ISSN : 2146-3123
E-ISSN : 2146-3131

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