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COVID-19 Nedeni ile Yatarak Tedavi Görenlerde Aşıların ve Hatırlatma Dozlarının Hastalık Sürecine ve Mortaliteye Etkisi

Year 2023, Volume: 6 Issue: 1, 130 - 139, 30.04.2023
https://doi.org/10.36516/jocass.1242107

Abstract

Amaç: 2020 yılının ilk aylarından itibaren hayatımızın bir parçası haline gelen COVID-19 pandemisi ile mücadelede en etkili yöntem aşılamadır. Bu çalışma ile yatan hastaların aşılanma durumu, rapel aşı protokollerinin etkinliği ve COVID-19 hastalarının yoğun bakım ünitesi (YBÜ) ve mortalite için risk faktörlerini tanımlamak amaçlanmaktadır.
Gereç ve Yöntem: Çalışmamıza COVID-19 nedeni ile 3.basamak hastanede yatarak tedavi gören 247 hasta dahil edilmiştir. COVID-19 dışı nedenler ile hastanede yatan hastalar PCR testi pozitif olsa da çalışma dışı bırakılmıştır. Katılımcıların sosyo-demografik verileri, klinik ve laboratuvar bulguları hastane veri tabanı ve bir anket yardımıyla kayıt altına alınmıştır. Hastalar, hastalık ağırlığı bakımından hafif-orta-ağır hastalık, yattığı klinik bakımından servis ve YBÜ şeklinde gruplara ayrılmıştır. Aşılanma durumlarına göre ise aşılanmamış, Sinovac tabanlı protokoller, BioNTech tabanlı protokoller ve diğerleri olarak kategorize edilmiştir.
Bulgular: Çalışmadaki 247 hastanın %55,1’i erkek ve yaş ortalaması 60 ± 17,26 idi. Hastaların %38,5’i YBÜ’ne kabul edilmiş ve %9,3’ü ise hayatını kaybetmiştir. YBÜ’ne kabul edilenlerin %38,8’i, hayatını kaybedenlerin ise %56,5’nin aşılanmamış olduğu gözlemlenmiştir. 65 yaş üzerinde olunması (p=0,008), 7 günden fazla hastanede yatıyor olmak (p=0,003), ağır hastalık varlığı (p=0,002), sinir sistemi hastalığı olması (p=0,005) ve diğer ek hastalıkların varlığı (p=0,000) YBÜ kabulü için; hastalık ağırlığı (p=0,000) ile komorbiditlerden hipertansiyon (p=0,000), diyabetes mellitus (p=0,020) ve kalp-damar hastalıkları varlığı (p=0,000) mortalite için risk faktörü olarak bulunmuştur.
Sonuç: Hatırlatma dozlarının ve özellikle de dördüncü dozun aşılanma protokollerine eklenmesinin COVID-19'da mortaliteyi artıran YBÜ takibi ihtiyacını önlemede daha faydalı olabileceği düşünülmüştür.

References

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  • 3. Kow CS, Hasan SS. Real-world effectiveness of BNT162b2 mRNA vaccine: a meta-analysis of large observational studies. Inflammopharma-cology 2021; 29: 1075–90. https://doi.org/10.1007/s10787-021-00839-2
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  • 7. Higdon MM, Wahl B, Jones CB, et al. A Sys-tematic Review of Coronavirus Disease 2019 Vaccine Efficacy and Effectiveness Against Se-vere Acute Respiratory Syndrome Coronavirus 2 Infection and Disease. Open Forum Infect Dis. 2022 Apr 18;9(6):ofac138. https://doi.org/10.1093/ofid/ofac138
  • 8. Atmar RL, Lyke KE, Deming ME, et al. Homol-ogous and Heterologous Covid-19 Booster Vac-cinations. N Engl J Med. 2022;386(11):1046-57. https://doi.org/10.1056/NEJMoa2116414
  • 9. Meggiolaro A, Sane Schepisi M, Nikolaidis GF, et al. Effectiveness of Vaccination against SARS-CoV-2 Infection in the Pre-Delta Era: A Systematic Review and Meta-Analysis. Vaccines (Basel). 2022;10(2):157. https://doi.org/10.3390/vac¬cines10020157
  • 10. Zeng B, Gao L, Zhou Q, Yu K, Sun F. Effective-ness of COVID-19 vaccines against SARS-CoV-2 variants of concern: a systematic review and meta-analysis. BMC Med. 2022;20(1):200. https://doi.org/10.1186/s12916-022-02397-y
  • 11. Bar-On YM, Goldberg Y, Mandel M, et al. Pro-tection of BNT162b2 Vaccine Booster against Covid-19 in Israel. New England Journal of Medicine 2021;385(15):1393-400. https://doi.org/10.1056/NEJMoa2114255
  • 12. Arbel R, Hammerman A, Sergienko R, et al. BNT162b2 Vaccine Booster and Mortality Due to Covid-19. New England Journal of Medicine 2021;385(26):2413-20. https://doi.org/10.1056/NEJMoa2115624
  • 13. Accorsi EK, Britton A, Fleming-Dutra KE, et al. Association Between 3 Doses of mRNA COVID-19 Vaccine and Symptomatic Infection Caused by the SARS-CoV-2 Omicron and Delta Variants. The Journal of the American Medical Association 2022 Feb 15;327(7):639-51. https://doi.org/10.1001/jama.2022.0470
  • 14. Olson SM, Newhams MM, Halasa NB, et al. Ef-fectiveness of BNT162b2 Vaccine against Criti-cal Covid-19 in Adolescents. N Engl J Med. 2022;386(8):713-23. https://doi.org/10.1056/NEJMoa2117995
  • 15. Sablerolles RSG, Rietdijk WJR, Goorhuis A, et al. Immunogenicity and Reactogenicity of Vac¬cine Boosters after Ad26.COV2.S Priming. New England Journal of Medicine 2022;386(10):951-63. https://doi.org/10.1056/NEJMoa2116747
  • 16. Costa Clemens SA, Weckx L, Clemens R, et al. Heterologous versus homologous COVID-19 booster vaccination in previous recipients of two doses of CoronaVac COVID-19 vaccine in Bra-zil (RHH-001): a phase 4, non-inferiority, single blind, randomised study. Lancet. 2022;399(10324):521-9. https://doi.org/10.1016/S0140-6736(22)00094-0
  • 17. Cerqueira-Silva T, Katikireddi SV, de Araujo Oliveira V, et al. Vaccine effectiveness of heter-ologous CoronaVac plus BNT162b2 in Brazil. Nature Medicine 2022;28(4):838-43. https://doi.org/10.1038/s41591-022-01701-w.
  • 18. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Dis-ease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Preven-tion. JAMA. 2020 Apr 7;323(13):1239-42. https://doi.org/10.1001/jama.2020.2648
  • 19. Richardson S, Hirsch JS, Narasimhan M, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA. 2020;323(20):2052-9. https://doi.org/10.1001/jama.2020.6775
  • 20. Armiñanzas C, Arnaiz de Las Revillas F, Gutiér-rez Cuadra M, et al. Usefulness of the COVID-GRAM and CURB-65 scores for predicting se-verity in patients with COVID-19. Int J Infect Dis. 2021;108:282-8. https://doi.org/10.1016/j.ijid.2021.05.048
  • 21. Liang W, Liang H, Ou L, et al. Development and Validation of a Clinical Risk Score to Predict the Occurrence of Critical Illness in Hospitalized Patients With COVID-19. JAMA Intern Med. 2020;180(8):1081-9. https://doi.org/10.1001/jamaintern-med.2020.2033
  • 22. Wang D, Hu B, Hu C, et al. Clinical Character-istics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wu-han, China. JAMA. 2020;323(11):1061-9. https://doi.org/10.1001/jama.2020.1585
  • 23. Kox M, Waalders NJB, Kooistra EJ, Gerretsen J, Pickkers P. Cytokine Levels in Critically Ill Patients With COVID-19 and Other Conditions. JAMA. 2020;324(15):1565–7. https://doi.org/10.1001/jama.2020.17052
  • 24. Wu C, Chen X, Cai Y, et al. Risk Factors Asso-ciated With Acute Respiratory Distress Syn-drome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Intern Med. 2020;180(7):934-43. https://doi.org/10.1001/jamaintern-med.2020.0994
  • 25. COVID-ICU Group on behalf of the REVA Net-work and the COVID-ICU Investigators. Clini¬cal characteristics and day-90 outcomes of 4244 critically ill adults with COVID-19: a prospec¬tive cohort study. Intensive Care Med. 2021;47(1):60-73. https://doi.org/10.1007/s00134-020-06294-x
  • 26. Docherty AB, Mulholland RH, Lone NI, et al. Changes in in-hospital mortality in the first wave of COVID-19: a multicentre prospective obser-vational cohort study using the WHO Clinical Characterisation Protocol UK. Lancet Respir Med. 2021;9(7):773-85. https://doi.org/10.1016/S2213-2600(21)00175-2

The Effect of Vaccines and Booster Doses on Disease Progression and Mortality in Inpatients with COVID-19

Year 2023, Volume: 6 Issue: 1, 130 - 139, 30.04.2023
https://doi.org/10.36516/jocass.1242107

Abstract

Objective: As of the first months of 2020, vaccination is the most effective method to combat the COVID-19 pandemic, which has become a part of our lives. This study aims to describe the vaccination status of inpatients, the effectiveness of booster vaccine protocols, and the risk factors for intensive care unit (ICU) and mortality of COVID-19 patients.
Materials and Methods: Our study included 247 patients hospitalized in a tertiary care hospital due to COVID-19. Patients hospitalized for non-COVID-19 reasons were excluded from the study even if the PCR test was positive. Socio-demographic data, clinical and laboratory findings of the participants were recorded using the hospital database and a questionnaire. Patients were divided into groups as mild-moderate-severe disease in terms of disease severity, ward and ICU in terms of hospitalization clinic. According to vaccination status, they were categorized as unvaccinated, Sinovac-based protocols, BioNTech-based protocols and others.
Results: Of the 247 patients in the study, 55.1% were male and the mean age was 60 ± 17.26 years. 38.5% of the patients were admitted to the ICU and 9.3% died. It was observed that 38.8% of those admitted to the ICU and 56.5% of those who died were not vaccinated. Being over 65 years of age (p=0.008), being hospitalized for more than 7 days (p=0.003), having a severe illness (p=0.002), having a nervous system disease (p=0.005) and having other comorbidities (p=0.000), were significant for ICU admission, whereas disease severity (p=0.000) and comorbidities such as hypertension (p=0.000), diabetes mellitus (p=0.020) and cardiovascular diseases (p=0.000) were found to be risk factors for mortality.
Conclusion: The addition of reminder doses, especially the fourth dose, to vaccination protocols may be more beneficial in preventing the need for ICU follow-up, which increases mortality in COVID-19.

References

  • 1. World Health Organization. Coronavirus dis¬ease (COVID-19) pandemic. [Online]. Availa¬ble from: https://covid19.who.int/ (accessed on Jan 3, 2023)
  • 2. Harder T, Koch J, Vygen-Bonnet S, et al. Effi-cacy and effectiveness of COVID-19 vaccines against SARS-CoV-2 infection: interim results of a living systematic review, 1 January to 14 May 2021. Euro Surveill. 2021;26(28):2100563. https://doi.org/10.2807/1560-7917.ES.2021.26.28.2100563
  • 3. Kow CS, Hasan SS. Real-world effectiveness of BNT162b2 mRNA vaccine: a meta-analysis of large observational studies. Inflammopharma-cology 2021; 29: 1075–90. https://doi.org/10.1007/s10787-021-00839-2
  • 4. World Health Organization. (‎2021)‎. COVID-19 weekly epidemiological update, edition 50, 27 July 2021. World Health Organization. https://apps.who.int/iris/handle/10665/343387 (accessed on Jan 6, 2023).
  • 5. Our World in Data. Coronavirus (COVID-19) Vaccinations. Available online: https://our-worldindata.org/covid-vaccinations (accessed on Jan 6, 2023).
  • 6. Harder T, Külper-Schiek W, Reda S, et al. Ef-fectiveness of COVID-19 vaccines against SARS-CoV-2 infection with the Delta (B.1.617.2) variant: second interim results of a living systematic review and meta-analysis, 1 January to 25 August 2021. Euro Surveill 2021; 26: 2100920. https://doi.org/10.2807/1560-7917.ES.2021.26.41.210092
  • 7. Higdon MM, Wahl B, Jones CB, et al. A Sys-tematic Review of Coronavirus Disease 2019 Vaccine Efficacy and Effectiveness Against Se-vere Acute Respiratory Syndrome Coronavirus 2 Infection and Disease. Open Forum Infect Dis. 2022 Apr 18;9(6):ofac138. https://doi.org/10.1093/ofid/ofac138
  • 8. Atmar RL, Lyke KE, Deming ME, et al. Homol-ogous and Heterologous Covid-19 Booster Vac-cinations. N Engl J Med. 2022;386(11):1046-57. https://doi.org/10.1056/NEJMoa2116414
  • 9. Meggiolaro A, Sane Schepisi M, Nikolaidis GF, et al. Effectiveness of Vaccination against SARS-CoV-2 Infection in the Pre-Delta Era: A Systematic Review and Meta-Analysis. Vaccines (Basel). 2022;10(2):157. https://doi.org/10.3390/vac¬cines10020157
  • 10. Zeng B, Gao L, Zhou Q, Yu K, Sun F. Effective-ness of COVID-19 vaccines against SARS-CoV-2 variants of concern: a systematic review and meta-analysis. BMC Med. 2022;20(1):200. https://doi.org/10.1186/s12916-022-02397-y
  • 11. Bar-On YM, Goldberg Y, Mandel M, et al. Pro-tection of BNT162b2 Vaccine Booster against Covid-19 in Israel. New England Journal of Medicine 2021;385(15):1393-400. https://doi.org/10.1056/NEJMoa2114255
  • 12. Arbel R, Hammerman A, Sergienko R, et al. BNT162b2 Vaccine Booster and Mortality Due to Covid-19. New England Journal of Medicine 2021;385(26):2413-20. https://doi.org/10.1056/NEJMoa2115624
  • 13. Accorsi EK, Britton A, Fleming-Dutra KE, et al. Association Between 3 Doses of mRNA COVID-19 Vaccine and Symptomatic Infection Caused by the SARS-CoV-2 Omicron and Delta Variants. The Journal of the American Medical Association 2022 Feb 15;327(7):639-51. https://doi.org/10.1001/jama.2022.0470
  • 14. Olson SM, Newhams MM, Halasa NB, et al. Ef-fectiveness of BNT162b2 Vaccine against Criti-cal Covid-19 in Adolescents. N Engl J Med. 2022;386(8):713-23. https://doi.org/10.1056/NEJMoa2117995
  • 15. Sablerolles RSG, Rietdijk WJR, Goorhuis A, et al. Immunogenicity and Reactogenicity of Vac¬cine Boosters after Ad26.COV2.S Priming. New England Journal of Medicine 2022;386(10):951-63. https://doi.org/10.1056/NEJMoa2116747
  • 16. Costa Clemens SA, Weckx L, Clemens R, et al. Heterologous versus homologous COVID-19 booster vaccination in previous recipients of two doses of CoronaVac COVID-19 vaccine in Bra-zil (RHH-001): a phase 4, non-inferiority, single blind, randomised study. Lancet. 2022;399(10324):521-9. https://doi.org/10.1016/S0140-6736(22)00094-0
  • 17. Cerqueira-Silva T, Katikireddi SV, de Araujo Oliveira V, et al. Vaccine effectiveness of heter-ologous CoronaVac plus BNT162b2 in Brazil. Nature Medicine 2022;28(4):838-43. https://doi.org/10.1038/s41591-022-01701-w.
  • 18. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Dis-ease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Preven-tion. JAMA. 2020 Apr 7;323(13):1239-42. https://doi.org/10.1001/jama.2020.2648
  • 19. Richardson S, Hirsch JS, Narasimhan M, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA. 2020;323(20):2052-9. https://doi.org/10.1001/jama.2020.6775
  • 20. Armiñanzas C, Arnaiz de Las Revillas F, Gutiér-rez Cuadra M, et al. Usefulness of the COVID-GRAM and CURB-65 scores for predicting se-verity in patients with COVID-19. Int J Infect Dis. 2021;108:282-8. https://doi.org/10.1016/j.ijid.2021.05.048
  • 21. Liang W, Liang H, Ou L, et al. Development and Validation of a Clinical Risk Score to Predict the Occurrence of Critical Illness in Hospitalized Patients With COVID-19. JAMA Intern Med. 2020;180(8):1081-9. https://doi.org/10.1001/jamaintern-med.2020.2033
  • 22. Wang D, Hu B, Hu C, et al. Clinical Character-istics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wu-han, China. JAMA. 2020;323(11):1061-9. https://doi.org/10.1001/jama.2020.1585
  • 23. Kox M, Waalders NJB, Kooistra EJ, Gerretsen J, Pickkers P. Cytokine Levels in Critically Ill Patients With COVID-19 and Other Conditions. JAMA. 2020;324(15):1565–7. https://doi.org/10.1001/jama.2020.17052
  • 24. Wu C, Chen X, Cai Y, et al. Risk Factors Asso-ciated With Acute Respiratory Distress Syn-drome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China. JAMA Intern Med. 2020;180(7):934-43. https://doi.org/10.1001/jamaintern-med.2020.0994
  • 25. COVID-ICU Group on behalf of the REVA Net-work and the COVID-ICU Investigators. Clini¬cal characteristics and day-90 outcomes of 4244 critically ill adults with COVID-19: a prospec¬tive cohort study. Intensive Care Med. 2021;47(1):60-73. https://doi.org/10.1007/s00134-020-06294-x
  • 26. Docherty AB, Mulholland RH, Lone NI, et al. Changes in in-hospital mortality in the first wave of COVID-19: a multicentre prospective obser-vational cohort study using the WHO Clinical Characterisation Protocol UK. Lancet Respir Med. 2021;9(7):773-85. https://doi.org/10.1016/S2213-2600(21)00175-2
There are 26 citations in total.

Details

Primary Language English
Subjects Clinical Sciences, Intensive Care
Journal Section Articles
Authors

Efraim Güzel 0000-0001-6677-9254

Oya Baydar Toprak 0000-0001-7320-976X

Publication Date April 30, 2023
Acceptance Date April 1, 2023
Published in Issue Year 2023 Volume: 6 Issue: 1

Cite

APA Güzel, E., & Baydar Toprak, O. (2023). The Effect of Vaccines and Booster Doses on Disease Progression and Mortality in Inpatients with COVID-19. Journal of Cukurova Anesthesia and Surgical Sciences, 6(1), 130-139. https://doi.org/10.36516/jocass.1242107

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