Mortality rates and epidemiological changes in critically ill Coronavirus Disease 2019 patients after a vaccination program in Brazil

Júnior, Donato da Silva Braz; Lyra3, Nathália Alves de Barros e; Viana, Mirela Muniz Arantes; Borba3, Vinícius Santos; Thuler, Luiz Cláudio Santos; Lima, Eduardo Jorge da Fonseca; Mello, Maria Julia Gonçalves

doi:10.36416/1806-3756/e20220268

Cited by 1 publication

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“… 2 - 4 , 11 , 12 Vaccines against SARS-CoV-2 have been effective in reducing the number of new COVID-19 cases, hospitalizations, ICU admissions, and deaths. 5 , 6 , 13 Our study showed that, after multivariate regression analysis, the risk factors for death, even in vaccinated patients after the multivariate regression analysis, were critical illness and need for IMV, vasopressors, or hemodialysis, even though obesity and fever at admission were protective factors against death. However, the frequency of ICU admissions, the need for IMV, and the number of deaths were significantly higher in unvaccinated patients than in vaccinated patients.…”

Section: Discussionmentioning

confidence: 64%

“…(2)(3)(4)11,12) As vacinas contra o SARS-CoV-2 foram efetivas na redução do número de novos casos de COVID-19, hospitalizações, internações em UTI e óbitos. (5,6,13) Nosso estudo mostrou que, após a análise de regressão multivariada, os fatores de risco para óbito, mesmo nos pacientes vacinados, foram doença crítica e necessidade de VMI, vasopressores ou hemodiálise, embora a obesidade e febre na admissão tenham sido fatores de proteção contra o óbito. No entanto, a frequência de internações em UTI, a necessidade de VMI e o número de óbitos foram significativamente maiores nos pacientes não vacinados do que nos vacinados.…”

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Risk factors for death and illness severity in vaccinated versus unvaccinated COVID-2019 inpatients: a retrospective cohort study

Jorge Costa1,

Roberto da Silva Junior2,

Cesar Arruda da Silva2

et al. 2023

J Bras Pneumol.

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Objective: To determine the clinical profile of COVID-19 inpatients who were vaccinated prior to hospitalization and to compare the risk factors for death and the 28-day survival rate of between those inpatients vaccinated with one, two, or three doses and unvaccinated COVID-19 inpatients. Methods: This was a retrospective observational cohort study involving COVID-19 patients admitted to a referral hospital in the city of Recife, Brazil, between July of 2020 and June of 2022. Results: The sample comprised 1,921 inpatients, 996 of whom (50.8%) were vaccinated prior to hospitalization. After adjusting the mortality risk for vaccinated patients, those undergoing invasive mechanical ventilation (IMV) had the highest mortality risk (adjusted OR [aOR] = 7.4; 95% CI, 3.8-14.1; p < 0.001), followed by patients > 80 years of age (aOR = 7.3; 95% CI, 3.4-15.4; p < 0.001), and those needing vasopressors (aOR = 5.6; 95% CI, 2.9-10.9; p < 0.001). After adjusting the mortality risk for all patients, having received three vaccine doses (aOR = 0.06; 95% CI, 0.03-0.11; p < 0.001) was the most important protective factor against death. There were progressive benefits of vaccination, reducing the frequency of ICU admissions, use for IMV, and death (respectively, from 44.9%, 39.0% and 39.9% after the first dose to 16.7%, 6.2% and 4.4% after the third dose), as well as significant improvements in survival after each subsequent dose (p < 0.001). Conclusions: Vaccines were effective in reducing illness severity and death in this cohort of COVID-19 inpatients, and the administration of additional doses conferred them with accumulative vaccine protection.

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