Clinical outcomes in vaccinated and unvaccinated patients with COVID-19: a population-based analysis.

OBJECTIVE: Real-life data for vaccination against COVID-19 are sorely needed. This was a population-based analysis aiming at investigating the hospitalization risk for COVID-19 of 98,982 subjects and compare features of vaccinated and unvaccinated patients. PATIENTS AND METHODS: Hospitalized patients with COVID-19 between 01/07/2021 and 11/02/2022 were included in the study. RESULTS: 582 patients were included in the analysis [males: 58.6% (n=341), vaccinated patients: 28.5% (n=166), unvaccinated patients: 71.5% (n=416)]. Median age of vaccinated patients was significantly higher compared to median age of unvaccinated [74.0 (95% CI: 72.0-77.0) vs. 59.0 (95% CI: 57.0-62.0), p=0.0001]. Mean latency time (±SD) from the second dose to hospitalization was 5.7±2.6 months. Between 01/07/2021 and 01/12/2021, unvaccinated subjects had higher risk for hospitalization compared to vaccinated [HR: 2.82, 95% CI: 2.30-3.45, p<0.0001]. Between 02/12/2021 and 11/02/2022, unvaccinated subjects presented with higher risk for hospitalization than subjects that had received booster dose [HR: 2.07, 95% CI: 1.44-2.98, p=0.005], but not than subjects that got two doses. Median value of hospitalization days was higher in unvaccinated patients compared to vaccinated [7.0 (95% CI: 7.0-8.0) vs. 6.0 (95% CI: 5.0-7.0), p=0.02]. Finally, age-adjusted analysis showed that hospitalized unvaccinated patients presented with significantly higher mortality risk compared to hospitalized vaccinated patients [HR: 2.59, 95% CI: 1.69-3.98, p<0.0001]. CONCLUSIONS: Vaccination against COVID-19 remains the best way to contain the pandemic. There is an amenable need for booster dose during the omicron era.

The impact of the COVID-19 outbreak on surgical site infections in elective colorectal cancer surgery: One potential benefit of the pandemic?

Background: The COVID-19 pandemic, also known as the coronavirus pandemic, has affected either directly or directly all medical fields. It caused a major reduction of elective surgical operations as well as overall admissions to surgical departments because of the widespread hospital fear and anxiety experienced by most patients during the peak of this outbreak. However, colorectal cancer operations were performed in large numbers also during the pandemic. In order to protect patients and health workers, hygiene and public health measures were intensified when the coronavirus pandemic began. The aim of the present study was to evaluate the rate of surgical site infections (SSIs) after the beginning of COVID-19 hygiene measures, which was in March 2020 in Greece. Methods: A total of 173 patients who underwent elective colorectal cancer surgery were enrolled retrospectively. Patients were divided into two groups. Group A included 98 patients undergoing colorectal cancer surgery between January 2019-December 2019 (pre-COVID-19 era), whereas 75 patients (group B) underwent colorectal cancer procedures between April 2020-March 2021 (after the beginning of COVID-19 hygiene measures). Statistical analyses were done using Stata13. The student’s t-test was used to compare results between groups. Results: SSI developed in 35 of the 173 patients (20.2%). According to the results of our study, there was a statistically significant difference between the total numbers of SSIs between the 2 examined periods. 25 (25.5%) wound infections occurred in group A-patients postoperatively, whereas only 10 (13.3%) SSIs were developed in patients undergoing colorectal cancer surgery after the beginning of COVID-19 measures (P=0.048). Conclusions: The current study demonstrates that COVID-19 hygiene and public health measures affect the rate of SSI after elective colorectal cancer surgery. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.

Serum Hydrogen Sulfide and Outcome Association in Pneumonia by the SARS-CoV-2 Coronavirus

BACKGROUND: The pneumonia of COVID-19 illness has often a subtle initial presentation making mandatory the use of biomarkers for evaluation of severity and prediction of final patient disposition. We evaluated the use of hydrogen sulfide (H2S) for the outcome of COVID-19 pneumonia. PATIENTS AND METHODS: We studied 74 patients with COVID-19. Clinical data were collected, and survival predictors were calculated. Blood was collected within 24 h after admission (day 1) and on day 7. H2S was measured in sera by monobromobimane derivation followed by high-performance liquid chromatography and correlated to other markers like procalcitonin and C-reactive protein (CRP). Tumor necrosis factor alpha and interleukin (IL)-6 were also measured in serum. RESULTS: Survivors had significantly higher H2S levels on days 1 and 7 after admission. A cut-off point of 150.44 muM could discriminate survivors from non-survivors with 80% sensitivity, 73.4% specificity, and negative predictive value 95.9%. Mortality after 28 days was 32% with admission levels lower than or equal to 150.44 muM and 4.1% with levels above 150.44 muM (P: 0.0008). Mortality was significantly greater among patients with a decrease of H2S levels from day 1 to day 7 greater than or equal to 36% (p: 0.0005). Serum H2S on day 1 was negatively correlated with IL-6 and CRP and positively correlated with the absolute lymphocyte count in peripheral blood. CONCLUSION: It is concluded that H2S is a potential marker for severity and final outcome of pneumonia by the SARS-CoV-2 coronavirus. Its correlation with IL-6 suggests anti-inflammatory properties.