Document Type

Article

Publication Date

2026

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This article is the author's final published version in Clinical Infection in Practice, Volume 31, 2026, Article Number 100715.

The published version is available at https://doi.org/10.1016/j.clinpr.2026.100715. Copyright © 2026 The Authors. Published by Elsevier Ltd on behalf of British Infection Association. This is an open access article under the CC BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0/

Abstract

In this retrospective study, we compared the cause of death among hospitalized patients who died with a diagnosis of COVID-19 across two periods of the pandemic two years apart: an early period (admissions June to October 2020), when the population was immunologically naïve, and a later period (admissions April to October 2022), when an estimated 96% of the population had immunity from prior infection, vaccination, or both. Two investigators independently reviewed the medical records of 100 in-hospital deaths (50 per period) and classified each death as COVID-19 related, uncertain, or not COVID-19 related, using logistic regression to compare the two periods. Deaths during the early period were more likely to reflect a direct consequence of COVID-19 infection than deaths in the later period (adjusted odds ratio 0.25 for the later vs. early period; 95% CI 0.10 to 0.64; p = 0.004). This difference was largely attenuated when vaccination status was added to the model, suggesting a protective effect of vaccination against COVID-19 related mortality.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Language

English

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