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Vaccination Status and In-Hospital Mortality among Adults with COVID-19 in Jakarta, Indonesia: A Retrospective Hospital-based Cohort Study
Hotma Martogi Lorensi Hutapea1,3corresp_iconorcid , Pandji Wibawa Dhewantara1orcid , Anton Suryatma1orcid , Raras Anasi2, Harimat Hendarwan1orcid , Mondastri Korib Sudaryo3, Dwi Gayatri3orcid

DOI: [Accepted]
Published online: October 30, 2023
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1National Research and Innovation Agency, Jakarta, Indonesia
2Institute of Health Policy Development, Ministry of Health, Jakarta, Indonesia
3Department of Epidemiology, Faculty of Public Health, University of Indonesia, Depok, Indonesia
Corresponding author:  Hotma Martogi Lorensi Hutapea,
Received: 16 August 2023   • Revised: 18 October 2023   • Accepted: 20 October 2023

Prospective studies on vaccination status and mortality related to coronavirus disease 2019 (COVID-19) in low-resource settings are still limited. We assessed the association between vaccination status (full, partial, or none) and in-hospital mortality among COVID-19 patients at most hospitals in Jakarta, Indonesia during the Delta predomination wave.
We conducted a retrospective cohort study among hospitalized COVID-19 patients who met the study criteria (>18 years old and admitted for inpatient treatment because of laboratory-confirmed SARS-CoV-2 infection). We linked individual-level data in the hospital admission database with vaccination records. Several sociodemographic and clinical characteristics were also analyzed. A Cox proportional hazards regression model was used to explore the association between vaccination status and in-hospital mortality in this patient group.
In total, 40,827 patients were included in this study. Of these, 70% were unvaccinated (n=28,543) and 19.3% (n=7,882) died during hospitalization. The mean age of the patients was 49 years (range, 35-59 years), 53.2% were female, 22.0% had hypertension, and 14.2% were treated in the intensive care unit, and the median hospital length of stay across the group was 9 days. Our study showed that the risk of in-hospital mortality among fully and partially vaccinated patients was lower than among unvaccinated adults (adjusted hazard ratio [aHR]=0.43; 95% confidence interval [CI], 0.40-0.47 and aHR=0.70; 95% CI, 0.64-0.77, respectively).
Vaccinated patients had fewer severe outcomes among hospitalized adults during the Delta wave in Jakarta. These features should be carefully considered by healthcare professionals in treating adults within this patient group.

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