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Publications

Journal Article Review Epublish

PubMed: 40266109 DOI: 10.3390/vaccines13030267

Efficacy of Bacille Calmette-Guérin Against COVID-19 Hospitalisation: A Meta-Analysis and Systematic Review of Randomised Control Trials.

Vaccines (Basel) 13(3)

Authors: Joseph Inauen, Sam LaBroome, Antonietta Maldari, Natalie E Stevens, James B Geake, David J Lynn, Simone Barry

Affiliations

  • Royal Adelaide Hospital, Port Road, Adelaide, SA 5000, Australia.
  • Faculty of Health and Medical Sciences, University of Adelaide, North Terrace, Adelaide, SA 5000, Australia.
  • Royal Adelaide Hospital, Port Road, Adelaide, SA 5000, Australia. Faculty of Health and Medical Sciences, University of Adelaide, North Terrace, Adelaide, SA 5000, Australia.
  • Precision Medicine Theme, South Australian Health and Medical Research Institute, North Terrace, Adelaide, SA 5000, Australia.
  • Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042, Australia.

Abstract

BACKGROUND

The BCG vaccine has long been hypothesised to have non-specific protective effects, and early epidemiological studies on COVID-19 suggested a possible protective effect against SARS-CoV-2 infection and COVID-19 severity. This systematic review and meta-analysis assesses the effect of the BCG vaccine on preventing severe COVID-19 disease, based on the rate of hospitalisation for COVID-19 related disease.

METHODS

We performed a literature search of randomised control trials comparing BCG vaccine to placebo in adult participants using EMBASE, MEDLINE, and Web of Science. A random effects model was used to generate summary estimates. Risk of bias was assessed regarding randomisation, allocation sequence concealment, blinding, incomplete outcome data, selective outcome reporting, and other biases.

RESULTS

We included 11 studies involving 18,412 participants, reporting COVID-19 incidence. The hospitalisation rate was sought from the authors of papers that did not report on this statistic. There was no significant reduction in COVID-19-related hospitalisation across all studies (relative risk 0.85, 0.51-1.40, = 0.335), COVID-19 incidence across all studies (relative risk 1.07, 0.94-1.21, = 0.264), deaths reported in six studies (relative risk 0.67, 0.36-1.26, = 0.733), and COVID-19-related critical care admissions reported in four studies (relative risk 0.43, 0.13-1.46, = 0.746).

CONCLUSIONS

The findings from this meta-analysis, involving a large number of participants, suggest no protective effect of BCG vaccination against severe COVID-19 outcomes or overall SARS-CoV-2 incidence. Further research may be needed to explore the potential non-specific effects of BCG vaccination in other specific populations and against other infections.

MeSH

Bias, Vaccines, Incidence, Vaccination, Covid-19, Infections