The Impact of CoronaVac Vaccination on 28-day Mortality Rate of Critically Ill Patients with COVID-19 in Türkiye.

Fethi Gül ,Hamza Gültekin ,İrem Akın Şen ,Sedef Gülçin Ural ,Kemal Tolga Saraçoğlu ,Nalan Demir ,Fatma Acıl ,Ayça Gümüş ,İlkay Ceylan ,Umut Sabri Kasapoğlu ,Mustafa Ay ,Pınar Ay,Verda Tuna ,Mustafa Yıldız ,Ayşen Erer ,Nimet Şenoğlu ,Funda Gök ,Volkan Yarar ,Cenk Kıraklı ,Feyyaz Kabadayı ,Kezban Özmen Süner ,Süleyman Yıldırım ,H Kirca ,Gülsüm Altuntaş ,Aydın Karahan ,Kübra Saçar Kübüç ,Andaç Dedeoğlu ,Özge Kuzgun ,Gülçin Hilal Alay ,Dilara Tüfek Öztan ,Burçin Doruk Oktay ,Ahmet Aytekin ,Volkan Alparslan ,Deniz Esin Tekcan Şanlı ,İsmet Sayan ,Hakan Dayanır ,Ülkü Yalçıntaş Arslan ,Osman Aydin ,Mehmet Süleyman Sabaz ,Melike Cengiz ,Onur Sinan Deveci ,Eda Macit Aydın ,Gülbahar Çalışkan ,Çağatay Erman Öztürk ,Devrim Akdağ ,Güneş Eskidemir ,Birgül Yelken ,Esra Aktaş Tekin ,Seda Banu Akıncı

doi:10.4274/balkanmedj.galenos.2023.2023-6-90

Abstract

Vaccines against coronavirus disease-19 (COVID-19) have been effective in preventing symptomatic diseases, hospitalizations, and intensive care unit (ICU) admissions. However, data regarding the effectiveness of COVID-19 vaccines in reducing mortality among critically ill patients with COVID-19 remains unclear. To determine the vaccination status and investigate the impact of the COVID-19 vaccine on the 28-day mortality in critically ill patients with COVID-19. Multicenter prospective observational clinical study. This study was conducted in 60 hospitals with ICUs managing critically ill patients with COVID-19. Patients aged ≥ 18 years with confirmed COVID-19 who were admitted to the ICU were included. The present study had two phases. The first phase was designed as a one-day point prevalence study, and demographic and clinical findings were evaluated. In the second phase, the 28-day mortality was evaluated. As of August 11, 2021, 921 patients were enrolled in the study. The mean age of the patients was 65.42 ± 16.74 years, and 48.6% (n = 448) were female. Among the critically ill patients with COVID-19, 52.6% (n = 484) were unvaccinated, 7.7% (n = 71) were incompletely vaccinated, and 39.8% (n = 366) were fully vaccinated. A subgroup analysis of 817 patients who were unvaccinated (n = 484) or who had received two doses of the CoronaVac vaccine (n = 333) was performed. The 28-day mortality rate was 56.8% (n = 275) and 57.4% (n = 191) in the unvaccinated and two-dose CoronaVac groups, respectively. The 28-day mortality was associated with age, hypertension, the number of comorbidities, type of respiratory support, and APACHE II and sequential organ failure assessment scores (p < 0.05). The odds ratio for the 28-day mortality among those who had received two doses of CoronaVac was 0.591 (95% confidence interval: 0.413-0.848) (p = 0.004). Vaccination with at least two doses of CoronaVac within six months significantly decreased mortality in vaccinated patients than in unvaccinated patients.

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