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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

Corresponding Author:[email protected]

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Tuğba Naziroğlu
Pendik State Hospital
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Pinar Özkan
Pendik State Hospital
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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.
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
30 Oct 2020Published in Clinical and Experimental Immunology volume 202 issue 2 on pages 220-225. 10.1111/cei.13507