ABSTRACT
OBJECTIVE: As the pandemic continues, different vaccine protocols have been implemented to maintain the protection of vaccines and to provide protection against new variants. The aim of this study was to assess hospitalized patients' vaccination status and document the efficacy of boosters. PATIENTS AND METHODS: The patients that were hospitalized due to COVID-19 were enrolled from 28 hospitals in Turkey for five months from September 2021. 5,331 confirmed COVID-19 patients from collaborating centers were randomly enrolled to understand/estimate the distribution of vaccination status in hospitalized patients and to compare the efficacy of vaccination/booster protocols. RESULTS: 2,779 men and 2,552 women of which 2,408 (45.2%) were admitted to Intensive Care Units participated in this study. It was found that the highest risk reduction for all age groups was found in groups that received 4 doses. Four doses of vaccination for every 3.7 people under 50 years of age, for every 5.7 people in the 50-64 age group, and for every 4.3 people over 65 years of age will prevent 1 patient from being admitted to intensive care. Regardless of the type of vaccine, it was found that the risk of ICU hospitalization decreased in those who were vaccinated compared to those who were not vaccinated. Regardless of the type of vaccine, the ICU risk was found to decrease 1.25-fold in those who received 1 or 2 doses of vaccine, 1.18-fold in those who received 3 doses, and 3.26-fold in those who received 4 doses. CONCLUSIONS: The results suggested that the addition of a fourth dose is more effective in preventing intensive unit care even in disadvantaged groups.
Subject(s)
COVID-19 , Male , Humans , Female , Aged , COVID-19/epidemiology , COVID-19/prevention & control , Hospitalization , Intensive Care Units , Hospitals , Critical CareABSTRACT
Introduction: Although there is limited data on the frequency of nosocomial infections in patients followed up in the intensive care unit due to COVID-19, the rate of empirical antibiotic use in these patients is quite high. In our study, it was planned to determine the frequency of nosocomial infections in patients hospitalized in intensive care units due to COVID-19, the pathogens isolated in nosocomial infections, and to investigate the characteristics of these infections. Materials and Methods: Our study is a retrospective study in which the records of 590 adult patients hospitalized in the COVID-19 intensive care unit and followed prospectively between April 1, 2020 and December 31, 2021 were examined. Results: In our study, nosocomial infection developed in 7.28% of patients hospitalized in the intensive care unit due to COVID-19, and mortality was 93% in patients who developed nosocomial infections. Of these infections, 67.44% were lower respiratory tract infections, 25.58% were bloodstream infections, and 6.97% were urinary tract infections. While the median number of toatl hospital stay was 20 days, the median time since admission to infection was 12 days. Infections often developed with a single microorganism, and the most frequently isolated microorganisms are A. baumannii and K. pneumoniae. Conclusion: Nosocomial infections that develop in patients followed in the intensive care unit due to COVID-19, are seen in approximately 7% of patients, but are mortal. In this patient group, regular microbiological follow-up and implementation of strict infection control measures especially for the prevention of ventilator-associated pneumonia;It is recommended to review the antibiotics frequently used in the follow-up and treatment of COVID-19 and to be selective in the decision to start empirical antibiotics in order to prevent the development of antimicrobial resistance.