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

Fethi Gül

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

Fethi Gül¹, Umut Sabri Kasapoğlu², Mehmet Süleyman Sabaz³, Pınar Ay⁴, Burçin Doruk Oktay¹, Gülbahar Çalışkan⁵, Nalan Demir⁶, İsmet Sayan⁷, Feyyaz Kabadayı⁷, Gülsüm Altuntaş⁸, Ayça Gümüş⁹, Hülya Kırca⁹, Deniz Şanlı¹⁰, Fatma Acil¹¹, Andaç Dedeoğlu¹¹, Sedef Gülçin Ural¹², İrem Akın Şen¹², Eda Macit Aydın¹³, Hakan Dayanır¹³, Birgül Yelken¹⁴, İlkay Ceylan¹⁵, Osman Özcan Aydın¹⁴, Güneş Eskidemir¹⁶, Ahmet Aytekin¹⁷, Melike Cengiz¹⁸, Ülkü Arslan¹⁸, Devrim Akdağ¹⁹, Gülçin Hilal Alay²⁰, Esra Tekin²¹, Volkan Yarar²², Kemal Tolga Saracoğlu²³, Funda Gök²⁴, Volkan Alparslan²⁵, Verda Tuna²⁶, Murside Yıldız²⁷, Nimet Şenoğlu²⁸, Cenk Kıraklı²⁹, Süleyman Yıldırım²⁹, Kübra Saçar Kübüç³⁰, Ayşen Erer³¹, Hamza Gültekin³², Kezban Özmen Süner³³, Özge Kuzgun³³, Çağatay Erman Öztürk³⁴, Aydın Karahan³⁵, Okan Deveci³⁵, Mustafa Ay³⁶, Dilara Tüfek Öztan³⁶, Seda Banu Akıncı³⁷, et al

¹Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Marmara University Faculty of Medicine, İstanbul, Türkiye
²Clinic of Critical Care Medicine, Malatya Training and Research Hospital, Malatya, Türkiye
³Clinic of Critical Care Medicine, Marmara University Pendik Training and Research Hospital, İstanbul, Türkiye
⁴Department of Public Health, Marmara University Faculty of Medicine, İstanbul, Türkiye
⁵Department of Anesthesiology and Reanimation, University of Health Sciences Türkiye, Bursa Faculty of Medicine, Bursa, Türkiye
⁶Division of Critical Care Medicine, Clinic of Chest Diseases, University of Health Sciences Türkiye, Ankara City Hospital, Ankara, Türkiye
⁷Clinic of Critical Care Medicine, Sancaktepe Training and Research Hospital, İstanbul, Türkiye
⁸Clinic of Critical Care Medicine, Elazığ City Hospital, Elazığ, Türkiye
⁹Clinic of Critical Care Medicine, Antalya Kepez State Hospital, Antalya, Türkiye
¹⁰Clinic of Critical Care Medicine, Batman Training and Research Hospital, Batman, Türkiye
¹¹Clinic of Anesthesiology and Reanimation, University of Health Sciences Türkiye, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyabakır, Türkiye
¹²Clinic Critical Care Medicine, University of Health Sciences Türkiye, Erzurum City Hospital, Erzurum, Türkiye
¹³Division of Critical Care Medicine, Clinic of Anesthesiology and Reanimation, University of Health Sciences Türkiye, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Türkiye
¹⁴Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Türkiye
¹⁵Clinic of Critical Care Medicine, University of Health Sciences Türkiye, Bursa High Specialization Training and Research Hospital, Bursa, Türkiye
¹⁶Clinic of Critical Care Medicine, Gaziosmanpaşa Training and Research Hospital, İstanbul, Türkiye
¹⁷Clinic of Anesthesiology and Reanimation, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, İstanbul, Türkiye
¹⁸Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Akdeniz University Faculty of Medicine, Antalya, Türkiye
¹⁹Clinic of Critical Care Medicine, University of Health Sciences Türkiye, Adana City Hospital, Adana, Türkiye
²⁰Department of Anesthesiology and Reanimation, University of Health Sciences Türkiye, İstanbul Başakşehir Çam and Sakura City Hospital, İstanbul, Türkiye
²¹Clinic of Critical Care Medicine, Denizli State Hospital, Denizli, Türkiye
²²Clinic of Critical Care Medicine, Balıkesir Atatürk City Hospital, Balıkesir, Türkiye
²³Clinic of Anesthesiology and Reanimation, University of Health Sciences Türkiye, Kartal Lütfi Kırdar Training and Research Hospital, İstanbul, Türkiye
²⁴Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Necmettin Erbakan University Faculty of Medicine, Konya, Türkiye
²⁵Clinic of Critical Care Medicine, Hatay Training and Research Hospital, Hatay, Türkiye
²⁶Clinic of Critical Care Medicine, Adıyaman Training and Research Hospital, Adıyaman, Türkiye
²⁷Clinic of Critical Care Medicine, Ağrı Training and Research Hospital, Ağrı, Türkiye
²⁸Division of Critical Care Medicine, Clinic of Anesthesiology and Reanimation, University of Health Sciences Türkiye, Tepecik Training and Research Hospital, İzmir, Türkiye
²⁹Department of Critical Care Medicine, University of Health Sciences Türkiye, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, İzmir, Türkiye
³⁰Clinic of Critical Care Medicine, University of Health Sciences Türkiye, Van Training and Research Hospital, Van, Türkiye
³¹Clinic of Critical Care Medicine, Tekirdağ İsmail Fehmi Cumalioğlu City Hospital, Tekirdag, Türkiye
³²Clinic of Critical Care Medicine, Şırnak State Hospital, Şırnak, Türkiye
³³Clinic of Critical Care Medicine, Sakarya Training and Research Hospital, Sakarya, Türkiye
³⁴Clinic of Critical Care Medicine, University of Health Sciences Türkiye, Samsun Training and Research Hospital, Samsun, Türkiye
³⁵Clinic of Critical Care Medicine, Mersin City Hospital, Mersin, Türkiye
³⁶Clinic of Anesthesiology and Reanimation, Antalya Training and Research Hospital, Antalya, Türkiye
³⁷Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Hacettepe University Faculty of Medicine, Ankara, Türkiye
³⁸Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Hitit University Faculty of Medicine, Çorum, Türkiye
³⁹Department of Critical Care Medicine, İzmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Türkiye
⁴⁰Division of Critical Care Medicine, Department of Chest Diseases, Karadeniz Technical University Faculty of Medicine, Trabzon, Türkiye
⁴¹Department Critical Care Medicine, Gaziantep Şehit Kamil State Hospital, Gaziantep, Türkiye
⁴²Division of Critical Care Medicine, Department of Internal Medicine, Gaziantep University Faculty of Medicine, Gaziantep, Türkiye
⁴³Division of Critical Care Medicine, Department of Internal Medicine, Gazi University Faculty of Medicine, Ankara, Türkiye
⁴⁴Department of Critical Care Medicine, Çankırı State Hospital, Çankırı, Türkiye
⁴⁵Department of Critical Care Medicine, Altunizade Acıbadem Hospital, İstanbul, Türkiye
⁴⁶Department of Critical Care Medicine, Sivas Numune Hospital, Sivas, Türkiye
⁴⁷Department of Anesthesiology and Reanimation, Recep Tayyip Erdoğan University Faculty of Medicine, Rize, Türkiye
⁴⁸Department of Critical Care Medicine, University of Health Sciences Türkiye, İstanbul Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Türkiye

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

Pages : 435-444

Abstract

Background: 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.
Aims: 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.
Study Design: Multicenter prospective observational clinical study.
Methods: 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.
Results: 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).
Conclusion: 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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