PDF(Pubmed)
Abstract：
BACKGROUND: Despite vaccines\' effectiveness in reducing COVID-19 infection rates and disease severity, their impact on critical patients presenting with acute respiratory failure is elusive. The aim of this study was to further investigate the influence of vaccination on mortality rates among severely ill COVID-19 patients experiencing acute respiratory failure.
METHODS: This retrospective cohort study was carried out at a tertiary medical center in Taiwan. From April to September 2022, patients who tested positive for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) through reverse transcription polymerase chain reaction (RT-PCR) and subsequently experienced acute respiratory failure were included in the study. Baseline characteristics, including vaccination history, along with information regarding critical illness and clinical outcomes, were gathered and compared between patients who received the vaccine and those who did not.
RESULTS: A total of 215 patients with COVID-19 exhibiting acute respiratory failure, as confirmed via RT‒PCR, were included in the analysis. Of this cohort, sixty-six (30.7%) patients died within 28 days. Neither administration of the vaccine nor achievement of primary series vaccination status had a significantly different effect on 28 day mortality, number of viral shedding events, acute respiratory distress syndrome (ARDS) incidence or other clinical outcomes. Patients who received the booster vaccine and completed the primary series showed a tendency of increased 28 days of ventilator-free status, though this difference was not statistically significant (p = 0.815).
CONCLUSIONS: Vaccination status did not significantly influence mortality rates, the occurrence of ARDS, or the viral shedding duration in COVID-19 patients with acute respiratory failure.
METHODS: This retrospective cohort study was carried out at a tertiary medical center in Taiwan. From April to September 2022, patients who tested positive for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) through reverse transcription polymerase chain reaction (RT-PCR) and subsequently experienced acute respiratory failure were included in the study. Baseline characteristics, including vaccination history, along with information regarding critical illness and clinical outcomes, were gathered and compared between patients who received the vaccine and those who did not.
RESULTS: A total of 215 patients with COVID-19 exhibiting acute respiratory failure, as confirmed via RT‒PCR, were included in the analysis. Of this cohort, sixty-six (30.7%) patients died within 28 days. Neither administration of the vaccine nor achievement of primary series vaccination status had a significantly different effect on 28 day mortality, number of viral shedding events, acute respiratory distress syndrome (ARDS) incidence or other clinical outcomes. Patients who received the booster vaccine and completed the primary series showed a tendency of increased 28 days of ventilator-free status, though this difference was not statistically significant (p = 0.815).
CONCLUSIONS: Vaccination status did not significantly influence mortality rates, the occurrence of ARDS, or the viral shedding duration in COVID-19 patients with acute respiratory failure.
摘要：
背景：尽管疫苗在降低COVID-19感染率和疾病严重程度方面有效，它们对出现急性呼吸衰竭的危重患者的影响是难以捉摸的。这项研究的目的是进一步调查疫苗接种对急性呼吸衰竭的重症COVID-19患者死亡率的影响。
方法：这项回顾性队列研究是在台湾的三级医疗中心进行的。从2022年4月至9月，通过逆转录聚合酶链反应（RT-PCR）检测出严重急性呼吸综合征冠状病毒2（SARS-CoV-2）阳性并随后经历急性呼吸衰竭的患者被纳入研究。基线特征，包括疫苗接种史,连同有关危重疾病和临床结果的信息，收集并比较接种疫苗的患者和未接种疫苗的患者。
结果：共有215例COVID-19患者出现急性呼吸衰竭，通过RT-PCR确认，包括在分析中。在这个队列中，66例(30.7%)患者在28天内死亡。接种疫苗和获得主要系列疫苗接种状态对28天死亡率没有显著不同的影响。病毒脱落事件的数量，急性呼吸窘迫综合征（ARDS）的发病率或其他临床结果。接受加强疫苗并完成主要系列的患者显示出28天无呼吸机状态增加的趋势，尽管这种差异没有统计学意义（p=0.815）。
结论：疫苗接种状况对死亡率没有显著影响，ARDS的发生，或COVID-19急性呼吸衰竭患者的病毒脱落持续时间。
方法：这项回顾性队列研究是在台湾的三级医疗中心进行的。从2022年4月至9月，通过逆转录聚合酶链反应（RT-PCR）检测出严重急性呼吸综合征冠状病毒2（SARS-CoV-2）阳性并随后经历急性呼吸衰竭的患者被纳入研究。基线特征，包括疫苗接种史,连同有关危重疾病和临床结果的信息，收集并比较接种疫苗的患者和未接种疫苗的患者。
结果：共有215例COVID-19患者出现急性呼吸衰竭，通过RT-PCR确认，包括在分析中。在这个队列中，66例(30.7%)患者在28天内死亡。接种疫苗和获得主要系列疫苗接种状态对28天死亡率没有显著不同的影响。病毒脱落事件的数量，急性呼吸窘迫综合征（ARDS）的发病率或其他临床结果。接受加强疫苗并完成主要系列的患者显示出28天无呼吸机状态增加的趋势，尽管这种差异没有统计学意义（p=0.815）。
结论：疫苗接种状况对死亡率没有显著影响，ARDS的发生，或COVID-19急性呼吸衰竭患者的病毒脱落持续时间。
