Citation Information :
Havaldar A A, Sheshala K, Chennabasappa A, Thomas RR, Sushmitha EC, Kumar R, Singh R, Kartik M, Swamy AH, Raj JM, Selvam S. Demographics and Clinical Characteristics of COVID-19-vaccinated Patients Admitted to ICU: A Multicenter Cohort Study from India (PostCoVac Study-COVID Group). Indian J Crit Care Med 2022; 26 (11):1184-1191.
Background: Emergency authorization and approval were given for the coronavirus disease-19 (COVID-19) vaccines. The efficacy reported after phase III trials were 70.4% and 78% for Covishield and Covaxin, respectively.
In this study, we aim to analyze the risk factors, which were associated with mortality in critically ill COVID-19-vaccinated patients admitted into intensive care unit (ICU).
Materials and methods: This study was conducted from April 1, 2021 to December 31, 2021 across five centers in India. Patients who had received either one or two doses of any of the COVID vaccines and developed COVID-19 were included. The ICU mortality was a primary outcome.
Results: A total of 174 patients with COVID-19 illness were included in the study. The mean age was 57 years standard deviation (SD 15). Acute physiology, age and chronic health evaluation (APACHE II) score and the sequential organ failure assessment (SOFA) score were 14 (8–24.5) and 6 (4–8), respectively. Multiple variable logistic regression showed patients who have received a single dose [odds ratio (OR): 2.89, confidence interval (CI): 1.18, 7.08], neutrophil:lymphocyte (NL) ratio (OR: 1.07, CI: 1.02,1.11), and SOFA score (OR: 1.18, CI: 1.03,1.36) were associated with higher mortality.
Conclusion: The mortality in the vaccinated patients admitted to the ICU was 43.68% due to COVID illness. The mortality was lower in patients who had received two doses.
https://www.who.int/news-room/feature-stories/detail/vaccine-efficacy-effectiveness-and-protection. (assessed on 11 January 2022).
Alimohamadi Y, Tola HH, Abbasi-Ghahramanloo A, Janani M, Sepandi M. Case fatality rate of COVID-19: a systematic review and meta-analysis. J prevent med hygiene 2021;62:E311. DOI: 10.15167/2421-4248/jpmh2021.62.2.1627.
Onder G, Rezza G, Brusaferro S. Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy. Jama 2020;323: 1775–1776. DOI: 10.1001/jama.2020.4683.
Fiolet T, Kherabi Y, MacDonald CJ, Ghosn J, Peiffer-Smadja N. Comparing COVID-19 vaccines for their characteristics, efficacy and effectiveness against SARS-CoV-2 and variants of concern: a narrative review. Clin Microbiol Infect 2021:S1198-743X (21)00604-2. DOI: 10.1016/j.cmi.2021.10.005.
Talukder A, Kalita C, Neog N, Goswami C, Sarma MK, Hazarika I. A comparative analysis on the safety and efficacy of Covaxin versus other vaccines against COVID-19: A review. Zeitschrift Für Naturforschung C 2022;2:351–362. DOI: 10.1515/znc-2021-0301.
Kadire SR, Wachter RM, Lurie N. Delayed second dose versus standard regimen for Covid-19 vaccination. N Engl J Med 2021;384:e28. DOI: 10.1056/NEJMclde2101987.
Haas EJ, Angulo FJ, McLaughlin JM, Anis E, Singer SR, Khan F, et al. Impact and effectiveness of mRNA BNT162b2 vaccine against SARS-CoV-2 infections and COVID-19 cases, hospitalisations, and deaths following a nationwide vaccination campaign in Israel: an observational study using national surveillance data. Lancet 2021;397: 1819–1829. DOI: 10.1016/S0140-6736 (21)00947-8.
Antonelli M, Penfold RS, Merino J, Sudre CH, Molteni E, Berry S, et al. Risk factors and disease profile of post-vaccination SARS-CoV-2 infection in UK users of the COVID Symptom Study app: a prospective, community-based, nested, case-control study. Lancet Infect Dis 2022;22:43–55. DOI: 10.1016/S1473-3099 (21)00460-6.
Kustin T, Harel N, Finkel U, Perchik S, Harari S, Tahor M, et al. Evidence for increased breakthrough rates of SARS-CoV-2 variants of concern in BNT162b2- mRNA-vaccinated individuals. Nat Med 2021;27:1379–1384. DOI: 10.1038/s41591-021-01413-7.
McEwen AE, Cohen S, Bryson-Cahn C, Liu C, Pergam SA, Lynch J, et al. Variants of concern are overrepresented among post-vaccination breakthrough infections of SARS-CoV-2 in Washington State. Clin Infect Dis 2022;15 (74):1089–1092. https://doi/org/10.1093/cid/ciab581.
Zirpe KG, Tiwari AM, Gurav SK, Deshmukh AM, Suryawanshi PB, Wankhede PP, et al. Timing of invasive mechanical ventilation and mortality among patients with severe COVID-19-associated acute respiratory distress syndrome. Indian J Crit Care Med 2021;25 (5):493–498. DOI: 10.5005/jp-journals-10071-23816.
Havaldar AA, Kumar MV, Vijayan B, Prakash J, Kartik M, Sangale A. Epidemiology and ventilation characteristics of confirmed cases of severe COVID-19 pneumonia admitted in intensive care unit (EPIC19): A multicentre observational study. Indian J Anaesth 2022;66: 724–733. DOI: 10.4103/ija.ija_179_22.
Bernal JL, Andrews N, Gower C, Gallagher E, Simmons R, Thelwall S, et al. Effectiveness of Covid-19 vaccines against the B. 1.617. 2 (Delta) variant. N Engl J Med 2021;385:585–594. DOI: 10.1056/NEJMoa2108891.
Abhilash KP, Mathiyalagan P, Krishnaraj VR, Selvan S, Kanagarajan R, Reddy NP, et al. Impact of prior vaccination with CovishieldTM and Covaxin® on mortality among symptomatic COVID-19 patients during the second wave of the pandemic in South India during April and May 2021: a cohort study. Vaccine 2022;40:2107–2113. DOI: 10.1016/j.vaccine.2022.02.023.
Vaishya R, Sibal A, Malani A, Prasad KH. SARS-CoV-2 infection after COVID-19 immunization in healthcare workers: A retrospective, pilot study. Indian J Med Res 2021;153 (5&6):550–554. DOI: 10.4103/ijmr.ijmr_1485_21.
Vaishya R, Sibal A, Malani A, Kar S, Kiran SV, Reddy S, et al. Symptomatic post-vaccination SARS-CoV-2 infections in healthcare workers–A multicenter cohort study. Diabetes Metab Syndr 2021;15:102306. DOI: 10.1016/j.dsx.2021.102306.
Gupta MK, Bhardwaj P, Goel A, Saurabh S, Misra S. COVID-19 appropriate behavior in India: Time to invest for the benefits in future. J Family Med Prim Care 2021;10:1818–1822. DOI: 10.4103/jfmpc.jfmpc_2382_20.
Lumley SF, O'Donnell D, Stoesser NE, Matthews PC, Howarth A, Hatch SB, et al. Antibody status and incidence of SARS-CoV-2 infection in health care workers. N Engl J Med 2021;384:533–540. DOI: 10.1056/NEJMoa2034545.