Сравнение смертности у госпитализированных пациентов с COVID-19 в зависимости от наличия или отсутствия вакцинации

Abstract

The coronavirus infection (COVID-19) is quite effectively contained by vaccination campaigns. However, in a number of patients, despite a history of vaccination, COVID-19 develops, requiring hospitalization and ending in death. Objectives. To study the differences in mortality and the course of a new coronavirus infection among patients hospitalized in hospitals in the city of Ryazan (Russian Federation) and Semey and Pavlodar (Republic of Kazakhstan). We determined mortality among hospitalized patients with a new coronavirus infection with and without vaccine status according to anamnestic data. And also compared the need for invasive oxygen support, laboratory data (СВС, CRP, ferritin, D-dimer) and the degree of lung damage according to CT at the time of admission. Results. There was no difference in the level of mortality depending on the presence or absence of a vaccination history. Fatal outcomes in the vaccinated and unvaccinated groups were equally frequent in 15 of 193 patients and 16 of 196 patients, respectively, p = 0.887. At the same time, the unvaccinated more often needed more intensive oxygen support and had higher levels of ferritin 437 (148–646) μg/l versus 323 (142–498) μg/l, p = 0.021. Also, unvaccinated patients spent more time in the hospital 12 (9–18) days versus 11 (8–16) days, p = 0.044. In general, the deceased were older than 66 ± 12 (62–70) years, versus 57 ± 14 (55–58) years in survivors, м < 0.001. They also had a greater need for oxygen support, as well as statistically significant higher levels of CRP 99 (59–144) mg/l vs. 50 (16–87) mg/l, p < 0.001, D-dimer – 5020 (1125–8350) ng /ml vs. 805 (440–1805) ng /ml p = 0.003, ferritin 451 (344–583) μg/l vs. 338 (138–557) μg/l at the time of admission. Conclusions. Vaccination history does not affect mortality among hospitalized patients with COVID-19. In predicting the course of COVID-19 in hospitalized patients, even if there is a history of vaccination, one should rely on standard biochemical methods for determining the level of CRP, D-dimer, and ferritin. Key words: COVID-19, vaccination, ferritin, D-dimer, CRP, mortality assessment