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Purpose The rollout of COVID-19 vaccines began in India in January 2021, with healthcare professionals being the first to receive vaccination. The purpose of this research was to study the incidence and severity of COVID-19 infections among Indian doctors, following vaccination with ChAdOx1 nCoV-19 or BBV152. Methods We conducted an online voluntary survey among Indian doctors who received one or two doses of ChAdOx1 nCoV-19 or BBV152. Questions pertaining to the incidence and severity of COVID-19 infection following vaccination were asked. Data thus obtained were analysed. Results 9146 doctors were included in this study. 8301 of these received ChAdOx1 nCoV-19, while 845 received BBV152. 2842 (31.07%) respondents reported having a COVID-19 infection following vaccination. Presence of pre-existing medical comorbidities was associated with a higher incidence, while prior COVID-19 infection and two doses of either vaccine were associated with a lower incidence of COVID-19 infection post-vaccination. Exposure to COVID-19 patients on a daily basis did not increase the incidence of COVID-19 infection among doctors who were vaccinated. Increasing age, male gender, presence of pre-existing medical comorbidities, and daily exposure to COVID-19 patients were associated with increased severity of COVID-19 infection after vaccination. Two doses of either vaccine resulted in less severity of disease compared to one dose. Conclusion ChAdOx1 nCoV-19 and BBV152 confer immunity against severe forms of COVID-19 infections. COVID-19 infections prior to vaccination result in a lower incidence of breakthrough infection. Presence of pre-existing medical comorbidities is associated with increased incidence and severity of breakthrough infections.

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Adult-onset Still's disease (AOSD) is an uncommon entity that can mimic infection. Patients present with fever for more than 1-week, joint pain, and rash. We report a case of 22-year-old male who presented with fever, sore throat, and abdominal pain. During hospitalization, he had multiple episodes of tachycardia and tachypnea requiring mechanical ventilation. The patient had elevated white blood cell count, procalcitonin, and troponin. He was extensively investigated and diagnosed as AOSD. He responded to steroids and was discharged on day 20.

How to cite this article: Jagathkar G. Elderly in the ICU. Indian J Crit Care Med 2023;27(3):157–158.