COVIDTW2研究：台湾地区新冠疫苗接种在插管的新冠相关急性呼吸窘迫综合征患者中的作用

The COVIDTW2 study: Role of COVID-19 vaccination in intubated patients with COVID-19-related acute respiratory distress syndrome in Taiwan.

作者信息

Wong Kuan-Chun, Kuo Chan-Yen, Tzeng I-Shiang, Hsu Ching-Fen, Wu Chih-Wei

机构信息

Department of Pharmacy, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.

Department of Research, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.

出版信息

J Infect Chemother. 2024 May;30(5):393-399. doi: 10.1016/j.jiac.2023.11.010. Epub 2023 Nov 14.

DOI:10.1016/j.jiac.2023.11.010

PMID:37972691

Abstract

BACKGROUND

COVID-19 vaccines have reduced the risk of disease progression to respiratory failure or death. However, in patients with breakthrough infections requiring invasive mechanical ventilation, the effect of prior COVID-19 vaccination on mortality remains inconclusive.

METHOD

We retrospectively analyzed data on patients intubated due to COVID-19 pneumonia between May 1, 2022 and October 31, 2022. Receipt of two or more doses of vaccine were considered as fully vaccinated. The primary outcome was the time from intubation to all-cause intensive care unit (ICU) mortality.

RESULT

A total of 84 patients were included (40 fully vaccinated versus 44 controls). The baseline characteristics, including age, comorbidities, and Sequential Organ Failure Assessment (SOFA) score on the day of intubation were similar between the two groups. The difference in ICU mortality rate between the fully vaccinated and control groups was not significant (35 % vs. 25 %, P = 0.317; hazard ratio with 95 % confidence interval = 1.246 (0.575-2.666), P = 0.571). The SOFA score (hazard ratio: 1.319, P = 0.001) and body mass index (BMI) (hazard ratio: 0.883, P = 0.022) were significantly associated with ICU mortality.

CONCLUSION

Being fully vaccinated was not associated with a mortality benefit in intubated patients with COVID-19. A higher SOFA score on the day of intubation and lower BMI were poor prognostic factors.

摘要

背景

新型冠状病毒肺炎（COVID-19）疫苗降低了疾病进展为呼吸衰竭或死亡的风险。然而，在需要有创机械通气的突破性感染患者中，先前接种COVID-19疫苗对死亡率的影响仍不明确。

方法

我们回顾性分析了2022年5月1日至2022年10月31日期间因COVID-19肺炎插管患者的数据。接种两剂或更多剂疫苗被视为完全接种。主要结局是从插管到全因重症监护病房（ICU）死亡的时间。

结果

共纳入84例患者（40例完全接种者与44例对照组）。两组在插管当天的基线特征，包括年龄、合并症和序贯器官衰竭评估（SOFA）评分相似。完全接种组和对照组的ICU死亡率差异不显著（35%对25%，P = 0.317；95%置信区间的风险比= 1.246（0.575 - 2.666），P = 0.571）。SOFA评分（风险比：1.319，P = 0.001）和体重指数（BMI）（风险比：0.883，P = 0.022）与ICU死亡率显著相关。