COVID-19 Nedeni ile Yatarak Tedavi Görenlerde Aşıların ve Hatırlatma Dozlarının Hastalık Sürecine ve Mortaliteye Etkisi

Year 2023, , 130 - 139, 30.04.2023

Efraim Güzel , Oya Baydar Toprak

https://doi.org/10.36516/jocass.1242107

Abstract

Amaç: 2020 yılının ilk aylarından itibaren hayatımızın bir parçası haline gelen COVID-19 pandemisi ile mücadelede en etkili yöntem aşılamadır. Bu çalışma ile yatan hastaların aşılanma durumu, rapel aşı protokollerinin etkinliği ve COVID-19 hastalarının yoğun bakım ünitesi (YBÜ) ve mortalite için risk faktörlerini tanımlamak amaçlanmaktadır.
Gereç ve Yöntem: Çalışmamıza COVID-19 nedeni ile 3.basamak hastanede yatarak tedavi gören 247 hasta dahil edilmiştir. COVID-19 dışı nedenler ile hastanede yatan hastalar PCR testi pozitif olsa da çalışma dışı bırakılmıştır. Katılımcıların sosyo-demografik verileri, klinik ve laboratuvar bulguları hastane veri tabanı ve bir anket yardımıyla kayıt altına alınmıştır. Hastalar, hastalık ağırlığı bakımından hafif-orta-ağır hastalık, yattığı klinik bakımından servis ve YBÜ şeklinde gruplara ayrılmıştır. Aşılanma durumlarına göre ise aşılanmamış, Sinovac tabanlı protokoller, BioNTech tabanlı protokoller ve diğerleri olarak kategorize edilmiştir.
Bulgular: Çalışmadaki 247 hastanın %55,1’i erkek ve yaş ortalaması 60 ± 17,26 idi. Hastaların %38,5’i YBÜ’ne kabul edilmiş ve %9,3’ü ise hayatını kaybetmiştir. YBÜ’ne kabul edilenlerin %38,8’i, hayatını kaybedenlerin ise %56,5’nin aşılanmamış olduğu gözlemlenmiştir. 65 yaş üzerinde olunması (p=0,008), 7 günden fazla hastanede yatıyor olmak (p=0,003), ağır hastalık varlığı (p=0,002), sinir sistemi hastalığı olması (p=0,005) ve diğer ek hastalıkların varlığı (p=0,000) YBÜ kabulü için; hastalık ağırlığı (p=0,000) ile komorbiditlerden hipertansiyon (p=0,000), diyabetes mellitus (p=0,020) ve kalp-damar hastalıkları varlığı (p=0,000) mortalite için risk faktörü olarak bulunmuştur.
Sonuç: Hatırlatma dozlarının ve özellikle de dördüncü dozun aşılanma protokollerine eklenmesinin COVID-19'da mortaliteyi artıran YBÜ takibi ihtiyacını önlemede daha faydalı olabileceği düşünülmüştür.

Keywords

COVID-19, YBÜ, mortalite, aşılar, BioNTech, Sinovac.

The Effect of Vaccines and Booster Doses on Disease Progression and Mortality in Inpatients with COVID-19

Abstract

Objective: As of the first months of 2020, vaccination is the most effective method to combat the COVID-19 pandemic, which has become a part of our lives. This study aims to describe the vaccination status of inpatients, the effectiveness of booster vaccine protocols, and the risk factors for intensive care unit (ICU) and mortality of COVID-19 patients.
Materials and Methods: Our study included 247 patients hospitalized in a tertiary care hospital due to COVID-19. Patients hospitalized for non-COVID-19 reasons were excluded from the study even if the PCR test was positive. Socio-demographic data, clinical and laboratory findings of the participants were recorded using the hospital database and a questionnaire. Patients were divided into groups as mild-moderate-severe disease in terms of disease severity, ward and ICU in terms of hospitalization clinic. According to vaccination status, they were categorized as unvaccinated, Sinovac-based protocols, BioNTech-based protocols and others.
Results: Of the 247 patients in the study, 55.1% were male and the mean age was 60 ± 17.26 years. 38.5% of the patients were admitted to the ICU and 9.3% died. It was observed that 38.8% of those admitted to the ICU and 56.5% of those who died were not vaccinated. Being over 65 years of age (p=0.008), being hospitalized for more than 7 days (p=0.003), having a severe illness (p=0.002), having a nervous system disease (p=0.005) and having other comorbidities (p=0.000), were significant for ICU admission, whereas disease severity (p=0.000) and comorbidities such as hypertension (p=0.000), diabetes mellitus (p=0.020) and cardiovascular diseases (p=0.000) were found to be risk factors for mortality.
Conclusion: The addition of reminder doses, especially the fourth dose, to vaccination protocols may be more beneficial in preventing the need for ICU follow-up, which increases mortality in COVID-19.

Keywords

COVID-19, ICU, mortality, vaccines, BioNTech, Sinovac.

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