Systematic Review on Pathophysiological Complications in Severe COVID-19 among the Non-Vaccinated and Vaccinated Population

Ali A Rabaan; Muhammed A Bakhrebah; Abbas Al Mutair; Saad Alhumaid; Jumana M Al-Jishi; Jehad AlSihati; Hawra Albayat; Ahmed Alsheheri; Mohammed Aljeldah; Mohammed Garout; Wadha A Alfouzan; Yousef N Alhashem; Salma AlBahrani; Saleh A Alshamrani; Sultan Alotaibi; Abdullah A AlRamadhan; Hanadi N Albasha; Khalid Hajissa; Mohamad-Hani Temsah

doi:10.3390/vaccines10070985

Systematic Review on Pathophysiological Complications in Severe COVID-19 among the Non-Vaccinated and Vaccinated Population

Vaccines (Basel). 2022 Jun 21;10(7):985. doi: 10.3390/vaccines10070985.

Authors

Ali A Rabaan^{1

2

3}, Muhammed A Bakhrebah⁴, Abbas Al Mutair^{5

6

7

8}, Saad Alhumaid⁹, Jumana M Al-Jishi¹⁰, Jehad AlSihati¹¹, Hawra Albayat¹², Ahmed Alsheheri¹², Mohammed Aljeldah¹³, Mohammed Garout¹⁴, Wadha A Alfouzan^{15

16}, Yousef N Alhashem¹⁷, Salma AlBahrani¹⁸, Saleh A Alshamrani¹⁹, Sultan Alotaibi²⁰, Abdullah A AlRamadhan²¹, Hanadi N Albasha²², Khalid Hajissa²³, Mohamad-Hani Temsah²⁴

Affiliations

¹ Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia.
² College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia.
³ Department of Public Health and Nutrition, The University of Haripur, Haripur 22610, Pakistan.
⁴ Life Science and Environment Research Institute, King Abdulaziz City for Science and Technology (KACST), Riyadh 11442, Saudi Arabia.
⁵ Research Center, Almoosa Specialist Hospital, Al-Ahsa 36342, Saudi Arabia.
⁶ College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia.
⁷ School of Nursing, Wollongong University, Wollongong, NSW 2522, Australia.
⁸ Nursing Department, Prince Sultan Military College of Health Sciences, Dhahran 33048, Saudi Arabia.
⁹ Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 31982, Saudi Arabia.
¹⁰ Internal Medicine Department, Qatif Central Hospital, Qatif 32654, Saudi Arabia.
¹¹ Internal Medicine Department, Gastroenterology Section, King Fahad Specialist Hospital, Dammam 31311, Saudi Arabia.
¹² Infectious Disease Department, King Saud Medical City, Riyadh 7790, Saudi Arabia.
¹³ Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of Hafr Al Batin, Hafr Al Batin 39524, Saudi Arabia.
¹⁴ Department of Community Medicine and Health Care for Pilgrims, Faculty of Medicine, Umm Al-Qura University, Makkah 21955, Saudi Arabia.
¹⁵ Department of Microbiology, Faculty of Medicine, Kuwait University, Safat 13110, Kuwait.
¹⁶ Microbiology Unit, Department of Laboratories, Farwania Hospital, Farwania 85000, Kuwait.
¹⁷ Department of Clinical Laboratory Sciences, Mohammed AlMana College of Health Sciences, Dammam 34222, Saudi Arabia.
¹⁸ Infectious Disease Unit, Specialty Internal Medicine, King Fahd Military Medical Complex, Dhahran 31932, Saudi Arabia.
¹⁹ Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Najran University, Najran 61441, Saudi Arabia.
²⁰ Molecular Microbiology Department, King Fahad Medical City, Riyadh 11525, Saudi Arabia.
²¹ Laboratory and Toxicology Department, Security Forces Specialized Comprehensive Clinics, Al-Ahsa 36441, Saudi Arabia.
²² Department of Infection Prevention and Control, Obeid Specialized Hospital, Riyadh 12627, Saudi Arabia.
²³ Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia.
²⁴ Pediatric Department, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia.

Abstract

COVID-19, caused by SARS-CoV-2, is one of the longest viral pandemics in the history of mankind, which have caused millions of deaths globally and induced severe deformities in the survivals. For instance, fibrosis and cavities in the infected lungs of COVID-19 are some of the complications observed in infected patients post COVID-19 recovery. These health abnormalities, including is multiple organ failure-the most striking pathological features of COVID-19-have been linked with diverse distribution of ACE2 receptor. Additionally, several health complications reports were reported after administration of COVID-19 vaccines in healthy individuals, but clinical or molecular pathways causing such complications are not yet studied in detail. Thus, the present systematic review established the comparison of health complication noted in vaccinated and non-vaccinated individuals (COVID-19 infected patients) to identify the association between vaccination and the multiorgan failure based on the data obtained from case studies, research articles, clinical trials/Cohort based studies and review articles published between 2020-2022. This review also includes the biological rationale behind the COVID-19 infection and its subsequent symptoms and effects including multiorgan failure. In addition, multisystem inflammatory syndrome (MIS) has been informed in individuals post vaccination that resulted in multiorgan failure but, no direct correlation of vaccination with MIS has been established. Similarly, hemophagocytic lymphohistiocytosis (HLH) also noted to cause multiorgan failure in some individuals following full vaccination. Furthermore, severe complications were recorded in elderly patients (+40 years of age), indicates that older age individuals are higher risk by COVID-19 and post vaccination, but available literature is not sufficient to comply with any conclusive statements on relationship between vaccination and multiorgan failure.

Keywords: ACE2 receptor; COVID-19; SARS-CoV-2; multiorgan failure; multisystem inflammatory syndrome; vaccination.

Publication types

Review

Grants and funding

This research received no external funding.