"Study" from Lombardy: Association of COVID-19 Vaccinations With ICU Admissions and Outcomes

The reality had to be stretched real hard to fit the narrative, as per usual...

Just as the new Italian Health Minister, immediately dubbed “right-wing”, expressed some tepid doubts about the Covid jabs’ efficiency, a brand new “study” from Lombardy has been brought to bear and prove, once and for all, that these jabs are the best thing since sliced bread: “Association of COVID-19 Vaccinations With Intensive Care Unit Admissions and Outcome of Critically Ill Patients With COVID-19 Pneumonia in Lombardy, Italy” (JAMA Netw Open, 2022.10.22). In the preamble, the “study” frankly admits the following:

Two multicenter studies conducted in Spain and Switzerland reported that fully vaccinated patients with COVID-19 admitted to an ICU had more comorbidities, greater exposure to immunosuppressive drugs, lower ICU length of stay but similar ICU mortality compared with unvaccinated patients. However, in both studies, the number of vaccinated and unvaccinated patients admitted during the Alpha and Delta variant waves may have been unbalanced.

My comment: Let me translate that: the Spain and Switzerland studies found out that fully Covid-19 jabbed ICU patients died faster than the unvaccinated, suffering less and freeing plenty many of ICU beds faster. Would have been so much worse had they not taken the shot.

Now, let’s proceed to the “study” at hand:

Design, setting, and participants: This retrospective cohort study on regional data sets reports: (1) daily number of administered vaccines and (2) data of all consecutive patients admitted to an ICU in Lombardy, Italy, from August 1 to December 15, 2021 (Delta variant predominant). Vaccinated patients received either mRNA vaccines (BNT162b2 or mRNA-1273) or adenoviral vector vaccines (ChAdOx1-S or Ad26.COV2). Incident rate ratios (IRRs) were computed from August 1, 2021, to January 31, 2022; ICU and baseline characteristics and outcomes of vaccinated and unvaccinated patients admitted to an ICU were analyzed from August 1 to December 15, 2021.

My comment: bear in mind that the “study” deems one to be “vaccinated” only 14 days after their second mRNA shot. So, when they compare vaccinated vs unvaccinated, most likely they compare freshly jabbed with long-ago jabbed. In the “study’s” own words:

Definitions: In the present work, individuals were considered vaccinated 14 days after the second dose of BNT162b2, mRNA-1273, ChADOx1-S, or the first dose of Ad26.COV2. Vaccinated individuals who received an additional dose of vaccine were considered boosted 14 days after the administration.

And yet, their results couldn’t be more stark.

Results: Among the 10 107 674 inhabitants of Lombardy, Italy, at the time of this study, the median [IQR] age was 48 [28-64] years and 5 154 914 (51.0%) were female. Of the 7 863 417 individuals who were vaccinated (median [IQR] age: 53 [33-68] years; 4 010 343 [51.4%] female), 6 251 417 (79.5%) received an mRNA vaccine, 550 439 (7.0%) received an adenoviral vector vaccine, and 1 061 561 (13.5%) received a mix of vaccines and 4 497 875 (57.2%) were boosted. Compared with unvaccinated people, incident rate ratio (IRR) of individuals who received an mRNA vaccine within 120 days from the last dose was 0.03 (95% CI, 0.03-0.04; P < .001), whereas IRR of individuals who received an adenoviral vector vaccine after 120 days was 0.21 (95% CI, 0.19-0.24; P < .001).

My comment: the “study” finds out that long-ago mRNA-jabbed are 33 times less likely, and long-ago AstraZeneka-jabbed are 4.77 times times less likely to be diagnozed with Covid than freshly-jabbed, and some unvaccinated. Be as it may, let’s proceed to the cherry on the cake.

There were 553 patients admitted to an ICU for COVID-19 pneumonia during the study period: 139 patients (25.1%) were vaccinated and 414 (74.9%) were unvaccinated. Compared with unvaccinated patients, vaccinated patients were older (median [IQR]: 72 [66-76] vs 60 [51-69] years; P < .001), primarily male individuals (110 patients [79.1%] vs 252 patients [60.9%]; P < .001), with more comorbidities (median [IQR]: 2 [1-3] vs 0 [0-1] comorbidities; P < .001) and had higher ratio of arterial partial pressure of oxygen (Pao2) and fraction of inspiratory oxygen (FiO2) at ICU admission (median [IQR]: 138 [100-180] vs 120 [90-158] mm Hg; P = .007). Factors associated with ICU and hospital mortality were higher age, premorbid heart disease, lower Pao2/FiO2 at ICU admission, and female sex (this factor only for ICU mortality). ICU mortality was similar between unvaccinated and vaccinated patients (25.9% [n = 107] vs 32.4% [n = 45]; P = .14), while hospital mortality was higher in vaccinated patients (29.9% [112 of 375 ] vs 40.2% [55 of 137], P = .03).

My comment: So, in spite of being 33 to 5 times less likely to “fall ill”, 1 in 4 of the ICU patients were old-ago jabbed, and only 3/4 were freshly jabbed (and few unvaccinated). As it turns out, the jabs didn’t help any with the mortality from Covid, and “ICU and hospital mortality were similar between vaccinated and unvaccinated patients“. Same as in Spain and Switzerland. So maybe, just maybe, the new “right-wing” Health Minister of Italy has a point? But similar does mean same, as both ICU mortality (32.4% vs 25.9% or IRR 1.25) and hospital mortality (40.2% vs 29.9% or IRR 1.34) has been markedly higher in the vaccinated vs “unvaccinated”.

Regardless, the “study” draws an unexpected, yet predictable, conclusion:

Conclusions and relevance: In this cohort study, mRNA and adenoviral vector vaccines were associated with significantly lower risk of ICU admission for COVID-19 pneumonia. ICU and hospital mortality were not associated with vaccinated status. These findings suggest a substantial reduction of the risk of developing COVID-19-related severe acute respiratory failure requiring ICU admission among vaccinated people.

My comment: Again, when they say “vaccinated”, they mean “those 2 weeks AFTER THE SECOND JAB”! And that is on the basis of the “study” finding 1 in 4 in the ICU being long-ago jabbed, and unknown (no doubt substantial) proportion of the other 3/4 being most recently jabbed. What can be wrong with that? Nothing, I guess, when you have as many conflicts of interest as the adverse events of interest in the Pfizer trial:

Conflict of Interest Disclosures: Dr Grasselli reported receiving grants and personal fees from Fisher & Paykel, grants from Merck Sharp & Dohme, and personal fees from Getinge, Draeger Medical, Pfizer, Biotest, and Cook Medical outside the submitted work. Dr Bellani reported receiving personal fees and grants from Draeger, personal fees from Getinge, personal fees from Dimar SRL, Flowmeter SPA, and GE Healthcare outside the submitted work. Dr Cecconi reported receiving personal fees from Edwards Life Sciences Consultancy and Directed Systems Consultancy outside the submitted work. Dr Mantovani reported receiving personal fees from Novartis (lecturer), Roche (lecturer), Ventana (lecturer), Pierre Fabre (consultancy), Verily (consultancy), Abbvie (consultancy), Bristol Myers Squibb (consultancy), Johnson & Johnson (consultancy), Imcheck (advisory board member), Myeloid Therapeutics (advisory board member), Astra Zeneca (consultancy and lecturer), Biovelocita (advisory board member), BG Fund (advisory board member), Third Rock Venture (consultancy), Biolegend (advisory board member), Verseau Therapeutics (advisory board member), Macrophage Pharma (advisory board member), Ellipses Pharma (advisory board member), and Olatec Therapeutics (advisory board member) outside the submitted work; and receipt of royalties for the sale of reagents related to innate immunity. Dr Mojoli reported receiving personal fees from Seda Spa (lecturer), GE Healthcare (lecturer), and Hamilton Medical (lecturer) outside the submitted work; and consultancy agreement between Hamilton Medical and University of Pavia. Dr Mongodì reported receiving personal fees from GH Healthcare (lecturer) outside the submitted work. Dr Pesenti reported receiving personal fees from Maquet, Xenios, Baxter International, and Boehringer Ingelheim outside the submitted work. No other disclosures were reported.

This game of “catch me on a lie” is becoming too easy.