Lower mortality rate of COVID-19 vaccinated patients admitted to a large intensive care center during the outbreak caused by SARS-CoV-2 Delta variant in Vietnam

https://doi.org/10.52322/jocmbmh.11.en.13

ABSTRACT

Introduction: Vaccinated critically ill COVID-19 patients, even with only the rst dose, showed better outcomes than non- vaccinated individuals during the Delta variant-driven outbreak in Vietnam. In developing countries with limited supply, mass immunization using any accessible type of vaccine are an eective strategy to reduce mortality and burden on health systems.

Objectives: To determine the association between COVID-19 vaccination status and mortality among hospitalized positive patients required intensive care unit (ICU) during the Delta variant-driven wave of COVID-19 in Vietnam

Participants and Methods: We conducted a retrospective observation study among 504 critically ill COVID-19 cases enrolled to ICUs of ICC, BMH from August to September 2021. Kaplan-Meier survival analysis was used to compare 28-day in-hospital mortality between groups. Cox proportional hazards regression adjusted for gender, age, comorbidities, and vital signs at baseline were used to determine the association between vaccination status and mortality outcome among patients. The secondary outcome was the proportion of patients required endotracheal intubation and invasive ventilation, and length of ICU stays.

Results: Out of 504 critically ill COVID-19 patients, 117 (23.2%) were vaccinated with at least one dose. Vaccinated patients were younger (median 57 vs 61 years, p<0.001) and had fewer comorbidities (36.5% vs 63.5%, p<0.001) compared to unvaccinated patients. Vaccinated patients also required less respiratory support and had lower 28-day mortality (31.6% vs 58.4%, p<0.001). In adjusted analysis, vaccination was associated with a 26% reduction in mortality risk (aHR 0.74, 95% CI 0.57-0.96, p=0.036).

Conclusions:  Partial COVID-19 vaccination was associated with signicantly reduced risk of death among critically ill patients admitted to the ICU during the Delta variant surge in Vietnam. Rapidly achieving high rst dose vaccine coverage, even with constraints on optimal vaccine supplies, appeared eective at decreasing COVID-19 mortality and healthcare burden. These real-world data support that vaccination with available options should be urgently prioritized globally to save lives during the pandemic.

Keywords: COVID-19, SARS-CoV-2, Delta variant, vaccines, severe and critical, non-pharmaceutical interventions, Asia, Vietnam

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