科兴疫苗接种对土耳其新冠肺炎危重症患者28天死亡率的影响
The Impact of CoronaVac Vaccination on 28-day Mortality Rate of Critically Ill Patients with COVID-19 in Türkiye.
作者信息
Gül Fethi, Kasapoğlu Umut Sabri, Sabaz Mehmet Süleyman, Ay Pınar, Oktay Burçin Doruk, Çalışkan Gülbahar, Demir Nalan, Sayan İsmet, Kabadayı Feyyaz, Altuntaş Gülsüm, Gümüş Ayça, Kırca Hülya, Şanlı Deniz, Acil Fatma, Dedeoğlu Andaç, Ural Sedef Gülçin, Akın Şen İrem, Macit Aydın Eda, Dayanır Hakan, Yelken Birgül, Ceylan İlkay, Aydın Osman Özcan, Eskidemir Güneş, Aytekin Ahmet, Cengiz Melike, Arslan Ülkü, Akdağ Devrim, Alay Gülçin Hilal, Tekin Esra, Yarar Volkan, Saracoğlu Kemal Tolga, Gök Funda, Alparslan Volkan, Tuna Verda, Yıldız Murside, Şenoğlu Nimet, Kıraklı Cenk, Yıldırım Süleyman, Saçar Kübüç Kübra, Erer Ayşen, Gültekin Hamza, Özmen Süner Kezban, Kuzgun Özge, Öztürk Çağatay Erman, Karahan Aydın, Deveci Okan, Ay Mustafa, Tüfek Öztan Dilara, Akıncı Seda Banu, Yalçın Solak Melahat, Bozbay Süha, Özçiftçi Serhat, Gönderen Kamil, Küçük Ahmet Oğuzhan, Uyan Berna, Elay Gülseren, Boyacı Nazlıhan, Timurkaan Mustafa, Karakoç Ebru, Doğan Lerzan, Yalçınkaya Erdem, Kazancıoğlu Leyla, Erdal Dönmez Gül, Yılmaz Barış, Ergül Dursun Fırat, Boran Maruf, Özkarakaş Hüseyin, Karakaş Buğra, Ergin Özcan Perihan, Anaklı İlkay, Bayar Mustafa Kemal, Yüksel Didem Yüksel, Akdağ Şükriye, Pişkin Özcan, Temur Sibel, Eyüpoğlu Selin, Tekir Yılmaz Elvan, Avcı Gizem Zaim, Turan Raziye, Alkan Bayburt Fatma, Şahintürk Helin, Güçyetmez Bülent, Alparslan Mustafa Muhlis, Yarıcı Metin, Yıldırım Fatma, Yektaş Abdulkadir, Yaman Güçlü, Demirkıran Oktay, Cinel İsmail
机构信息
Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Marmara University Faculty of Medicine, İstanbul, Türkiye.
Clinic of Critical Care Medicine, Malatya Training and Research Hospital, Malatya, Türkiye.
出版信息
Balkan Med J. 2023 Oct 20;40(6):435-444. doi: 10.4274/balkanmedj.galenos.2023.2023-6-90.
BACKGROUND
Vaccines against coronavirus disease-19 (COVID-19) have been effective in preventing symptomatic diseases, hospitalizations, and intensive care unit (ICU) admissions. However, data regarding the effectiveness of COVID-19 vaccines in reducing mortality among critically ill patients with COVID-19 remains unclear.
AIMS
To determine the vaccination status and investigate the impact of the COVID-19 vaccine on the 28-day mortality in critically ill patients with COVID-19.
STUDY DESIGN
Multicenter prospective observational clinical study.
METHODS
This study was conducted in 60 hospitals with ICUs managing critically ill patients with COVID-19. Patients aged ≥ 18 years with confirmed COVID-19 who were admitted to the ICU were included. The present study had two phases. The first phase was designed as a one-day point prevalence study, and demographic and clinical findings were evaluated. In the second phase, the 28-day mortality was evaluated.
RESULTS
As of August 11, 2021, 921 patients were enrolled in the study. The mean age of the patients was 65.42 ± 16.74 years, and 48.6% (n = 448) were female. Among the critically ill patients with COVID-19, 52.6% (n = 484) were unvaccinated, 7.7% (n = 71) were incompletely vaccinated, and 39.8% (n = 366) were fully vaccinated. A subgroup analysis of 817 patients who were unvaccinated (n = 484) or who had received two doses of the CoronaVac vaccine (n = 333) was performed. The 28-day mortality rate was 56.8% (n = 275) and 57.4% (n = 191) in the unvaccinated and two-dose CoronaVac groups, respectively. The 28-day mortality was associated with age, hypertension, the number of comorbidities, type of respiratory support, and APACHE II and sequential organ failure assessment scores ( < 0.05). The odds ratio for the 28-day mortality among those who had received two doses of CoronaVac was 0.591 (95% confidence interval: 0.413-0.848) ( = 0.004).
CONCLUSION
Vaccination with at least two doses of CoronaVac within six months significantly decreased mortality in vaccinated patients than in unvaccinated patients.
背景
2019冠状病毒病（COVID-19）疫苗在预防有症状疾病、住院治疗和重症监护病房（ICU）收治方面已显示出有效性。然而，关于COVID-19疫苗在降低COVID-19重症患者死亡率方面的有效性数据仍不明确。
目的
确定COVID-19重症患者的疫苗接种状况，并调查COVID-19疫苗对其28天死亡率的影响。
研究设计
多中心前瞻性观察性临床研究。
方法
本研究在60家设有ICU的医院开展，这些ICU负责管理COVID-19重症患者。纳入年龄≥18岁、确诊COVID-19且入住ICU的患者。本研究分为两个阶段。第一阶段设计为为期一天的现况调查研究，评估人口统计学和临床特征。在第二阶段，评估28天死亡率。
结果
截至2021年8月11日，921例患者纳入本研究。患者的平均年龄为65.42±16.74岁，48.6%（n = 448）为女性。在COVID-19重症患者中，52.6%（n = 484）未接种疫苗，7.7%（n = 71）接种不完全，39.8%（n = 366）接种完全。对817例未接种疫苗（n = 484）或接种两剂科兴疫苗（n = 333）的患者进行亚组分析。未接种疫苗组和两剂科兴疫苗组的28天死亡率分别为56.8%（n = 275）和57.4%（n = 191）。28天死亡率与年龄、高血压、合并症数量、呼吸支持类型以及急性生理与慢性健康状况评分系统（APACHE II）和序贯器官衰竭评估（SOFA）评分相关（P < 0.05）。接种两剂科兴疫苗患者28天死亡率的比值比为0.591（95%置信区间：0.413 - 0.848）（P = 0.004）。
结论
在6个月内接种至少两剂科兴疫苗可显著降低接种患者的死亡率，相较于未接种患者。
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