ABSTRACT
Introduction: We aimed to compare the COVID-19 outcomes in unvaccinated and CoronaVac vaccinated older adults. Material(s) and Method(s): In this single-center study, patients aged >=65 years who were hospitalized for COVID-19 were retrospectively analyzed in two groups: unvaccinated and vaccinated. Result(s): A total of 742 patients were included. The mean age was 76.6+/-7.6 years. Of these, 46.1% (n=342) were male, 76.0% (n=564) were vaccinated. Among patients who were transferred to the intensive care unit (n=217), 206 (27.8%) received invasive mechanical ventilation support and 194 (26.1%) were died. In the multivariate analysis, advanced age (OR=1.03, 95%CI=1.01-1.06, p<0.01) and a high Charlson Comorbidity Index (OR=1.24, 95%CI=1.12-1.38, p<0.01) were predictors of mortality, while being vaccinated (OR=0.75, 95%CI=0.62-0.91, p<0.01) was associated with survival. Vaccination reduced the need for intensive care by 26.5% and mortality by 24.9 %. When the vaccinated group was evaluated, high Charlson Comorbidity Index (OR=1.428, 95%CI=1.14-1.64, p<0.01) was an independent predictor for mortality. However, booster vaccination in the last 130 days was the only protective factor that reduced mortality (p=0.04, 95%CI=0.43-0.99, OR=0.66) in multivariate analysis. Booster dose vaccination in the last 130 days reduced mortality by 33.8%. Conclusion(s): CoronaVac vaccination improved survival in hospitalized older adult patients (>=65 years old) with COVID-19. However, delaying the booster dose for more than 130 days were significantly associated with decreased survival. Therefore, older adults who completed their primary vaccination series with CoronaVac should not delay their booster dose to reduce the risk of death. Copyright © 2022, Geriatrics Society. All rights reserved.
ABSTRACT
Aim: To date, limited data exists on 1-year mortality and associated factors in patients with coronavirus diseases-2019 (COVID-19). We determined risk factors and predictors of 1-year mortality. Method(s): In this retrospective and single-center study, hospitalized patients with COVID-19 were enrolled between March 11 and March 11, 2020. The primary outcome was 1-year all-cause mortality after discharge from the hospital. Secondary outcomes were the risk factors and predictors of 1-year mortality. A comparative analysis was applied to patients who died after recovering from acute COVID-19 and patients who survived. Result(s): A total of 567 patients were analyzed. The 1-year mortality occurred in 18 (3.2%) patients. Older age (p=0.001), chronic obstructive pulmonary disease (p=0.001), chronic artery disease (p=0.001), chronic renal failure (p=0.001), presence of pleural fluid (p=0.001), high levels of leukocyte (p=0.001), neutrophil (p=0.001), monocyte (p=0.026), C-reactive protein (p=0.042), procalcitonin (p=0.004), urea (p=0.001), creatinine (p=0.001), troponin (p=0.001), lactate dehydrogenase (p=0.019), potassium (p=0.003), and a low level of alanine aminotransferase (p=0.001) at the first admission were associated with increased long-term mortality. Additionally, the need for intensive care unit (ICU) admission (p=0.007) and invasive ventilation (p=0.019) during the hospital stay for COVID-19 were associated with increased 1-year mortality. Conclusion(s): This study suggests that age, underlying diseases, pleural fluid, certain laboratory parameters, and ICU care are somewhat associated with 1-year mortality. Copyright © 2022 by The Medical Bulletin of Istanbul Haseki Training and Research Hospital The Medical Bulletin of Haseki published by Galenos Yayinevi.
ABSTRACT
Aim: Real-life data on the effect of coronavirus disease-2019 (COVID-19) vaccination is limited. We aimed to compare the incidence of COVID-19 among healthcare workers (HCWs) in the pre-vaccination and post-vaccination periods during the COVID-19 pandemic and identify associated factors for COVID-19 development. Method(s): In this single-center and cross-sectional study, HCWs employed in a tertiary care hospital were included. Pre-vaccination (14 October, 2020 and 14 January, 2021) and post-vaccination periods (1 March, 2021 and 1 June, 2021) were compared. A subgroup analysis was performed on HCWs without a previous history of COVID-19. Additionally, univariate regression analysis of COVID-19 development in the post-vaccination period was performed. Result(s): Of 2,922 HCWs, 2,096 (71.7%) were vaccinated. The incidence of COVID-19 was higher in the pre-vaccination period (16.3%) than in the post-vaccination (6.6%) (p<0.01). In the subgroup analysis, the incidence of COVID-19 was 16.6% in the pre-vaccination period and 8.1% in the post-vaccination period (p<0.01). Previous history of COVID-19 (p<0.01) and double-dose vaccination (p<0.01) were associated with a decreased risk of COVID-19 development. Conclusion(s): This study demonstrates the real-life impact of COVID-19 vaccination in reducing disease development and preventing poor clinical outcomes in a setting where the vaccination rate among HCWs was fairly low. Copyright © 2022 by The Medical Bulletin of Istanbul Haseki Training and Research Hospital The Medical Bulletin of Haseki published by Galenos Yayinevi.
ABSTRACT
Background. We aimed to explore a novel risk score to predict mortality in hospitalised patients with COVID-19 pneumonia. In additoon, we compared the accuracy of the novel risk score with CURB-65, qSOFA and NEWS2 scores. Methods. The study was conducted in hospitalised patients with laboratory and radiologically confirmed COVID-19 pneumonia between November 1, 2020 and November 30, 2020. In this retrospective multicenter study. independent predictors were identified using multivariate logistic regression analysis. A receiver operating characteristics (ROC) analysis with area under the curve (AUC) was used to evaluate the performance of the novel score. The optimal cut-off points of the candidate variables were calculated by the Youden's index of ROC curve. Mortality was defined as all cause in-hospital death. Results. A total of 1013 patients with COVID-19 were included. The mean age was 60,5 ±14,4 years, and 581 (57,4%) patients were male. In-hospital death was occured in 124 (12,2%) patients. Multivariate analysis revealed that peripheral capillary oxygen saturation (SpO2), albumin, D-dimer, and age were independent predictors for mortality (Table). A novel scoring model was named as SAD-60 (SpO2, Albumin, D-dimer, ≥60 years old). SAD-60 score (0,776) had the highest AUC compared to CURB-65 (0,753), NEWS2 (0,686), and qSOFA (0,628) scores (Figure). Conclusion. We demonstrated that SAD-60 score had a promising predictive capacity for mortality in hospitalised patients with COVID-19. Univariate and multivariate analysis of factors predicting mortality Comparison of CURB-65, qSOFA, NEWS-2 and SAD-60 for predicting pneumonia mortality in hospitalised patients with COVID-19 by ROC analysis.