. Departamento de Pneumologia, Centro Hospitalar e Universitário de Coimbra, Universidade de Coimbra, Coimbra, Portugal.
. Unidad de Cuidados Intensivos y Ventilación No Invasiva, Hospital General Universitario Morales Meseguer, Murcia, España.
J Bras Pneumol. 2024 Feb 23;50(1):e20230116. doi: 10.36416/1806-3756/e20230116. eCollection 2024.
To analyze the clinical characteristics and outcomes of patients with COVID-19-related acute respiratory failure on the basis of their vaccination status at the time of ICU admission.
We conducted a retrospective observational study using a prospective database of patients admitted to the ICU of a university hospital in the city of Murcia, in Spain, between January 1, 2021 and September 1, 2022. Clinical, analytical, and sociodemographic data were collected and analyzed on the basis of patient vaccination status. We adjusted for confounding variables using propensity score matching and calculated adjusted ORs and 95% CIs.
A total of 276 patients were included in the study. Of those, 8.3% were fully vaccinated, 12% were partially vaccinated, and 79.7% were unvaccinated. Although fully vaccinated patients had more comorbidities, partially vaccinated patients had higher disease severity. The proportion of patients with severe acute respiratory failure was higher in the unvaccinated group, followed by the partially vaccinated group. No significant differences were found among the different groups regarding complications, duration of ventilatory support, or length of ICU/hospital stay. In the sample selected by propensity score matching, the number of patients with severe complications and the in-hospital mortality rate were higher in unvaccinated patients, but the differences were not significant.
This study failed to show a significant improvement in outcomes in critically ill COVID-19 patients vaccinated against SARS-CoV-2. However, the CIs were wide and the mortality point estimates favored patients who received at least one dose of COVID-19 vaccine.
根据患者入住 ICU 时的疫苗接种状况，分析 COVID-19 相关急性呼吸衰竭患者的临床特征和结局。
我们对西班牙穆尔西亚市一家大学医院 ICU 收治的患者进行了回顾性观察性研究，该研究使用了前瞻性数据库。根据患者的疫苗接种状况收集和分析了临床、分析和社会人口学数据。我们使用倾向评分匹配调整了混杂变量，并计算了调整后的 OR 和 95%CI。
共有 276 名患者纳入研究。其中，8.3%的患者完全接种了疫苗，12%的患者部分接种了疫苗，79.7%的患者未接种疫苗。尽管完全接种疫苗的患者有更多的合并症，但部分接种疫苗的患者疾病严重程度更高。未接种疫苗组的严重急性呼吸衰竭患者比例较高，其次是部分接种疫苗组。在不同组之间，并发症、通气支持时间或 ICU/住院时间没有显著差异。在通过倾向评分匹配选择的样本中，未接种疫苗患者严重并发症和住院死亡率的比例较高，但差异无统计学意义。
本研究未能显示 COVID-19 患者接种 SARS-CoV-2 疫苗对危重症患者结局有显著改善。然而，CI 较宽，死亡率的点估计结果有利于至少接种过一剂 COVID-19 疫苗的患者。
