Impacto de la vacunación en la mortalidad de adultos colombianos con síndrome de dificultad respiratoria aguda por SARS-CoV-2 que requirieron ventilación mecánica invasiva

Abstract

Introduction

Vaccination for SARS-CoV-2 made it possible to reduce severe cases that require invasive mechanical ventilation (IMV) and care in the ICU. However, its impact on severe disease is not clear. The objective was to assess whether adults with severe SARS-CoV-2 pneumonia who required mechanical ventilation had a different clinical behavior in terms of mortality, depending on their vaccination status.

Methodology

Retrospective cohort study, in adults with severe pneumonia due to SARS-CoV-2 requiring IMV and ICU. Clinical outcomes were evaluated according to vaccination status, controlling for comorbidities.

Results

Two hundred patients (24% vaccinated, age 61 ± 13 years, men 68%) were analyzed. The vaccinated had lower CRP at admission, distension pressure and PEEP requirement for IMV. Mortality (43.8 vs 36.8%, p: 0.335), hospital stay, ICU stay, and time on IMV were similar between groups. Acute kidney injury and hemodialysis requirement (0 vs 9.2%, p: 0.03) were more frequent in the unvaccinated. There was no association between mortality and receiving at least one dose of vaccination (RR 1.21; CI 95% 0.829–1.774, p: 0.335).

Conclusions

Vaccination did not impact mortality. However, our data suggest that it may reduce the inflammatory state produced by the disease and the occurrence of acute kidney injury and the requirement for hemodialysis. Future studies will be required to assess the impact of the type of vaccine and/or the number of doses received.