Background: In recent years, the severity of COVID-19 has diminished. However, some patients progressed to respiratory failure, necessitating intubation and mechanical ventilation. This study investigated the impact of variants of concern and vaccination status on mortality in mechanically ventilated patients. Method: We conducted a retrospective analysis of the medical records of intubated COVID-19 patients from 1 January 2021, to 31 December 2023. Patients who received at least one dose of a vaccine were classified as vaccinated, and variant types were classified based on the dominant variant reported by the Taiwan Centers for Disease Control. The primary outcome measured was time from intubation to all-cause in-hospital death. Result: A total of 254 patients were analyzed, comprising 65 patients infected with the Alpha variant and 189 with the Omicron variant. Clinical data, including variant type, vaccination status, and SOFA score at the time of intubation, were meticulously recorded. The overall mortality rate was 40%, with two epidemic surges occurring in 2021 and 2022. Infection with the Alpha variant was associated with a significantly higher risk of mortality (adjusted hazard ratio = 5.42 (2.78–10.7); p < 0.01). Key prognostic factors identified included age, body mass index, SOFA score, and serum bicarbonate levels. Conclusions: The overall mortality rate remained notably high. The study identified several factors associated with increased mortality risk, including older age, higher SOFA scores, Alpha variant infection, decreased serum bicarbonate levels, and lower BMI. However, vaccination status was not a significant prognostic indicator.
Wong et al. (Thu,) studied this question.