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. 2023 Nov 13;3(1):47.
doi: 10.1186/s44158-023-00130-6.

Clinical features and 28-day mortality predictors of vaccinated patients admitted to a COVID-19 ICU hub in Italy

Claudia Stella  1 , Cecilia Berardi  2 , Annalisa Chiarito  2 , Veronica Gennenzi  3 , Stefania Postorino  3 , Donatella Settanni  3 , Melania Cesarano  3 , Rikardo Xhemalaj  2 , Eloisa Sofia Tanzarella  3 , Salvatore Lucio Cutuli  3 , Domenico Luca Grieco  3 , Giorgio Conti  2   3 , Massimo Antonelli  2   3 , Gennaro De Pascale  2   3
Affiliations

Clinical features and 28-day mortality predictors of vaccinated patients admitted to a COVID-19 ICU hub in Italy

Claudia Stella et al. J Anesth Analg Crit Care. .

Abstract

Background: COVID-19 vaccination has been proved to be effective in preventing hospitalization and illness progression, even though data on mortality of vaccinated patients in the intensive care unit (ICU) are conflicting. The aim of this study was to investigate the characteristics of vaccinated patients admitted to ICU according to their immunization cycle and to outline the risk factors for 28-day mortality. This observational study included adult patients admitted to ICU for acute respiratory failure (ARF) due to SARS-CoV-2 and who had received at least one dose of vaccine.

Results: Fully vaccination was defined as a complete primary cycle from < 120 days or a booster dose from > 14 days. All the other patients were named partially vaccinated. One-hundred sixty patients (91 fully and 69 partially vaccinated) resulted eligible, showing a 28-day mortality rate of 51.9%. Compared to partially vaccinated, fully vaccinated were younger (69 [60-77.5] vs. 74 [66-79] years, p 0.029), more frequently immunocompromised (39.56% vs. 14.39%, p 0.003), and affected by at least one comorbidity (90.11% vs 78.26%, p 0.045), mainly chronic kidney disease (CKD) (36.26% vs 20.29%, p 0.035). At multivariable analysis, independent predictors of 28-day mortality were as follows: older age [OR 1.05 (CI 95% 1.01-1.08), p 0.005], history of chronic obstructive pulmonary disease (COPD) [OR 3.05 (CI 95% 1.28-7.30), p 0.012], immunosuppression [OR 3.70 (CI 95% 1.63-8.40), p 0.002], and admission respiratory and hemodynamic status [PaO2/FiO2 and septic shock: OR 0.99 (CI 95% 0.98-0.99), p 0.009 and 2.74 (CI 95% 1.16-6.48), p 0.022, respectively].

Conclusions: Despite a full vaccination cycle, severe COVID-19 may occur in patients with relevant comorbidities, especially immunosuppression and CKD. Regardless the immunization status, predisposing conditions (i.e., older age, COPD, and immunosuppression) and a severe clinical presentation were predictors of 28-day mortality.

Keywords: COVID-19; Intensive care unit; Mortality; Vaccination.

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Conflict of interest statement

GC, Editor in Chief of the Journal of Anesthesia Analgesia and Critical Care, is a co-author of this manuscript. The other authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Enrollment process flowchart. AKI, acute kidney injury; ARF, acute respiratory failure; P/F, PaO2 to FiO2 ratio; VTE, venous thromboembolism
Fig. 2
Fig. 2
Clinical outcomes according to vaccination status p <0.05 was considered significant and marked with “asterisk” (*)
See this image and copyright information in PMC

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References

    1. Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect Dis. 2020;20:533–534. doi: 10.1016/S1473-3099(20)30120-1. - DOI - PMC - PubMed
    1. Istituto Superiore di Sanità, Epidemiology for Public Health (2023) https://www.epicentro.iss.it/en/vaccines/covid-19-vaccination-plan. Accessed 24 May 2023
    1. Ministero della Salute (2023) https://www.salute.gov.it/portale/nuovocoronavirus/homeNuovoCoronavirus.jsp. Accessed 24 May 2023
    1. Tenforde MW, Self WH, Adams K, et al. Association between mRNA vaccination and COVID-19 hospitalization and disease severity. JAMA. 2021;326:2043–2054. doi: 10.1001/jama.2021.19499. - DOI - PMC - PubMed
    1. Lauring AS, Tenforde MW, Chappell JD, et al (2022) Clinical severity of, and effectiveness of mRNA vaccines against, covid-19 from omicron, delta, and alpha SARS-CoV-2 variants in the United States: prospective observational study. BMJ. 376. 10.1136/bmj-2021-069761 - PMC - PubMed

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