Clinical Characteristics and Outcomes of Vaccinated VS Non-Vaccinated Critically Ill COVID-19 Patients: Retrospective Observation Study

Shaya Yaanallah AlQahtani,1 Ahmed Anwer Alabdulqader,2 Waleed Abdulrahman Al Mashhour,3 Zahra Mohammed Aldawood,4 Osama Ali Al Masari,1 Thabit Alotaibi,1 Zeead M AlGhamdi,5 Ibrahim M Alzahrani,6 Noor Nabil Albaloushi7 1Department of Internal Medicine and Critical Care Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2King Fahad Hospital Hofuf, Hofuf, Saudi Arabia; 3Dammam Medical Complex, Dammam, Saudi Arabia; 4King Khalid Hospital- AlKharaj, Alkharaj, Saudi Arabia; 5Thoracic Surgery Division, Department of Surgery, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 6Department of Internal medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia; 7Ministry of Health, Dammam, Saudi ArabiaCorrespondence: Shaya Yaanallah AlQahtani, Department of Internal Medicine and Critical Care Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, P.O. Box. 2208, Dammam, 31952, Saudi Arabia, Email saalQahthani@iau.edu.saObjective: We aim to identify the clinical characteristics and outcome of vaccine breakthrough infection in critically ill COVID-19 patients and to compare the clinical course of disease between vaccinated and non-vaccinated patients.Methods: A retrospective review of all adult patients aged ≥ 18 years admitted to the ICU in King Fahd Hospital of the University in Saudi Arabia with positive COVID-19 RT-PCR test between the period of January 1st to August 31st, 2021, were included. The recruited patients were grouped in to “vaccinated and non-vaccinated group” based on their immunization status. The demographic data, co-morbidities, modality of oxygen support, ICU length of stay (ICU LOS) and mortality were collected and analyzed.Results: A total of 167 patients were included. Seventy-two patients (43%) were vaccinated. Cardiovascular diseases were higher among the vaccinated group (33.3% vs 12.6%, p value < 0.001). Requirements of Non-invasive ventilation was significantly lower in vaccinated group compared to non-vaccinated group (73.6% vs 91.6%, p value < 0.011). The rates of intubation were similar between both groups. The total intubation days was longer in non-vaccinated patients compared to vaccinated patients and the median duration of intubation was 8 days vs 2 days, respectively (p value 0.027). In subgroup analysis, the P/F ratio was significantly higher in patients who received two doses of vaccine compared to single dose (p value < 0.002).Conclusion: In critically ill COVID-19 patients, the vaccinated group has significantly less need for Non-invasive ventilation, fewer intubation days and less hypoxia compared to non-vaccinated patients. We recommend more policies and public education nationwide and worldwide to encourage vaccination and raise awareness of the general population.Keywords: COVID-19 vaccine, breakthrough infection, intensive care unit, vaccine effectiveness, inflammatory markers