Libyan Biotechnology Research Center, Tripoli, Libya.
Department of Forensic and toxicology, Faculty of Medicine, University of Tripoli, Tripoli, Libya.
PLoS One. 2023 Aug 4;18(8):e0289490. doi: 10.1371/journal.pone.0289490. eCollection 2023.
The Delta variant has led to a surge in COVID-19 cases in Libya, making it crucial to investigate the impact of vaccination on mortality rates among hospitalized patients and the critically ill. This study aimed to explore the risk factors for COVID-19 mortality and the mortality rates among unvaccinated and vaccinated adults during the Delta wave who were admitted to a single COVID-19 care center in Tripoli, Libya.
The study involved two independent cohorts (n = 341). One cohort was collected retrospectively from May 2021-August 2021 and the second cohort was prospectively collected from August 2021-October 2021. Most of the patients in the study became ill during the Delta wave. The two cohorts were merged and analysed as one group.
Most patients were male (60.5%) and 53.3% were >60 years old. The vast majority of patients did not have a previous COVID-19 infection (98.9%) and were unvaccinated (90.3%). Among vaccinated patients, 30 had received one dose of vaccine and only 3 had received two doses. Among patients who received one dose, 58.1% (18/31) died and 41.9% (13/31) survived. Most patients (72.2%) had a pre-existing medical condition. A multivariable prediction model showed that age >60 years was significantly associated with death (odds ratio = 2.328, CI 1.5-3.7, p-value = <0.0001).
Our results indicate that previous infection or full vaccination against COVID-19 significantly reduces hospitalization and death. However, a single vaccine dose may not be adequate, especially for older individuals and those with underlying medical conditions. High-risk older patients with comorbidities should be fully vaccinated and offered up to date bivalent COVID-19 booster doses.
德尔塔变异株导致利比亚 COVID-19 病例激增，因此研究疫苗接种对住院患者和重症患者死亡率的影响至关重要。本研究旨在探讨 COVID-19 死亡率的危险因素，以及在利比亚的的黎波里单一 COVID-19 护理中心住院的未接种和接种疫苗的成年人在德尔塔波期间的死亡率。
该研究涉及两个独立队列（n = 341）。一个队列是从 2021 年 5 月至 2021 年 8 月回顾性收集的，第二个队列是从 2021 年 8 月至 10 月前瞻性收集的。研究中的大多数患者在德尔塔波期间患病。两个队列合并并作为一个组进行分析。
大多数患者为男性（60.5%），53.3%年龄>60 岁。绝大多数患者没有既往 COVID-19 感染（98.9%）且未接种疫苗（90.3%）。在接种疫苗的患者中，30 人接种了一剂疫苗，只有 3 人接种了两剂。在接种一剂疫苗的患者中，58.1%（18/31）死亡，41.9%（13/31）存活。大多数患者（72.2%）有基础疾病。多变量预测模型显示，年龄>60 岁与死亡显著相关（优势比=2.328，CI 1.5-3.7，p 值<0.0001）。
我们的结果表明，既往感染或完全接种 COVID-19 疫苗显著降低了住院和死亡风险。然而，单剂疫苗可能不够，特别是对于老年人和有基础疾病的人。患有合并症的高危老年患者应充分接种疫苗，并提供最新的二价 COVID-19 加强针。
