Pandemi Servisinde Yatan Kovid-19 Hastalarında Aşılanma Durumunun Prognoza Etkisinin Araştırılması

Öz

Amaç: Hastanede yatış sırasında değişen aşı kombinasyonları ile aşı durumunun COVID-19 hastalarının prognozuna etkisini değerlendirmeyi amaçladık. Materyal ve Metot: Araştırma 457'si kadın olmak üzere 854 COVİD-19 hastasının verileriyle gerçekleştirildi. Karşılaştırmalarda yer alan bağımlı değişken yoğun bakım ihtiyacı, bağımsız değişkenler; cinsiyet, risk skoru, şiddet skoru, aşılanma durumlarıdır. Bulgular: Hastaların yaş ortalaması 57,7±15,71 standart sapma (SS) yıl olup, %49,2’si hiç aşı olmamış ve %18,3’ününde yoğun bakım ihtiyacı olmuştur. Hastaların. Farklı aşı kombinasyonları kullanılarak üç lojistik regresyon modeli oluşturulmuştur. İlk modelde üç doz CoronaVac ya da iki doz CoronaVac bir doz Comirnaty aşısı, ikinci modelde üç doz CoronaVac aşısı, son modelde sadece aşı olmanın (hastalık öncesi 6 ayda en az bir doz) yoğun bakım ünitesi (YBÜ)’ne yatış riskini sırasıyla %82, %77 ve %42’lik azalma sağladığı saptanmıştır. Sonuç: Aşılamanın yatan hastalarda yoğun bakım ihtiyacını önlemedeki etkinliği bir kez daha ortaya kondu ve rapel aşı dozlarıyla bu etkinliğin daha da arttığı gözlendi.

Anahtar Kelimeler

• COVID-19
• COVID-19 aşıları
• yatan hastalar
• yoğun bakım

Investigation of the Effect of Vaccination Status on the Prognosis of Covid-19 Patients Hospitalized in Pandemic Service

Abstract

Objective: We aimed to evaluate the effect of vaccination status on the prognosis of COVID-19 patients with varying vaccine combinations during hospitalization Materials and Methods: The study was conducted with the data of 854 COVID-19 patients, of which 457 were female. The dependent variable in the comparisons was the need for intensive care, and the independent variables were gender, risk score, severity score, and vaccination status. Results: The mean age of the patients was 57.7±15.71 with standard deviation (SD); 49.2% had never been vaccinated, and 18.3% needed intensive care. Three logistic regression models were developed using different vaccine combinations. Three doses of CoronaVac or two doses of CoronaVac and one dose of Comirnaty vaccine in the first model, three doses of CoronaVac vaccine in the second model, and receiving the vaccine solely (at least one dose in the 6 months before the disease) in the last model were found to reduce the risk of intensive care unit (ICU) admission by 82%, 77%, and 42%, respectively. Conclusion: The effectiveness of vaccination in preventing the need for intensive care in inpatients was once again demonstrated, and it was observed that this effectiveness increased even more with booster vaccine doses.

Keywords

• COVID-19
• COVID-19 Vaccines
• Inpatients
• Intensive care

References

1. 1- Rothe C, Schunk M, Sothmann P, et al. Transmission of 2019-nCoV infection from an asymptomatic contact in Germany. N Engl J Med. 2020;382(10):970-971.
2. 2- Hassan SA, Sheikh FN, Jamal S, Ezeh JK, Akhtar A. Coronavirus (COVID-19): A review of clinical features, diagnosis, and treatment. Cureus. 2020;12(3):e7355. doi:10.7759/cureus.7355
3. 3- Cohen PA, Hall LE, John JN, Rapoport AB. The early natural history of SARS-CoV-2 infection: Clinical observations from an urban, ambulatory COVID-19 clinic. Mayo Clin Proc. 2020;95(6):1124-1126.
4. 4- Eliezer M, Hautefort C, Hamel AL, et al. Sudden and complete olfactory loss of function as a possible symptom of COVID-19. JAMA Otolaryngol Head Neck Surg. 2020;146(7):674-675.
5. 5- Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: Summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239–1242.
6. 6- Yurumez Y, Alacam M. Covid-19 and management in emergency service. J Biotechnol and Strategic Health Res. 2020;1(Special Issue):116-122.
7. 7- Xu L, Liu J, Lu M, Yang D, Zheng X. Liver injury during highly pathogenic human coronavirus infections. Liver international: Official Journal of the International Associationf or the Study of the Liver. 2020;40(5):998–1004.
8. 8- T.C. Sağlik Bakanliği Halk Sağliği Genel Müdürlüğü Bilimsel Danışma Kurulu Çalışması. COVID-19 (SARS-CoV-2 enfeksiyonu) çocuk hasta yönetimi ve tedavi 2021. https://covid19rehberi.com/wp-content/uploads/2021/05/covid-19rehbericocukhastayonetimivetedavipdf.pdf. Accessed July 27, 2023.

9. 9- Dagan N, Barda N, Kepten E, et al. Lipsitch M, Reis B, Balicer RD. BNT162b2 mRNA Covid-19 vaccine in a nationwide mass vaccination Setting. N Engl J Med. 2021;384(15):1412-1423.
10. 10- Lopez Bernal, J., Andrews, N., Gower, et al. Effectiveness of Covid-19 vaccines against the B. 1.617. 2 (Delta) variant. New England Journal of Medicine. 2021;385(7):585-594.
11. 11- Xie J, Tong Z, Guan X, Du B, Qiu H, Slutsky AS. Critical care crisis and some recommendations during the COVID-19 epidemic in China. Intensive Care Med. 2020;46(5):837-840.
12. 12- Grasselli G, Greco M, Zanella A, et al. COVID-19 Lombardy ICU network. risk factors associated with mortality among patients with COVID-19 in intensive care units in Lombardy, Italy. JAMA Intern Med. 2020;180(10):1345-1355.
13. 13- Docherty AB, Harrison EM, Green CA et al. Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO clinical characterisation protocol: prospective observational cohort study. BMJ. 2020;369:m1985. doi:10.1136/bmj.m1985
14. 14- Yavuz H, Aydin H. Laboratory findings in coronavirus disease 2019 (COVID-19). Cumhuriyet Medical Journal. 2020;42(2):198-202.
15. 15- Zhu F, Cao Y, Xu S, Zhou M. Co-infection of SARS-CoV-2 and HIV in a patient in Wuhan city, China. J Med Virol. 020 92(6):529-530.
16. 16- Jin YH, Cai L, Cheng ZS, et al. for the Zhongnan Hospital of Wuhan University novel coronavirus management and research team, Evidence-Based Medicine Chapter of China International Exchange and Promotive Association for Medical and Health Care (CPAM). A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Mil Med Res. 2020;7(1):4. doi:10.1186/s40779-020-0233-6