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Gül F, Kasapoğlu US, Sabaz MS, Ay P, Doruk Oktay B, Çalışkan G, Demir N, Sayan İ, Kabadayı F, Altuntaş G, Gümüş A, Kırca H, Şanlı D, Acil F, Dedeoğlu A, Ural SG, Akın Şen İ, Macit Aydın E, Dayanır H, Yelken B, Ceylan İ, Aydın OÖ, Eskidemir G, Aytekin A, Cengiz M, Arslan Ü, Akdağ D, Alay GH, Tekin E, Yarar V, Saracoğlu KT, Gök F, Alparslan V, Tuna V, Yıldız M, Şenoğlu N, Kıraklı C, Yıldırım S, Saçar Kübüç K, Erer A, Gültekin H, Özmen Süner K, Kuzgun Ö, Öztürk ÇE, Karahan A, Deveci O, Ay M, Tüfek Öztan D, Akıncı SB, Solak MY, Bozbay S, Özçiftçi S, Gönderen K, Küçük AO, Uyan B, Elay G, Boyacı N, Timurkaan M, Karakoç E, Doğan L, Yalçınkaya E, Kazancıoğlu L, Erdal Dönmez G, Yılmaz B, Ergül DF, Boran M, Özkarakaş H, Karakaş B, Ergin Özcan P, Anaklı İ, Bayar MK, Yüksel D, Akdağ Ş, Pişkin Ö, Temur S, Eyüpoğlu S, Tekir Yılmaz E, Avcı GZ, Turan R, Alkan Bayburt F, Şahintürk H, Güçyetmez B, Alparslan MM, Yarıcı M, Yıldırım F, Yektaş A, Yaman G, Demirkıran O, Cinel İ. The Impact of CoronaVac Vaccination on 28-day Mortality Rate of Critically Ill Patients with COVID-19 in Türkiye. Balkan Med J 2023; 40:435-444. [PMID: 37867428 PMCID: PMC10613737 DOI: 10.4274/balkanmedj.galenos.2023.2023-6-90] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/03/2023] [Indexed: 10/24/2023] Open
Abstract
Background Vaccines against coronavirus disease-19 (COVID-19) have been effective in preventing symptomatic diseases, hospitalizations, and intensive care unit (ICU) admissions. However, data regarding the effectiveness of COVID-19 vaccines in reducing mortality among critically ill patients with COVID-19 remains unclear. Aims To determine the vaccination status and investigate the impact of the COVID-19 vaccine on the 28-day mortality in critically ill patients with COVID-19. Study Design Multicenter prospective observational clinical study. Methods This study was conducted in 60 hospitals with ICUs managing critically ill patients with COVID-19. Patients aged ≥ 18 years with confirmed COVID-19 who were admitted to the ICU were included. The present study had two phases. The first phase was designed as a one-day point prevalence study, and demographic and clinical findings were evaluated. In the second phase, the 28-day mortality was evaluated. Results As of August 11, 2021, 921 patients were enrolled in the study. The mean age of the patients was 65.42 ± 16.74 years, and 48.6% (n = 448) were female. Among the critically ill patients with COVID-19, 52.6% (n = 484) were unvaccinated, 7.7% (n = 71) were incompletely vaccinated, and 39.8% (n = 366) were fully vaccinated. A subgroup analysis of 817 patients who were unvaccinated (n = 484) or who had received two doses of the CoronaVac vaccine (n = 333) was performed. The 28-day mortality rate was 56.8% (n = 275) and 57.4% (n = 191) in the unvaccinated and two-dose CoronaVac groups, respectively. The 28-day mortality was associated with age, hypertension, the number of comorbidities, type of respiratory support, and APACHE II and sequential organ failure assessment scores (p < 0.05). The odds ratio for the 28-day mortality among those who had received two doses of CoronaVac was 0.591 (95% confidence interval: 0.413-0.848) (p = 0.004). Conclusion Vaccination with at least two doses of CoronaVac within six months significantly decreased mortality in vaccinated patients than in unvaccinated patients.
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Affiliation(s)
- Fethi Gül
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Marmara University Faculty of Medicine, İstanbul, Türkiye
| | - Umut Sabri Kasapoğlu
- Clinic of Critical Care Medicine, Malatya Training and Research Hospital, Malatya, Türkiye
| | - Mehmet Süleyman Sabaz
- Clinic of Critical Care Medicine, Marmara University Pendik Training and Research Hospital, İstanbul, Türkiye
| | - Pınar Ay
- Department of Public Health, Marmara University Faculty of Medicine, İstanbul, Türkiye
| | - Burçin Doruk Oktay
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Marmara University Faculty of Medicine, İstanbul, Türkiye
| | - Gülbahar Çalışkan
- Department of Anesthesiology and Reanimation, University of Health Sciences Türkiye, Bursa Faculty of Medicine, Bursa, Türkiye
| | - Nalan Demir
- Division of Critical Care Medicine, Clinic of Chest Diseases, University of Health Sciences Türkiye, Ankara City Hospital, Ankara, Türkiye
| | - İsmet Sayan
- Clinic of Critical Care Medicine, Sancaktepe Training and Research Hospital, İstanbul, Türkiye
| | - Feyyaz Kabadayı
- Clinic of Critical Care Medicine, Sancaktepe Training and Research Hospital, İstanbul, Türkiye
| | - Gülsüm Altuntaş
- Clinic of Critical Care Medicine, Elazığ City Hospital, Elazığ, Türkiye
| | - Ayça Gümüş
- Clinic of Critical Care Medicine, Antalya Kepez State Hospital, Antalya, Türkiye
| | - Hülya Kırca
- Clinic of Critical Care Medicine, Antalya Kepez State Hospital, Antalya, Türkiye
| | - Deniz Şanlı
- Clinic of Critical Care Medicine, Batman Training and Research Hospital, Batman, Türkiye
| | - Fatma Acil
- Clinic of Anesthesiology and Reanimation, University of Health Sciences Türkiye, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyabakır, Türkiye
| | - Andaç Dedeoğlu
- Clinic of Anesthesiology and Reanimation, University of Health Sciences Türkiye, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyabakır, Türkiye
| | - Sedef Gülçin Ural
- Clinic Critical Care Medicine, University of Health Sciences Türkiye, Erzurum City Hospital, Erzurum, Türkiye
| | - İrem Akın Şen
- Clinic Critical Care Medicine, University of Health Sciences Türkiye, Erzurum City Hospital, Erzurum, Türkiye
| | - Eda Macit Aydın
- Division of Critical Care Medicine, Clinic of Anesthesiology and Reanimation, University of Health Sciences Türkiye, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Türkiye
| | - Hakan Dayanır
- Division of Critical Care Medicine, Clinic of Anesthesiology and Reanimation, University of Health Sciences Türkiye, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Türkiye
| | - Birgül Yelken
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Türkiye
| | - İlkay Ceylan
- Clinic of Critical Care Medicine, University of Health Sciences Türkiye, Bursa High Specialization Training and Research Hospital, Bursa, Türkiye
| | - Osman Özcan Aydın
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Türkiye
| | - Güneş Eskidemir
- Clinic of Critical Care Medicine, Gaziosmanpaşa Training and Research Hospital, İstanbul, Türkiye
| | - Ahmet Aytekin
- Clinic of Anesthesiology and Reanimation, Göztepe Prof. Dr. Süleyman Yalçın City Hospital, İstanbul, Türkiye
| | - Melike Cengiz
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Akdeniz University Faculty of Medicine, Antalya, Türkiye
| | - Ülkü Arslan
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Akdeniz University Faculty of Medicine, Antalya, Türkiye
| | - Devrim Akdağ
- Clinic of Critical Care Medicine, University of Health Sciences Türkiye, Adana City Hospital, Adana, Türkiye
| | - Gülçin Hilal Alay
- Department of Anesthesiology and Reanimation, University of Health Sciences Türkiye, İstanbul Başakşehir Çam and Sakura City Hospital, İstanbul, Türkiye
| | - Esra Tekin
- Clinic of Critical Care Medicine, Denizli State Hospital, Denizli, Türkiye
| | - Volkan Yarar
- Clinic of Critical Care Medicine, Balıkesir Atatürk City Hospital, Balıkesir, Türkiye
| | - Kemal Tolga Saracoğlu
- Clinic of Anesthesiology and Reanimation, University of Health Sciences Türkiye, Kartal Lütfi Kırdar Training and Research Hospital, İstanbul, Türkiye
| | - Funda Gök
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Necmettin Erbakan University Faculty of Medicine, Konya, Türkiye
| | - Volkan Alparslan
- Clinic of Critical Care Medicine, Hatay Training and Research Hospital, Hatay, Türkiye
| | - Verda Tuna
- Clinic of Critical Care Medicine, Adıyaman Training and Research Hospital, Adıyaman, Türkiye
| | - Murside Yıldız
- Clinic of Critical Care Medicine, Ağrı Training and Research Hospital, Ağrı, Türkiye
| | - Nimet Şenoğlu
- Division of Critical Care Medicine, Clinic of Anesthesiology and Reanimation, University of Health Sciences Türkiye, Tepecik Training and Research Hospital, İzmir, Türkiye
| | - Cenk Kıraklı
- Department of Critical Care Medicine, University of Health Sciences Türkiye, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, İzmir, Türkiye
| | - Süleyman Yıldırım
- Department of Critical Care Medicine, University of Health Sciences Türkiye, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, İzmir, Türkiye
| | - Kübra Saçar Kübüç
- Clinic of Critical Care Medicine, University of Health Sciences Türkiye, Van Training and Research Hospital, Van, Türkiye
| | - Ayşen Erer
- Clinic of Critical Care Medicine, Tekirdağ İsmail Fehmi Cumalioğlu City Hospital, Tekirdag, Türkiye
| | - Hamza Gültekin
- Clinic of Critical Care Medicine, Şırnak State Hospital, Şırnak, Türkiye
| | - Kezban Özmen Süner
- Clinic of Critical Care Medicine, Sakarya Training and Research Hospital, Sakarya, Türkiye
| | - Özge Kuzgun
- Clinic of Critical Care Medicine, Sakarya Training and Research Hospital, Sakarya, Türkiye
| | - Çağatay Erman Öztürk
- Clinic of Critical Care Medicine, University of Health Sciences Türkiye, Samsun Training and Research Hospital, Samsun, Türkiye
| | - Aydın Karahan
- Clinic of Critical Care Medicine, Mersin City Hospital, Mersin, Türkiye
| | - Okan Deveci
- Clinic of Critical Care Medicine, Mersin City Hospital, Mersin, Türkiye
| | - Mustafa Ay
- Clinic of Anesthesiology and Reanimation, Antalya Training and Research Hospital, Antalya, Türkiye
| | - Dilara Tüfek Öztan
- Clinic of Anesthesiology and Reanimation, Antalya Training and Research Hospital, Antalya, Türkiye
| | - Seda Banu Akıncı
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Melahat Yalçın Solak
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Süha Bozbay
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Hitit University Faculty of Medicine, Çorum, Türkiye
| | - Serhat Özçiftçi
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Hitit University Faculty of Medicine, Çorum, Türkiye
| | - Kamil Gönderen
- Department of Critical Care Medicine, İzmir Katip Çelebi University, Atatürk Training and Research Hospital, İzmir, Türkiye
| | - Ahmet Oğuzhan Küçük
- Division of Critical Care Medicine, Department of Chest Diseases, Karadeniz Technical University Faculty of Medicine, Trabzon, Türkiye
| | - Berna Uyan
- Department Critical Care Medicine, Gaziantep Şehit Kamil State Hospital, Gaziantep, Türkiye
| | - Gülseren Elay
- Division of Critical Care Medicine, Department of Internal Medicine, Gaziantep University Faculty of Medicine, Gaziantep, Türkiye
| | - Nazlıhan Boyacı
- Division of Critical Care Medicine, Department of Internal Medicine, Gazi University Faculty of Medicine, Ankara, Türkiye
| | - Mustafa Timurkaan
- Clinic of Critical Care Medicine, Elazığ City Hospital, Elazığ, Türkiye
| | - Ebru Karakoç
- Department of Critical Care Medicine, Çankırı State Hospital, Çankırı, Türkiye
| | - Lerzan Doğan
- Department of Critical Care Medicine, Altunizade Acıbadem Hospital, İstanbul, Türkiye
| | - Erdem Yalçınkaya
- Department of Critical Care Medicine, Sivas Numune Hospital, Sivas, Türkiye
| | - Leyla Kazancıoğlu
- Department of Anesthesiology and Reanimation, Recep Tayyip Erdoğan University Faculty of Medicine, Rize, Türkiye
| | - Gül Erdal Dönmez
- Department of Critical Care Medicine, University of Health Sciences Türkiye, İstanbul Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Türkiye
| | - Barış Yılmaz
- Department of Critical Care Medicine, University of Health Sciences Türkiye, İstanbul Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Türkiye
| | - Dursun Fırat Ergül
- Department of Critical Care Medicine, Amasya University Sabuncuoğlu Şerafettin Training and Research Hospital, Amasya, Türkiye
| | - Maruf Boran
- Department of Critical Care Medicine, Amasya University Sabuncuoğlu Şerafettin Training and Research Hospital, Amasya, Türkiye
| | - Hüseyin Özkarakaş
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, University of Health Sciences Türkiye, İzmir Bozyaka Training and Research Hospital, İzmir, Türkiye
| | - Buğra Karakaş
- Clinic of Critical Care Medicine, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Türkiye
| | - Perihan Ergin Özcan
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, İstanbul University Capa Faculty of Medicine, İstanbul, Türkiye
| | - İlkay Anaklı
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, İstanbul University Capa Faculty of Medicine, İstanbul, Türkiye
| | - Mustafa Kemal Bayar
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Ankara University Faculty of Medicine, Ankara, Türkiye
| | - Didem Yüksel
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Ankara University Faculty of Medicine, Ankara, Türkiye
| | - Şükriye Akdağ
- Department of Anesthesiology and Reanimation, Yasar Eryılmaz Ağrı Doğubeyazıt State Hospital, Ağrı, Türkiye
| | - Özcan Pişkin
- Department of Anesthesiology and Reanimation, Zonguldak Bülent Ecevit University Faculty of Medicine, Zonguldak, Türkiye
| | - Sibel Temur
- Department of Anesthesiology and Reanimation, Yeditepe University Faculty of Medicine, İstanbul, Türkiye
| | - Selin Eyüpoğlu
- Clinic of Critical Care Medicine, Giresun Training and Research Hospital, Giresun, Türkiye
| | - Elvan Tekir Yılmaz
- Clinic of Anesthesiology and Reanimation, Giresun University Faculty of Medicine, Giresun Training and Research Hospital, Giresun, Türkiye
| | - Gizem Zaim Avcı
- Clinic of Anesthesiology and Reanimation, Giresun Prof. Dr. İlhan Özdemir State Hospital, Giresun Türkiye
| | - Raziye Turan
- Clinic of Anesthesiology and Reanimation, Giresun Prof. Dr. İlhan Özdemir State Hospital, Giresun Türkiye
| | - Fatma Alkan Bayburt
- Clinic of Anesthesiology and Reanimation, Giresun Prof. Dr. İlhan Özdemir State Hospital, Giresun Türkiye
| | - Helin Şahintürk
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Başkent University Faculty of Medicine, Ankara, Türkiye
| | - Bülent Güçyetmez
- Department of Anesthesiology and Reanimation, Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, İstanbul, Türkiye
| | - Mustafa Muhlis Alparslan
- Clinic of Anesthesiology and Reanimation, Aksaray University Training and Research Hospital, Aksaray, Türkiye
| | - Metin Yarıcı
- Department of Critical Care Medicine, University of Health Sciences Türkiye, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Türkiye
| | - Fatma Yıldırım
- Department of Chest Diseases, University of Health Sciences Türkiye, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Türkiye
| | - Abdulkadir Yektaş
- Department of Anesthesiology and Reanimation, Siirt University Faculty of Medicine, Siirt, Türkiye
| | | | - Oktay Demirkıran
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, İstanbul, Türkiye
| | - İsmail Cinel
- Division of Critical Care Medicine, Department of Anesthesiology and Reanimation, Marmara University Faculty of Medicine, İstanbul, Türkiye
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Bozdemir SE, Türe E, Altin H, Ertek S, Aktürk B, Kırkas ÖG, Koçkuzu E, Yarci E, Sahin S. Management of Multisystem Inflammatory Syndrome in Children with Combined Use of Corticosteroids and Intravenous Immunoglobulin—Report from Bursa, Turkey. J PEDIAT INF DIS-GER 2022. [DOI: 10.1055/s-0042-1745835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Abstract
Objective In this article, we aimed to evaluate the clinical, laboratory, and radiological findings and outcomes of patients treated with corticosteroids and intravenous immunoglobulin (IVIG) with the multisystem inflammatory syndrome in children (MIS-C) in two centers in Bursa, Turkey.
Methods We retrospectively collected the clinical characteristics, laboratory results, and treatment outcomes of MIS-C cases treated in two centers from April 2020 to February 2021. Patients were compared both according to their clinical categorization and the place they were hospitalized in, as well as with studies published in the literature.
Results Fifty-six patients were included. Thirty-six (64.3%) were male with a mean age of 67.95 ± 50.87 months. Thirty patients (53.5%) were categorized as Kawasaki-like disease, 17 (30.3%) sepsis-like disease, and 9 (16%) were toxic shock syndrome (TSS). Admission symptoms were fever (100%), rash (71.4%), myalgia (69.6%), and abdominal pain (62.5%). Seventeen (30.3%) patients were hospitalized in pediatric intensive care unit. Elevated C-reactive protein levels, procalcitonin, erythrocyte sedimentation rate, D-dimer, and troponin were found in 100, 77, 84, 84, and 23.2% of the patients, respectively. Of all, 55 (98.2%) received IVIG, 54 (96.4%) corticosteroids, 56 (100%) antibiotic therapy, 22 (40%) albumin infusion, and 13 (23.2%) inotropic support. Fifty patients (89.3%) received low-molecular-weight heparin: enoxaparin, followed by acetylsalicylic acid treatment. Only one patient who was resistant to both IVIG and steroid treatment received Anakinra. One patient (1.7%) with TSS died within 1 hour of hospitalization.
Conclusion Combined use of IVIG and corticosteroids is an effective way of treatment in MIS-C patients resulting in low mortality.
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Affiliation(s)
- Sefika Elmas Bozdemir
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Bursa City Hospital, Bursa, Turkey
| | - Esra Türe
- Division of Pediatric Emergency Diseases, Department of Pediatrics, Bursa City Hospital, Bursa, Turkey
| | - Hakan Altin
- Division of Pediatric Cardiology, Department of Pediatrics, Bursa City Hospital, Bursa, Turkey
| | - Sümeyye Ertek
- Department of Pediatrics, Dortcelik Children's Hospital, Bursa, Turkey
| | - Berna Aktürk
- Department of Pediatrics, Bursa City Hospital, Bursa, Turkey
| | - Özlem Gül Kırkas
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Dortcelik Children's Hospital, Bursa, Turkey
| | - Esra Koçkuzu
- Division of Pediatric Intensive Care Unit, Department of Pediatrics, Dortcelik Children's Hospital, Bursa, Turkey
| | - Erbu Yarci
- Division of Neonatology, Department of Pediatrics, Dortcelik Children's Hospital, Bursa, Turkey
| | - Sabit Sahin
- Department of Pediatrics, Dortcelik Children's Hospital, Bursa, Turkey
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