Prediction of mortality and the development of critical illness in the course of COVID-19 with tertiary hospital data: vaccines? Critical illness scores? Mortality scores?

OBJECTIVE: Even though COVID-19 affects some risk groups more severely than others, there are still unknowns concerning the intensive care procedure and death in non-risk categories, making it vital to identify critical sickness and fatality risk factors at this time. The purpose of this study was to look into the efficacy of critical illness and mortality scores, as well as other risk factors in COVID-19. PATIENTS AND METHODS: Two hundred twenty-eight inpatients diagnosed with COVID-19 were included in the study. Sociodemographic, clinical, and laboratory data were recorded and risk calculations were made with the help of web-based patient data-based calculation programs called COVID-GRAM Critical Illness and 4C-Mortality score. RESULTS: The median age of 228 patients included in the study was 56.5 years, 51.3% of them were males, and ninety-six (42.1%) were unvaccinated. According to the multivariate analysis, the factors affecting the development of critical illness were cough [odds ratio=0.303, 95% CI (0.123,0.749), p=0.010], creatinine [odds ratio=1.542, 95% CI (1.100, 2.161), p=0.012], respiratory rate [odds ratio=1.484, 95% CI (1.302, 1.692), p=0.000], COVID-GRAM Critical Illness Score [odds ratio=3.005, 95% CI (1.288, 7.011), p=0.011]. Factors affecting survival were vaccine status [odds ratio=0.320, 95% CI (0.127,0.802), p=0.015], blood urea nitrogen (BUN) [odds ratio=1.032, 95% CI (1.012, 1.053), p=0.002], respiratory rate [odds ratio=1.173, 95% CI (1.070, 1.285), p=0.001], COVID-GRAM-critical-illness score [odds ratio=2.714, 95% CI (1.123, 6.556), p=0.027]. CONCLUSIONS: The findings suggested that risk assessment might employ risk scoring, such as COVID-GRAM Critical Illness, and that immunization against COVID-19 will reduce the occurrence of mortality.

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.