# Analysis of Vaccination Status of Patients Admitted to the Intensive Care Unit with Confirmed COVID-19-Related ARDS: A Retrospective Cross-Sectional Study

## Authors

- Haci Yusuf Gunes ([ORCID](https://orcid.org/0000-0003-3594-0345)) — Department of Anesthesiology, Faculty of Medicine, Van Yuzuncu Yil University, Tuşba, Van, Türkiye
- Nurettin Kurt ([ORCID](https://orcid.org/0000-0001-7713-5120)) — Department of Anesthesiology, Faculty of Medicine, Van Yuzuncu Yil University, Tuşba, Van, Türkiye

## Article information

- **Journal:** The Ulutas Medical Journal (Ulutas Med J), ISSN 2149-388X
- **Issue:** Volume 9, Issue 3 (2023), pages 118–127
- **Article type:** Original Article
- **Published online:** 2023-09-12
- **DOI:** [10.5455/umj.20230810014855](https://doi.org/10.5455/umj.20230810014855)
- **Licence:** [CC BY-NC 4.0](https://creativecommons.org/licenses/by-nc/4.0/)
- **Article page:** https://www.ulutasmedicaljournal.com/?mno=164821
- **PDF:** https://www.ulutasmedicaljournal.com/pdf/164821.pdf

## Abstract

Introduction: Although vaccination is considered the most effective and essential way to prevent and control COVID-19, immune responses may differ. This study investigated the relationship between vaccination status and gender, noninvasive ventilation (NIV) needs, intubation, length of stay in the intensive care unit (ICU), and mortality. Materials and methods: During this study, 124 patients aged 18 years and older were admitted to the ICU. We analyzed data from 99 patients with confirmed COVID-19. The patients were divided into three groups according to their vaccination status: vaccinated (≥2 doses of vaccine), partially vaccinated (only one dose of vaccine), or unvaccinated. Vaccination status, age, gender, APACHE II, modified Charlson comorbidity index, need for NIV and intubation, date of intubation, length of stay in the ICU, and ICU outcome were recorded. Results: A total of 99 patients were analyzed during the study period: 36 (36%) were vaccinated, 8 (8%) were partially vaccinated, and 55 (56%) were not vaccinated. The mean age was 58.7±18.8 years, and 51 (51.5%) were female. Comorbidity was present in 77% (n=76) of the patients. There was no correlation between vaccination status and gender (p=0.564), NIV needs (p=0.810), intubation (p=0.639), length of stay in the ICU (p=0.479), or mortality (p=0.769). The age (p=0.002), modified Charlson comorbidity index (p=0.002), APACHE II score at admission to the ICU (p=0.039), and creatinine (p=0.036) were higher in the vaccinated patients and were associated with mortality. Conclusion: No correlation was found between vaccination status and gender, need for NIV, intubation, length of stay in the ICU, or mortality

## Keywords

Vaccines; COVID-19; comorbidity; mortality; critical care

## How to cite

Gunes HY, Kurt N. Analysis of Vaccination Status of Patients Admitted to the Intensive Care Unit with Confirmed COVID-19-Related ARDS: A Retrospective Cross-Sectional Study. Ulutas Med J. 2023;9(3):118-127. doi:10.5455/umj.20230810014855

## References

1. Cascella M, Rajnik M, Aleem A, Dulebohn S, Di Napoli R. Features, evaluation, and treatment of coronavirus (COVID-19). StatPearls. 2023. Accessed on 30.07.2022 https://www.statpe arls.com/ArticleLibrary/viewarticle/52171
2. Cavanaugh AM, Spicer KB, Thoroughman D, Glick C, Winter K. Reduced risk of reinfection with SARS-CoV -2 after COVID- 19 vaccination Kentucky. MMWR. 2021;70(32): 1081.
3. Spitzer A, Angel Y, Marudi O, Zeltser D, Saiag E, Goldshmidt H, et al. Association of a third dose of BNT162b2 vaccine with incidence of SARS-CoV-2 infection among health care workers in Israel. JAMA. 2022;327(4):341–349. https://doi.org/10.1001/jama.2021.23641
4. Barlas G, Öztürk H, Pehlivantürk G, Aydin S. Turkey's response to COVID- 19 pandemic: strategy and key actions. Turkish Journal of Medical Sciences, 2021;51(7):3150-3156. https://doi.org/10.3906/sag-2106-212
5. Jin L, Li Z, Zhang X, Li J, Zhu F. CoronaVac: a review of efficacy, safety, and immunogenicity of the inactivated vaccine against SARS-CoV-2. Hum Vaccin Immunother. 2022;18(6):2096970. https://doi.org/10.1080/21645515.2022.2096970
6. Sadoff J, Gray G, Vandebosch A, Cárdenas V, Shukarev G, Grinsztejn B, et al. Safety and efficacy of single-dose Ad26. COV2. S vaccine against Covid-19. N Engl J Med. 2022;384(23): 2187–2201. https://doi.org/10.1056/nejmoa2101544
7. Chia PY, Ong SWX, Chiew CJ, Ang LW, Chavatte JM, Mak TM, et al. Virological and serological kinetics of SARS-CoV-2 Delta variant vaccine breakthrough infections: a multicentre cohort study. Clin Microbiol Infect 2022;28:612.e1. https://doi.org/10.1016/j.cmi.2021.11.010
8. Puhach O, Adea K, Hulo N, Sattonnet P, Genecand C, Iten A, et al. Infectious viral load in unvaccinated and vaccinated individuals infected with ancestral, Delta or Omicron SARS-CoV-2. Nat Med 2022;28:1491-1500. https://doi.org/10.1038/s41591-022-01816-0
9. Jung J, Kim JY, Park H, Park S, Lim JS, Lim SY, et al. Transmission and infectious SARS-CoV-2 shedding kinetics in vaccinated and unvaccinated individuals. JAMA Netw Open 2022;5:e2213606. https://doi.org/10.1001/jamanetworkopen.2022.13606
10. Kissler SM, Fauver JR, Mack C, Tai CG, Breban MI, Watkins AE, et al. Viral dynamics of SARS-CoV-2 variants in vaccinated and unvaccinated persons. N Engl J Med 2021; 385:2489. https://doi.org/10.1056/nejmc2102507
11. Charlson M, Szatrowski T, Peterson J, Gold J. Validation of a combined comorbidity index. J Clin Epidemiol. 1994;47:1245– 51. https://doi.org/10.1016/0895-4356(94)90129-5
12. Aydoğan O, Şaylan Gözün E, Güven Ö, Ayaz A, Yiğitbaşı T. Prevalence of SARS-CoV-2 variants in COVID-19 positive patients. Klimik Derg. 2022;35(4): 220–223. https://doi.org/10.36519/kd.2022.4264
13. Tian D, Sun Y, Zhou J, Ye Q. The global epidemic of SARS-CoV-2 variants and their mutational immune escape. J Med Virol. 2021;5:10.1002/jmv.27376
14. Finelli L, Gupta V, Petigara T, Yu K, Bauer KA, Puzniak LA. Mortality among US patients hospitalized with SARS-CoV-2 infection in 2020. JAMA Netw Open. 2021;4(4):e216556. https://doi.org/10.1001/jamanetworkopen.2021.6556
15. Combat COVID U.S. Department of Health and Human Services (HHS). Frequently asked questions about COVID-19 vaccine. Available: combatcovid.hhs.gov/covid-19-vaccineinformation.
16. Shahid Z, Kalayanamitra R, McClafferty B, Kepko D, Ramgobin D, Patel R, et al. COVID-19 and older adults: what we know. J Am Geriatr Soc. 2020;68:926–929. https://doi.org/10.1111/jgs.16472
17. Birliği TT. Yeni Koronavirüs Pandemisi Sürecinde Türkiye'de Covid-19 Aşılaması ve Bağışıklama Hizmetlerinin Durumu. 2021
18. Clinical characteristics and day-90 outcomes of 4244 critically ill adults with COVID-19: a prospective cohort study. Intensive care med. 2021;47:60–73. https://doi.org/10.1007/s00134-020-06294-x
19. Grasselli G, Zangrillo A, Zanella A, Antonelli M, Cabrini L, Castelli A, et al. Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region, Italy. JAMA 2020. https://doi.org/10.1001/jama.2020.5394
20. Jara A, Undurraga EA, González C, Paredes F, Fontecilla T, Jara G, et al. Effectiveness of an inactivated SARS-CoV-2 vaccine in Chile. N Engl J Med. 2021;2;385(10):875–884. https://doi.org/10.1056/nejmoa2107715
21. Edwards K, Orenstein WA. COVID-19: Vaccines to prevent SARS-CoV-2 infection. U: UpToDate. 2021;20 [Internet]. https:// www.uptodate.com/contents/covid-19-vaccines-to-prevent-sars-cov-2-infection.
22. Ranzani OT, Hitchings MDT, Dorion M, D'Agostini TL, de Paula RC, de Paula OFP et al. Effectiveness of the CoronaVac vaccine in older adults during a gamma variant associated epidemic of covid-19 in Brazil: test negative case-control study. BMJ. 2021; 374:2015. https://doi.org/10.1136/bmj.n2091
23. Sevinc SA, Metin S, Basi NB, Ling J, Cinar AS, Oba S. Effectiveness of inactivated SARS-CoV-2 vaccine (CoronaVac) on intensive care unit survival. Epidemiol & Infect. 2022:150. https://doi.org/10.1017/s0950268822000267
24. Martinez- Rojas MA, Vega-Vega O, Bobadilla NA. Is the kidney a target of SARS-CoV-2? Am J Physiol Renal Physiol. 2020; 318(6):F1454–F1462. https://doi.org/10.1152/ajprenal.00160.2020
25. Combe C, Kirsch AH, Alfano G, Luyckx VA, Shroff R, Kanbay M, van der Sande F, Basile C, EUDIAL Working Group of the ERA-EDTA. At least 156 reasons to prioritize COVID-19 vaccination in patients receiving in-centre haemodialysis. Nephrol Dial Transplant. 2021;36(4):571–574. https://doi.org/10.1093/ndt/gfab007
26. Eren Sadioğlu R, Demir E, Evren E, Aktar M, Şafak S, Artan AS et al. Antibody response to two doses of inactivated SARS-CoV-2 vaccine (CoronaVac) in kidney transplant recipients. Transpl Infect Dis. 2021;23(6):e13740. https://doi.org/10.1111/tid.13740
27. Medina-Pestana J, Covas DT, Viana LA, Dreige YC, Nakamura MR, Lucena EF et al. Inactivated whole-virus vaccine triggers low response against SARS-CoV-2 infection among renal transplant patients: prospective phase 4 study results. Transplantation. 2022;106(4):853–861. https://doi.org/10.1097/tp.0000000000004036
