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Inicio Medicina Clínica (English Edition) Retrospective study of the effect of vaccination against SARS-CoV-2 in seriously...
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Vol. 161. Issue 5.
Pages 199-204 (September 2023)
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Vol. 161. Issue 5.
Pages 199-204 (September 2023)
Original article
Retrospective study of the effect of vaccination against SARS-CoV-2 in seriously ill patients admitted to an intensive care unit
Estudio retrospectivo del efecto de la vacunación frente al SARS-CoV-2 en enfermos graves que ingresan en una unidad de cuidados intensivos
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Juan Carlos Rodríguez-Borregána, Elena Cuenca-Fitoa, Yhivian Peñascoa, Carmen Huertas Marína, Trinidad Dierssen-Sotob, Alba Fernándeza, Raquel Ferrero-Francoc, Alejandro González-Castroa,
Corresponding author
e409@humv.es

Corresponding author.
a Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Spain
b Departamento de Estadística y Salud Pública, Facultad de Medicina de la Universidad de Cantabria, Cantabria, Spain
c Servicio Cántabro de Salud, Cantabria, Spain
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Tables (4)
Table 1. Main variables of the analysed cohort.
Table 2. Comparison of the clinical-epidemiological characteristics of the patients categorised according to groups studied.
Table 3. Comparative analysis between groups of the main variables associated with acute respiratory failure and therapeutic actions in the ICU.
Table 4. Main progressive variables analysed between the different groups categorised by vaccination level.
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Abstract
Background and objective

Our study aims to compare the clinical and epidemiological characteristics, length of stay in the ICU, and mortality rates of COVID-19 patients admitted to the ICU who are fully vaccinated, partially vaccinated, or unvaccinated.

Patients and methods

Retrospective cohort study (March 2020–March 2022). Patients were classified into unvaccinated, fully vaccinated, and partially vaccinated groups. We initially performed a descriptive analysis of the sample, a multivariable survival analysis adjusting for a Cox regression model, and a 90-day survival analysis using the Kaplan-Meier method for the death time variable.

Results

A total of 894 patients were analyzed: 179 with full vaccination, 32 with incomplete vaccination, and 683 were unvaccinated. Vaccinated patients had a lower incidence (10% vs. 21% and 18%) of severe ARDS. The survival curve did not show any differences in the probability of surviving for 90 days among the studied groups (P=.898). In the Cox regression analysis, only the need for mechanical ventilation during admission and the value of LDH (per unit of measurement) in the first 24h of admission were significantly associated with mortality at 90 days (HR: 5.78; 95% CI: 1.36–24.48); P=.01 and HR: 1.01; 95% CI: 1.00–1.02; P=.03, respectively.

Conclusions

Patients with severe SARS-CoV-2 disease who are vaccinated against COVID-19 have a lower incidence of severe ARDS and mechanical ventilation than unvaccinated patients.

Keywords:
Vaccination
COVID-19
SARS-CoV-2
Intensive care unit
Mechanical ventilation
Mortality
Resumen
Antecedentes y objetivo

Planteamos nuestro trabajo con el objetivo de comparar las características clínico epidemiológicas, la estancia en la UCI y la mortalidad de pacientes con COVID-19 que ingresaron en la UCI con vacunación completa, incompleta o sin vacunar.

Pacientes y métodos

Estudio retrospectivo de cohortes (Marzo 2020–Marzo 2022). Los pacientes fueron clasificados en pacientes no vacunados, pauta de vacunación completa y pauta de vacunación incompleta. Se realizó inicialmente un análisis descriptivo de la muestra, un análisis multivariable de la supervivencia ajustando un modelo de regresión de Cox y un análisis de supervivencia a 90 días con el método de Kaplan-Meier para la variable de tiempo de muerte.

Resultados

Fueron analizados los 894 pacientes: 179 con una pauta de vacunación completa, 32 con una pauta incompleta y 683 no estaban vacunados. Los enfermos vacunados presentaron con menor frecuencia (10% frente al 21% y 18%) un SDRA grave. La curva de supervivencia, no presentó diferencias en la probabilidad de sobrevivir a los 90 días entre los grupos estudiados (P=,898). En el análisis de regresión de COX, únicamente la necesidad de VM durante el ingreso y el valor de LDH (por unidad de medida) en las primeras 24 horas de ingreso se asociaron de forma significativa con la mortalidad a los 90 días (HR: 5,78; IC95%: 1,36–24,48); P=,01 y HR: 1,01; IC95%: 1,00–1,02; P=,03 respectivamente.

Conclusiones

Los pacientes vacunados frente al COVID-19 con enfermedad grave por SARS-CoV-2 presentan unas tasas de SDRA grave y de VM menores que las de aquellos pacientes no vacunados.

Palabras clave:
Vacunación
COVID-19
SARS-CoV-2
Cuidados intensivos
Ventilación mecánica
Mortalidad

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