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意大利卡拉布里亚地区未接种疫苗和接种疫苗的危重症 COVID-19 患者的特征:一项回顾性研究。

Characteristics of unvaccinated and vaccinated critically ill COVID-19 patients in calabria region (Italy): A retrospective study.

作者信息

Bruni Andrea, Longhini Federico, Macheda Sebastiano, Biamonte Eugenio, Pasqua Pino, Neri Giuseppe, Guzzo Maria Laura, Garofalo Eugenio

机构信息

Anaesthesia and Intensive Care, Department of Medical and Surgical Sciences, Magna Græcia University, Catanzaro, Italy.

Anesthesia and Intensive Care Unit, Grande Ospedale Metropolitano, Reggio Calabria, Italy.

出版信息

Front Med (Lausanne). 2022 Nov 24;9:1042411. doi: 10.3389/fmed.2022.1042411. eCollection 2022.

Abstract

INTRODUCTION

After the rapid surge of a novel coronavirus (SARS-CoV-2) in 2020 anti-SARS-CoV-2 vaccines have been developed to prevent the development of critical forms of COVID-19 leading to Intensive Care Unit (ICU) admission. The possibility of ICU admission after the first-cycle vaccination has been already reported; however, no data have been published regarding vaccinated patients with a "booster" dose. This retrospective study describes the characteristics of critically ill patients after the implementation of the regional "booster" dose vaccination program in a southern region of Italy.

MATERIALS AND METHODS

We screened all medical records of critically ill COVID-19 patients in the period between January to April 2022. We collected the demographic characteristics, the presence of comorbidities, the vaccination status, the clinical course (arterial blood gases and type of respiratory support) and outcomes (rate of tracheostomy, ICU length of stay and mortality).

RESULTS

A total of 272 patients were admitted to ICUs during the study period. 161 patients were unvaccinated, whereas 111 were vaccinated with the complete first-cycle or "booster" dose. The type of respiratory support was similar between groups. Vaccinated patients were characterized by a better oxygenation throughout the whole ICU length of stay. Fourteen unvaccinated and 3 vaccinated patients required tracheostomy ( = 0.045). ICU length of stay was 12.2 (± 7.3) days in unvaccinated patients and 10.4 (± 6.7) days in vaccinated patients ( = 0.036). ICU mortalities were 38.5 and 24.3% in unvaccinated and vaccinated patients, respectively ( = 0.014).

CONCLUSION

Vaccinated patients have better clinical course and outcomes as compared to the unvaccinated population.

摘要

引言

2020年新型冠状病毒(SARS-CoV-2)迅速蔓延后,已研发出抗SARS-CoV-2疫苗以预防导致入住重症监护病房(ICU)的重症COVID-19的发生。首次接种疫苗后入住ICU的可能性已有报道;然而,关于接种“加强针”剂量的患者的数据尚未公布。这项回顾性研究描述了意大利南部一个地区实施区域性“加强针”剂量疫苗接种计划后重症患者的特征。

材料与方法

我们筛查了2022年1月至4月期间所有重症COVID-19患者的病历。我们收集了人口统计学特征、合并症情况、疫苗接种状况、临床病程(动脉血气和呼吸支持类型)以及结局(气管切开率、ICU住院时间和死亡率)。

结果

在研究期间,共有272名患者入住ICU。161名患者未接种疫苗,而111名患者接种了完整的第一周期或“加强针”剂量。两组之间的呼吸支持类型相似。接种疫苗的患者在整个ICU住院期间氧合情况较好。14名未接种疫苗的患者和3名接种疫苗的患者需要气管切开(P = 0.045)。未接种疫苗的患者ICU住院时间为12.2(±7.3)天,接种疫苗的患者为10.4(±6.7)天(P = 0.036)。未接种疫苗和接种疫苗的患者的ICU死亡率分别为38.5%和24.3%(P = 0.014)。

结论

与未接种疫苗的人群相比,接种疫苗的患者临床病程和结局更好。

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