. Departamento de Ensino e Pesquisa, Hospital Alfa, Recife (PE) Brasil.
. Departamento de Ensino e Pesquisa, Instituto de Medicina Integral Professor Fernando Figueira - IMIP - Recife (PE) Brasil.
J Bras Pneumol. 2023 Sep 15;49(4):e20230145. doi: 10.36416/1806-3756/e20230145. eCollection 2023.
To determine the clinical profile of COVID-19 inpatients who were vaccinated prior to hospitalization and to compare the risk factors for death and the 28-day survival rate of between those inpatients vaccinated with one, two, or three doses and unvaccinated COVID-19 inpatients.
This was a retrospective observational cohort study involving COVID-19 patients admitted to a referral hospital in the city of Recife, Brazil, between July of 2020 and June of 2022.
The sample comprised 1,921 inpatients, 996 of whom (50.8%) were vaccinated prior to hospitalization. After adjusting the mortality risk for vaccinated patients, those undergoing invasive mechanical ventilation (IMV) had the highest mortality risk (adjusted OR [aOR] = 7.4; 95% CI, 3.8-14.1; p < 0.001), followed by patients > 80 years of age (aOR = 7.3; 95% CI, 3.4-15.4; p < 0.001), and those needing vasopressors (aOR = 5.6; 95% CI, 2.9-10.9; p < 0.001). After adjusting the mortality risk for all patients, having received three vaccine doses (aOR = 0.06; 95% CI, 0.03-0.11; p < 0.001) was the most important protective factor against death. There were progressive benefits of vaccination, reducing the frequency of ICU admissions, use for IMV, and death (respectively, from 44.9%, 39.0% and 39.9% after the first dose to 16.7%, 6.2% and 4.4% after the third dose), as well as significant improvements in survival after each subsequent dose (p < 0.001).
Vaccines were effective in reducing illness severity and death in this cohort of COVID-19 inpatients, and the administration of additional doses conferred them with accumulative vaccine protection.
确定住院前接种疫苗的 COVID-19 住院患者的临床特征，并比较接种一剂、两剂或三剂疫苗的 COVID-19 住院患者与未接种疫苗的 COVID-19 住院患者之间的死亡风险因素和 28 天生存率。
这是一项回顾性观察性队列研究，涉及 2020 年 7 月至 2022 年 6 月期间在巴西累西腓市一家转诊医院住院的 COVID-19 患者。
该样本包括 1921 名住院患者，其中 996 名（50.8%）在住院前接种了疫苗。在调整接种患者的死亡风险后，接受有创机械通气（IMV）的患者死亡风险最高（调整后的比值比[aOR] = 7.4；95%置信区间[CI]，3.8-14.1；p < 0.001），其次是> 80 岁的患者（aOR = 7.3；95%CI，3.4-15.4；p < 0.001）和需要血管加压药的患者（aOR = 5.6；95%CI，2.9-10.9；p < 0.001）。在调整所有患者的死亡风险后，接种三剂疫苗（aOR = 0.06；95%CI，0.03-0.11；p < 0.001）是预防死亡的最重要保护因素。疫苗接种具有渐进性获益，降低了 ICU 入院率、有创机械通气使用率和死亡率（分别从第一剂后的 44.9%、39.0%和 39.9%降至第三剂后的 16.7%、6.2%和 4.4%），并且在每次接种后都显著提高了生存率（p < 0.001）。
疫苗在降低该队列 COVID-19 住院患者的疾病严重程度和死亡方面是有效的，并且接种额外剂量可提供累积疫苗保护。
