A small multicenter study from Greece showed that survival in intubated patients with acute respiratory distress syndrome (ARDS) due to COVID-19 was associated with being fully vaccinated. rice field.
In a cohort containing 265 consecutive patients requiring intubation for COVID-19 ARDS, mortality was 61.5% of fully vaccinated patients compared to fully unvaccinated controls. 68.2%, a significant difference after adjusting for confounders (HR 0.55, 95% CI 0.32-0.94, P.=0.03), reported by Ilias Siempos, MD and colleagues of the National and Kapodistrian University of Athens Medical School.
“Explanation of this finding is hampered by the low number of patients in the full vaccination cohort,” write Siempos and colleagues. JAMA network openonly 26 patients were fully vaccinated.
“Given that vaccination prevents serious illness requiring intubation, the fact that this number is low may not be surprising,” argued Siempos and colleagues.Only at the start of the exam (June 7, 2021) 23% of those living in Greece were fully vaccinated, increasing to 70% by the end of the study (1 February 2022).
“Even three days after intubation, oxygenation was higher in the fully vaccinated group than in the control group.” Evidence suggests that in patients with ARDS, post-intubation oxygenation on day 3 may be more strongly associated with mortality than oxygenation on the day of intubation.”
Of note, those who completed the primary vaccination series more than 5 months before intubation were not considered ‘fully vaccinated’. This is because it is time for the CDC to recommend booster vaccinations for these individuals. Thus, the control group of 239 patients included her 1 individual who was partially vaccinated and his 32 who were vaccinated more than 5 months before he required intubation. individuals, the so-called “remotely vaccinated individuals,” were included.
When restricted to patients who received only mRNA vaccines or when fully vaccinated patients were compared with fully unvaccinated patients or those who completed vaccination >5 months before intubation Multiple sensitivity analyzes supported the main findings.
“One speculation is that full vaccination may reduce the severity of ARDS, even though it may not completely prevent the onset of ARDS.” Patients have better lung function (albeit not statistically significant) and higher oxygenation (that is, less severe ARDS) at baseline than patients in the control group, supported by the observations. “
A total of 265 intubated patients from 3 ICUs in Greece participated in this study. The median age of patients he was 66 years old and 64.2% were male. Of her 26 fully vaccinated patients, 20 received Pfizer’s mRNA vaccine and 6 received AstraZeneca’s mRNA vaccine.
Fully vaccinated patients were older than controls (median age 72.5 vs. 66 years) and more likely to have comorbidities (92.3% vs. 66.9%, respectively). Although not a statistically significant difference, more patients had mild or moderate disease in the fully vaccinated group (56% vs 43.3%, P.=0.14).
There were no significant between-group differences in secondary outcomes including length of ICU stay, length of hospital stay, use of vasopressors or vasopressor-free days.
The researchers noted that 57.1% of vaccinated survivors had bacteremia, compared with 73.9% in controls. “Although not statistically significant, this difference in incidence may be related to differences in mortality between groups,” suggests Siempos and his colleagues.
The researchers had nothing to disclose.