SARS-CoV-2 infection in chronic kidney disease patients vaccinated with Oxford/AstraZeneca COVID-19 vaccine: initial Indian experience

接种牛津/阿斯利康新冠疫苗的慢性肾病患者感染SARS-CoV-2的情况:印度初步经验

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Abstract

BACKGROUND: Chronic obstructive pulmonary disease (COPD) care across the world has high heterogeneity concerning cost and the services available. Variations in mechanical ventilation and mortality duration may be attributed to patient characteristics, intubation period, age, history of smoking, Tuberculosis, albumin level, pneumonia, number of organ involvement, pre-intubation PH, pC02, gender, and pre-intubation pa02. AIMS & OBJECTIVES: Factors affecting mortality and period of mechanical ventilation in COPD patients. MATERIALS/PATIENTS AND METHODS: This retrospective study included AECOPD of 104 patients admitted to a tertiary hospital's respiratory intensive care unit in Mumbai from March 2019 to June 2023. Patient's clinical history details, sputum microbiological profile, blood test, and comorbidities were extracted from the medical record system and compared between survivors and non-survivors, Analysis duration of the mechanical ventilation. RESULTS: Out of 104 patients admitted,23 died, and 81 survived. The mean ages were 61.00±14.03 years death group and 52.56±13.44 years in the survivors. The overall mortality rate was 22.11%. Analysis showed that the mortality rate was significantly associated with the older age, intubation period, history of smoking, Tuberculosis, low albumin level, pneumonia, more organ involvement, pre-intubation PH(acidotic), and high pC02. Gender and pre-intubation paO2 do not affect mortality. Analysis out of 104 patients,43 required mechanical ventilation > 1 week. Data shows that the duration of mechanical intubation was significantly associated with female gender, history of smoking, history of Tuberculosis, low albumin level, pneumonia (cap, hap), number of organ involvement, pre-intubation PH(acidotic), and high pC02. Age and pre-intubation paO2 does not affect the duration of mechanical ventilation. CONCLUSIONS: Identifying factors affecting mortality and duration of mechanical ventilation and providing targeted interventions at an early stage offers the potential to reduce it. The complex interactions between factors and systems were more important than any single factor or organizational factor in determining differences. LIMITATION: Limitations of this study variation in the treatment protocols, variability in COPD severity, and single center case study. CONFLICT OF INTEREST: There are no conflicts of interest.

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