"Sinopharm", "Oxford-AstraZeneca", and "Pfizer-BioNTech" COVID-19 vaccinations: testing efficacy using lung CT-volumetry with comparative analysis of variance (ANOVA)
Authors: Samir Ahmed , Altarawy Dina , Sweed Rania Ahmed , Abdel-Kerim Amr A. 
Published: March 2023

Abstract
Background
Several clinical studies tested the efficacy of the different COVID-19 vaccinations while very few radiological researches targeted this issue before.

Aim of the work
To verify the additive role of lung CT-Volumetry in testing the efficacy of three widely distributed COVID-19 vaccinations; namely the "Sinopharm", "Oxford-AstraZeneca", and "Pfizer-BioNTech" vaccinations, with comparative analysis of variance (ANOVA).

Results
This study was retrospectively conducted on 341 COVID-19 patients during the period between June/2021 and March/2022. Based on the immunization status, they were divided into four groups; group (A) included 156/341 (46%) patients who did not receive any vaccination (control group), group (B) included 92/341 (27%) patients who received "Sinopharm" vaccine, group (C) included 55/341 (16%) patients who received "Oxford-AstraZeneca" vaccine, group (D) included 38/341 (11%) patients who received "Pfizer-BioNTech" vaccine. Every group was subdivided based on the medical history into three groups; group (1) patients without comorbidities, group (2) patients with comorbidities, and group (3) immunocompromised patients. Automated CT volumetry was calculated for the pathological lung parenchyma. Five CT-severity scores were provided (score 0 = 0%, score 1 = 1–25%, score 2 = 25–50%, score 3 = 51–75%, and score 4 = 76–100%). Analysis of variance (ANOVA) including Tukey HSD testing was utilized in comparison to the non-immunized patients. The "Phizer-Biontech" vaccine succeeded to eliminate severity in patients without and with comorbidity, and also decreased severity in immunocompromised patients (from 79 to 17%). The "Oxford-AstraZeneca" vaccine and to a lesser extent "Sinopharm" vaccine also decreased the clinical severity in patients with comorbidities and immunocompromised patients (from 15 to 9% & 10% as well as from 79 to 20% & 50% respectively). Significant variance was proved regarding the use of "Sinopharm", "Oxford-AstraZeneca", and "Phizer-Biontech" vaccines in patients without comorbidities (f-ratio averaged 4.0282, 10.8049, and 8.4404 respectively, also p-value averaged 0.04632, 0.001268, and 0.004294). Significant variance was proved regarding the use of "Oxford-AstraZeneca", and "Phizer-Biontech" vaccines in patients with comorbidities and immunocompromised patients (f-ratio averaged 4.7521, and 4.1682 as well as 11.7811, and 15.6 respectively, also p-value averaged 0.03492, and 0.04857, as well as both 0.003177, and 0.0009394 respectively, all < 0.05). No significant variance was proved regarding the use of the "Sinopharm" vaccine.

Conclusions
In addition to the decline of clinical severity rates & CT severity scores, a significant variance was proved regarding the use of the "Sinopharm", "Oxford-AstraZeneca", and "Phizer-Biontech" vaccines in patients without comorbidities. Significant variance was also proved regarding the use of the "Oxford-AstraZeneca" and "Phizer-Biontech" vaccines in patients with comorbidities and immunocompromised patients. Despite that, no significant variance could be proved regarding the use of the "Sinopharm" vaccine in these patients, it decreases the percentage of clinical severity and CT severity scores.