Department of Emergency Medicine, University of Health Sciences Kayseri City Training and Research Hospital, Kayseri, Turkey.
Department of Infectious Disease and Clinical Microbiology, University of Health Sciences Kayseri City Training and Research Hospital, Kayseri, Turkey.
Am J Emerg Med. 2022 Apr;54:102-106. doi: 10.1016/j.ajem.2022.01.067. Epub 2022 Feb 3.
It is thought vaccines allowed for emergency use significantly reduce hospitalizations and emergency room visits. It is a matter of curiosity how many of the patients who come to the emergency department (ED) are vaccinated. We aimed to examine the characteristics of ED patients needing hospitalizations related to moderate and severe COVID-19 by vaccination status.
A retrospective study of 559 rRT-PCR-confirmed SARS-CoV-2 infection cases with moderate or severe COVID-19 needing hospitalization was performed in August 2021. Univariate and multivariate logistic regression analyses were performed for factors associated with mortality.
The mean age of the patients was 60.8 ± 18.1 years old, and 54.2% (n = 303) of the patients were women. The most common comorbidities were hypertension (37.2%), diabetes mellitus (31.1%) and chronic obstructive pulmonary disease (13.8%), respectively. The number of patients with alpha variant was 399 (71.4%), and delta variant was 83 (14.8%). Fifty point 6% (n = 283) of the patients were fully vaccinated. The total number of patients who died in the study was 114 (20.4%), and the number of patients hospitalized in the intensive care unit was 168 (30.1%). The day between the last dose of vaccine and hospitalization was 117 ± 45.9 days. In multivariate logistic regression analysis: age (odds ratio (OR), 1.05; 95% confidence intervals (95% CI) 1.03-1.08- year increase), male gender (OR, 1.8; 95% CI, 1.1-2.9), presence of at least one comorbid disease (OR, 2; 95% CI, 1.1-3.7) and partial (OR, 0.24;95% CI, 0.09-0.6) and fully vaccinated status (OR, 0.1; 95% CI, 0.05-0.18) were associated with mortality among COVID-19 patients.
In this study, age older than 65, unvaccinated, and comorbidities had significantly higher mortality. In multivariate regression analyses, age, vaccination status, comorbidities and the male gender were associated with mortality. Our study did not evaluate the vaccine efficacy but, a lower mortality rate was observed in those fully vaccinated with CoronaVac and Pfizer-BioNTech. Additionally, Alpha, Delta and other variants had the same mortality rates.
人们认为，紧急使用的疫苗显著降低了住院和急诊就诊率。令人好奇的是，有多少因中度和重度 COVID-19 前来急诊科（ED）就诊的患者接种了疫苗。我们旨在研究接种疫苗与未接种疫苗的因中度和重度 COVID-19 而需要住院的 ED 患者的特征。
2021 年 8 月，对 559 例经逆转录聚合酶链反应（rRT-PCR）确诊的 SARS-CoV-2 感染且需住院治疗的中度或重度 COVID-19 患者进行了一项回顾性研究。对与死亡率相关的因素进行了单变量和多变量逻辑回归分析。
患者的平均年龄为 60.8 ± 18.1 岁，54.2%（n = 303）为女性。最常见的合并症分别为高血压（37.2%）、糖尿病（31.1%）和慢性阻塞性肺疾病（13.8%）。399 例（71.4%）患者的病毒株为阿尔法变异株，83 例（14.8%）为德尔塔变异株。50.6%（n = 283）的患者已完全接种疫苗。研究中总共有 114 例（20.4%）患者死亡，168 例（30.1%）患者住院重症监护病房。最后一剂疫苗与住院之间的天数为 117 ± 45.9 天。在多变量逻辑回归分析中：年龄（比值比（OR），1.05；95%置信区间（95%CI）1.03-1.08-每增加 1 岁）、男性（OR，1.8；95%CI，1.1-2.9）、至少存在一种合并症（OR，2；95%CI，1.1-3.7）、部分（OR，0.24；95%CI，0.09-0.6）和完全接种疫苗（OR，0.1；95%CI，0.05-0.18）与 COVID-19 患者的死亡率相关。
在这项研究中，年龄大于 65 岁、未接种疫苗和合并症与更高的死亡率显著相关。在多变量回归分析中，年龄、疫苗接种状况、合并症和男性与死亡率相关。我们的研究没有评估疫苗的疗效，但观察到完全接种科兴和国药疫苗的患者死亡率较低。此外，阿尔法、德尔塔和其他变异株的死亡率相同。
