outcomes on functional outcomes, a factor that should be considered when determining vaccination strategies for populations at higher risk of infection, such as healthcare workers.”
reference
Ippoliti L, Coppeta L, Somma G, et al. Assessment of lung function after COVID-19 in vaccinated healthcare workers. J Occup Med Toxicol. Published online 15 December 2023 doi:10.1186/s12995-023-00400-7
