Vaccinated COVID-19 patients admitted in a Tunisian ICU: clinical features and outcome

Abstract

Objective: Anti COVID vaccines are efficient in preventing most severe forms of SARS-COV-2 infections. Nevertheless, many vaccinated patients are still at risk to have severe forms.

We aimed to describe characteristics, severity and outcome of COVID-19 vaccinated patients admitted in ICU.

Methods: A prospective study conducted between August 15th 2021 and February 20th 2022 in the ICU of Abderrahmen Mami hospital in Tunisia. Patients who received at least one dose of vaccine were included. Epidemiological characteristics, ventilation strategy and vaccine data were collected.

Results: During the study period, 133 patients were admitted to the ICU, from whom 36 (27%) met the inclusion criteria. All of them received the first dose of the vaccine, 27 (75%) were fully vaccinated (2 doses); only 2 of them have received a booster dose (3rd dose). The majority of vaccinated patients were male (gender-ratio 2.3), mean age was 64 years. Thirty-one patients (86%) had at least one comorbidity. Reason for ICU admission was acute respiratory failure (n = 26; 72%) with high O2 needs or complications related to comorbidities (n = 10; 28 %). The mean P/F ratio at admission was 160 mmHg. Ventilatory requirement was: high flow nasal canula (22%), non-invasive ventilation (69.4%) and invasive ventilation (33%). ICU mortality among fully vaccinated patients (2 or 3 doses) was 55% (15/27). The most common cause of death was severe hypoxemia and/or a related complication. Only 5 patients died due to complications of their comorbidities.

Conclusions: Vaccinated patients admitted in ICU were elderly and had comorbidities. ICU mortality among fully vaccinated remains high.