Tandon Pranai, Leibner Evan, Hackett Anna, Maguire Katherine, Leonardi Kayla, Levin Matthew A, Kohli-Seth Roopa
Institute for Critical Care Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Acute Crit Care. 2022 Aug;37(3):339-346. doi: 10.4266/acc.2022.00675. Epub 2022 Aug 29.
We aim to describe the demographics and outcomes of patients with severe disease with the Omicron variant. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus continues to mutate, and the availability of vaccines and boosters continue to rise, it is important to understand the health care burden of new variants. We analyze patients admitted to intensive care units (ICUs) in a large Academic Health System during New York City's fourth surge beginning on November 27, 2021.
All patients admitted to an ICU were included in the primary analysis. Key demographics and outcomes were retrospectively compared between patients stratified by vaccination status. Univariate and multivariate logistic regression was used to identify risk factors for in-hospital mortality.
In-hospital mortality for all admitted patients during the fourth wave was significantly lower than in previous waves. However, among patients requiring intensive care, in-hospital mortality was high across all levels of vaccination status. In a multivariate model older age was associated with increased in-hospital mortality, vaccination status of overdue for booster was associated with decreased in hospital mortality, and vaccination status of up-to-date with vaccination showed a trend to reduced mortality.
In-hospital mortality of patients with severe respiratory failure from coronavirus disease 2019 (COVID-19) remains high despite decreasing overall mortality. Vaccination against SARS-CoV-2 was protective against mortality. Vaccination remains the best and safest way to protect against serious illness and death from COVID-19. It remains unclear that any other treatment will have success in changing the natural history of the disease.
我们旨在描述感染奥密克戎变异株的重症患者的人口统计学特征和预后情况。严重急性呼吸综合征冠状病毒2（SARS-CoV-2）持续变异，且疫苗和加强针的接种率不断提高，了解新变异株对医疗保健的负担很重要。我们分析了2021年11月27日纽约市第四波疫情高峰期间，一家大型学术医疗系统中入住重症监护病房（ICU）的患者情况。
所有入住ICU的患者均纳入初步分析。按疫苗接种状态分层的患者之间，对关键人口统计学特征和预后进行回顾性比较。采用单因素和多因素逻辑回归分析确定院内死亡的危险因素。
第四波疫情期间所有入院患者的院内死亡率显著低于前几波。然而，在需要重症监护的患者中，无论疫苗接种状态如何，院内死亡率都很高。在多因素模型中，年龄较大与院内死亡率增加相关，加强针逾期接种状态与院内死亡率降低相关，及时接种疫苗状态显示出死亡率降低的趋势。
尽管总体死亡率有所下降，但2019冠状病毒病（COVID-19）导致的严重呼吸衰竭患者的院内死亡率仍然很高。接种SARS-CoV-2疫苗可降低死亡率。接种疫苗仍然是预防COVID-19导致严重疾病和死亡的最佳、最安全的方法。目前尚不清楚其他任何治疗方法能否成功改变该疾病的自然病程。
