Sardinha Daniele Melo, Ferreira Ana Lúcia da Silva, Guimarães Ricardo José de Paula Souza E, Lima Karla Valéria Batista, Lima Luana Nepomuceno Gondim Costa
Programa de Pós-Graduação em Biologia Parasitária na Amazônia, Universidade do Estado do Pará and Instituto Evandro Chagas (PPGBPA/UEPA/IEC), Belém 66087-670, Pará, Brazil.
Programa de Pós-Graduação em Epidemiologia e Vigilância em Saúde, Instituto Evandro Chagas (PPGEVS/IEC), Ananindeua 67030-000, Pará, Brazil.
Vaccines (Basel). 2023 Apr 18;11(4):861. doi: 10.3390/vaccines11040861.
COVID-19 in Brazil has already caused, and it still causes, several impacts on health, economy, and education. The risk factors for death involved those with cardiovascular diseases (CVD), which were prioritized for the vaccination of COVID-19.
To investigate the clinical characteristics and outcomes between vaccinated and unvaccinated patients with cardiovascular diseases hospitalized for COVID-19 in Brazil in the year 2022.
A retrospective cohort was analyzed from the year 2022, with cases being hospitalized by COVID-19 being drawn from SIVEP-GRIPE surveillance. We compared clinical characteristics, comorbidities, and outcomes between CVD carriers and non-carriers, and we also compared vaccinated with two doses vs. those that are unvaccinated in CVD carriers. We performed chi-square, odds ratio, logistic regression, and survival analysis.
We included, in the cohort, 112,459 hospital inpatients. An amount of 71,661 (63.72%) of the hospitalized patients had CVD. Regarding deaths, 37,888 (33.69%) died. Regarding vaccination against COVID-19, 20,855 (18.54%) people were not vaccinated with any dose among those with CVD. Death - < 0.001 (OR 1.307-CI 1.235-1.383) and fever - < 0.001 (OR 1.156-CI 1.098-1.218) were associated with the unvaccinated CVD carriers, and diarrhea -0.015 (OR 1.116-CI 1.022-1.218), dyspnea -0.022 (OR 1.074-CI 1.011-1.142), and respiratory distress -0.021 (OR 1.070-CI 1.011-1.134) were also recorded. Those patients who possessed predictors of death, including invasive ventilation (- < 0.001 (OR 8.816-CI 8.313-9.350)), were admitted to the ICU - < 0.001 (OR 1.754-CI 1.684-1.827), and some had respiratory distress - < 0.001 (OR 1.367-CI 1.312-1.423), dyspnea < 0.001 (OR 1.341-CI 1.284-1.400), O saturation < 95% - < 0. 001 (OR 1.307-CI 1.254-1.363), they were unvaccinated against COVID-19 - < 0.001 (OR 1.258-CI 1.200-1.319), they were of male sex - < 0.001 (OR 1.179-CI 1.138-1.221), they had diarrhea -0.018 (OR 1.081-CI 1.013-1.154), and they may have been old < 0.001 (OR 1.034-CI 1.033-1.035). Survival was shorter for the unvaccinated -0.003, and - <0.001.
We highlight the predictors of death for those unvaccinated against COVID-19 in this research, and we evidenced the benefits of the COVID-19 vaccine in reducing deaths in hospitalized CVD patients.
巴西的新冠疫情已经并仍在对健康、经济和教育造成多方面影响。死亡风险因素涉及心血管疾病（CVD）患者，这些患者被列为新冠疫苗接种的优先对象。
调查2022年巴西因新冠住院的心血管疾病患者中，接种疫苗和未接种疫苗者的临床特征及预后情况。
对2022年的回顾性队列进行分析，新冠住院病例来自SIVEP - GRIPE监测系统。我们比较了心血管疾病患者与非患者的临床特征、合并症及预后情况，还比较了心血管疾病患者中接种两剂疫苗者与未接种者的情况。我们进行了卡方检验、比值比、逻辑回归和生存分析。
该队列纳入了112,459名住院患者。其中71,661名（63.72%）住院患者患有心血管疾病。在死亡方面，37,888人（33.69%）死亡。在新冠疫苗接种方面，心血管疾病患者中有20,855人（18.54%）未接种任何一剂疫苗。未接种疫苗的心血管疾病患者与死亡相关（<0.001，比值比1.307 - 置信区间1.235 - 1.383）以及发热相关（<0.001，比值比1.156 - 置信区间1.098 - 1.218），同时还记录到腹泻（-0.015，比值比1.116 - 置信区间1.022 - 1.218）、呼吸困难（-0.022，比值比1.074 - 置信区间1.011 - 1.142）和呼吸窘迫（-0.021，比值比1.070 - 置信区间1.011 - 1.134）。具有死亡预测因素的患者，包括有创通气（<0.001，比值比8.816 - 置信区间8.313 - 9.350）、入住重症监护病房（<0.001，比值比1.754 - 置信区间1.684 - 1.827），部分患者存在呼吸窘迫（<0.001，比值比1.367 - 置信区间1.312 - 1.423）、呼吸困难（<0.001，比值比1.341 - 置信区间1.284 - 1.400）、血氧饱和度<95%（<0.001，比值比1.307 - 置信区间1.254 - 1.363）、未接种新冠疫苗（<0.001，比值比1.258 - 置信区间1.200 - 1.319）、男性（<0.001，比值比1.179 - 置信区间1.138 - 1.221）、腹泻（-0.018，比值比1.081 - 置信区间1.013 - 1.154）以及年龄较大（<0.001，比值比1.034 - 置信区间1.033 - 1.035）。未接种疫苗者的生存时间较短（-0.003，<0.001）。
本研究突出了未接种新冠疫苗者的死亡预测因素，并证明了新冠疫苗在降低心血管疾病住院患者死亡方面的益处。
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