Girgin Ayten, Ileri Fatih, Kaya Senem, Koca Nizameddin
Department of Internal Medicine, Bursa City Hospital, Bursa, TUR.
Cureus. 2023 Oct 27;15(10):e47794. doi: 10.7759/cureus.47794. eCollection 2023 Oct.
Background The coronavirus disease 2019 (COVID-19) pandemic has been largely controlled by vaccines. However, a notable increase in COVID-19 infections has been observed among vaccinated individuals. The protection conferred by vaccination remains a topic of ongoing discussion and research. Our study aims to assess the impact of vaccination status on the demographics, clinical presentations, and laboratory characteristics of patients who were admitted to the hospital and subsequently hospitalized for further evaluation and treatment. Methods We examined hospitalized COVID-19 patients in terms of demographics, immunization status, clinical and laboratory findings, and outcomes over a seven-month period during which the delta variant was prevalent. Patients were categorized into three groups based on their vaccination status: unvaccinated (n=1,321, 53.3%), partially vaccinated (n=214, 8.6%), and fully vaccinated (n=944, 38.1%). Data from these patients were compared across groups. Results The study included 2,479 polymerase chain reaction (PCR)-confirmed hospitalized COVID-19 patients. The median ages (range) for the unvaccinated, partially vaccinated, and fully vaccinated patients who required hospitalization due to COVID-19 infection were 51 (18-98), 61 (21-91), and 71 (23-99), respectively (p<0.001). White blood cell count, neutrophils, monocytes, platelet count, and inflammatory markers such as erythrocyte sedimentation rate, C-reactive protein, procalcitonin, and IL-6, as well as fibrinogen and troponin T levels, were observed to be higher in the fully vaccinated patients compared to the unvaccinated and partially vaccinated patients. Clinical follow-ups showed that the intensive care unit (ICU) admission rates, length of hospital stay, and mortality rates were also higher in the fully vaccinated group compared to the other groups. Conclusion Our findings indicate that full vaccination significantly reduces hospitalization rates in younger individuals with average risk. However, patients with high-risk factors, such as advanced age and multiple comorbidities, exhibited higher hospitalization rates, increased need for intensive care, longer hospital stays, elevated inflammatory markers, and higher mortality even when fully vaccinated. It is crucial for elderly patients to receive thorough evaluations during emergency visits and to be provided with early treatment to reduce potential morbidity and mortality.
背景 2019 冠状病毒病(COVID-19)大流行在很大程度上已通过疫苗得到控制。然而,在接种疫苗的个体中观察到 COVID-19 感染显著增加。疫苗提供的保护仍然是一个持续讨论和研究的话题。我们的研究旨在评估疫苗接种状况对因 COVID-19 入院并随后住院进行进一步评估和治疗的患者的人口统计学、临床表现和实验室特征的影响。方法 我们在德尔塔变异株流行的七个月期间,对住院的 COVID-19 患者进行了人口统计学、免疫状态、临床和实验室检查结果以及结局方面的检查。根据患者的疫苗接种状况将其分为三组:未接种疫苗组(n = 1321,53.3%)、部分接种疫苗组(n = 214,8.6%)和完全接种疫苗组(n = 944,38.1%)。对这些患者的数据进行组间比较。结果 该研究纳入了 2479 例经聚合酶链反应(PCR)确诊的住院 COVID-19 患者。因 COVID-19 感染需要住院治疗的未接种疫苗、部分接种疫苗和完全接种疫苗患者的中位年龄(范围)分别为 51(18 - 98)岁、61(21 - 91)岁和 71(23 - 99)岁(p < 0.001)。与未接种疫苗和部分接种疫苗的患者相比,完全接种疫苗的患者的白细胞计数、中性粒细胞、单核细胞、血小板计数以及红细胞沉降率、C 反应蛋白、降钙素原和白细胞介素 - 6 等炎症标志物,以及纤维蛋白原和肌钙蛋白 T 水平均更高。临床随访表明,完全接种疫苗组的重症监护病房(ICU)入住率、住院时间和死亡率也高于其他组。结论 我们的研究结果表明,完全接种疫苗可显著降低平均风险的年轻个体的住院率。然而,具有高龄和多种合并症等高风险因素的患者,即使完全接种疫苗,其住院率也较高,对重症监护的需求增加,住院时间延长,炎症标志物升高,死亡率更高。老年患者在急诊就诊时接受全面评估并获得早期治疗以降低潜在的发病率和死亡率至关重要。