Immunocompromise among vaccinated versus unvaccinated COVID-19 cases admitted to critical care in Ireland, July to October 2021

As the COVID-19 pandemic progressed, so too did the proportion of cases admitted to critical care in Ireland who were fully vaccinated. Reporting of this observation has public health implications as incorrect interpretation may affect public confidence in COVID-19 vaccines. A potential explanation is the reduced ability of those who are immunocompromised to produce an adequate, sustained immune response to vaccination. We conducted an analysis of the association between COVID-19 vaccination status and underlying degree of immunocompromise among a cohort of critical care patients all with a confirmed diagnosis of COVID-19 admitted to critical care between July and October 2021. Multinomial logistic regression was used to estimate an odds ratio of immunocompromise among vaccinated COVID-19 cases in critical care compared to unvaccinated cases. In this study, we found a statistically significant association between the vaccination status of severe COVID-19 cases requiring critical care admission and underlying immunocompromise. Fully vaccinated patients were significantly more likely to be highly (OR=19.3, 95% CI 7.7 – 48.1) or moderately immunocompromised (OR=9.6, 95% CI 5.0 – 18.1) compared to unvaccinated patients with COVID-19. These findings support our hypothesis, that highly immunocompromised patients are less likely to produce an adequate and sustained immune response to COVID-19 vaccination, and are therefore more likely to require critical care admission for COVID-19 infection.

Immunocompromise among vaccinated versus unvaccinated COVID-19 cases admitted to critical care in Ireland, July to October 2021.

As the COVID-19 pandemic progressed, so too did the proportion of cases admitted to critical care in Ireland who were fully vaccinated. Reporting of this observation has public health implications as incorrect interpretation may affect public confidence in COVID-19 vaccines. A potential explanation is the reduced ability of those who are immunocompromised to produce an adequate, sustained immune response to vaccination. We conducted an analysis of the association between COVID-19 vaccination status and underlying degree of immunocompromise among a cohort of critical care patients all with a confirmed diagnosis of COVID-19 admitted to critical care between July and October 2021. Multinomial logistic regression was used to estimate an odds ratio of immunocompromise among vaccinated COVID-19 cases in critical care compared to unvaccinated cases. In this study, we found a statistically significant association between the vaccination status of severe COVID-19 cases requiring critical care admission and underlying immunocompromise. Fully vaccinated patients were significantly more likely to be highly (OR = 19.3, 95 % CI 7.7-48.1) or moderately immunocompromised (OR = 9.6, 95 % CI 5.0-18.1) compared to unvaccinated patients with COVID-19. These findings support our hypothesis, that highly immunocompromised patients are less likely to produce an adequate and sustained immune response to COVID-19 vaccination, and are therefore more likely to require critical care admission for COVID-19 infection.

Traumatic Brain Injury: Epidemiology and Rehabilitation in Ireland

Research Objectives To estimate the incidence of traumatic brain injury (TBI) in survivors 18 years old and above in Ireland. To describe the trajectory of rehabilitation/community services for survivors of moderate to severe TBI. To document the experiences of informal caregivers who provide support to TBI survivors in the Republic of Ireland. Design Data were collected retrospectively and prospectively using a mixed-method, observational cohort study design. Setting Interviews were carried out primarily in respondents’ homes (pre Covid-19) or via phone, to assist participants to complete questionnaires. Participants Three cohorts were involved in the study;all were aged 18 years and above, had the capacity to give informed consent and resided in Ireland. Cohort 1 - participants sustained a moderate to severe TBI in the past 3 to 12 months;cohort 2 - participants sustained a TBI over 12 months ago;cohort 3 - non-professional caregivers or family members who provide support to individuals with moderate to severe TBI. Interventions There were no interventions. Main Outcome Measures Epidemiological patterns using existing routine data (Major Trauma Audit, Hospital In-Patient Inquiry data, etc.) and calculate the societal burden of TBI from morbidity and mortality data using the Global Burden of Disease framework. Describe the trajectory of care/rehabilitation of TBI survivors and document the experiences of informal carer/support persons. Results It is expected that we will have epidemiological data, findings on rehabilitation services and caregivers’ experiences ready to report for the conference. Conclusions There is a paucity of TBI Research in Ireland. This national epidemiology and rehabilitation study will inform resource allocation for the redevelopment of neuro-rehabilitation services for brain injured survivors and inform us of carer/support persons’ experiences. Author(s) Disclosures There are no conflicts of interest for any of the authors listed on the abstract.