COVID-19: booster(s) vs. hospitalization and Intensive Care Unit admission.

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.

The effect of the vitamin d level on the clinical, laboratory, and outcome in patients over 65 years of age with covid-19: Comprehensive tertiary center experience

Introduction: This study aimed to examine the relationship between vitamin D levels and the disease course, laboratory results, and clinical outcomes in patients aged > 65 years with coronavirus disease 2019 (COVID-19). Methods: The laboratory and clinical results of patients aged > 65 years who were admitted to a tertiary intensive care unit due to COVID-19 between April 2020 and May 2021 were retrospectively examined. Results: A total of 299 patients aged >65 years (median: 76 years [interquartile range: 70–83]) diagnosed with COVID-19 were admitted in the ICU. The regression analysis performed between vitamin D level ≥30 ng/mL and <30 ng/mL and the inflammatory markers revealed the significant correlation of vitamin D <30 ng/mL with a low lymphocyte count and fibrinogen level. When the relationship between mortality, inflammatory markers, and clinical parameters was examined, lymphocyte count, D-dimer level, fibrinogen level, chest tomography stage 3, and vitamin D deficiency were also effective factors for predicting mortality. In COVID-19 patients, the vitamin D cut-off value for mortality was found to be 18.5 ng/mL. Conclusion: We observed a high rate of patients with low vitamin D levels in patients aged > 65 years who were admitted to the intensive care unit due to COVID-19. The rates of inflammation and mortality were higher in patients with vitamin D deficiency. © 2021, Geriatrics Society. All rights reserved.