COVID-19 still represents an important challenge for health systems worldwide and for our society. Public health interventions, new drugs and vaccines have all been developed in an attempt to curb the effects of this pandemic. The results of the vaccination campaign have been witnessed from the clinical practice as a reduction in both the number of patients seeking help to the Emergency Room (ER) and the severity of the respiratory insufficiency caused by SARS-CoV-2. The aim of the study is to evaluate these results with a statistical approach. A cohort of 2637 swab – confirmed COVID-19 patients underwent ABG analysis and their P/F ratio was examined to evaluate the overall trend of the severity of SARS-CoV-2 induced respiratory insufficiency. All patients that were admitted to the ER from the 1st of June 2021 were considered vaccinated according to the trend of the vaccination campaign in the province of Pavia. Three subgroups were also identified for people affected by either arterial hypertension, diabetes mellitus or COPD. The Kolmogorov-Smirnov test was used to evaluate whether the two populations were normally distributed; a non-parametric test, i.e. the Wilcoxon signed-rank test, was used to reject null hypothesis (p value < 0.05). The number of patients that accessed the ER was found to be lower from June 2021 onward. The median P/F ratio of the vaccinated population was found to be higher than the one of the non – vaccinated population (355 vs 298, p value 1.34*10-26). Similar results were obtained for the three subgroups of patients with specific pathologies (arterial hypertension: 351 vs 299, p value 2.03*10-7; diabetes mellitus: 339 vs 282, p value 0.002; COPD: 324 vs 282, p value 0.193). This study confirmed how the vaccination campaign is aiding the containment of the COVID-19 pandemic. Further research is needed as to evaluate the same objective with a larger cohort of patients, the long-term efficacy of vaccines, the development of efficacious drugs and the overall effects of vaccines on the “long – COVID-19”.
La pandemia da COVID-19 rappresenta, ancora oggi, un’importante sfida sia per la nostra società che per il sistema sanitario italiano e internazionale. Misure preventive di salute pubblica, nuovi medicinali e differenti tipologie di vaccino sono state adottate per ridurre e contenere gli effetti di questa malattia. Dal punto di vista della pratica clinica, i risultati della campagna vaccinale si sono evidenziati sia con una riduzione del numero di accessi (giornalieri e mensili) al Pronto Soccorso (PS) di pazienti infetti da SARS-CoV-2 sia con una diminuzione della gravità dell’insufficienza respiratoria causata da questo virus. L’obiettivo di questo studio è quello di valutare tali risultati tramite un analisi statistica. Un gruppo di 2637 pazienti con una positività di infezione da SARS-CoV-2 accertata al tampone naso-faringeo molecolare è stato arruolata nello studio e ha effettuato una emogasanalisi arteriosa per ottenere il rapporto P/F così da analizzare la gravità dell’insufficienza respiratoria. Tutti quei pazienti che hanno fatto accesso al PS dopo Giugno 2021 sono stati considerati vaccinati considerando l’andamento della copertura vaccinale nella provincia di Pavia. Tre sottogruppi di pazienti sono stati ulteriormente identificati, ciascuno affetto o da ipertensione arteriosa, o da diabete mellito o da BPCO. Il test di Kolmogorov-Smirnov è stato utilizzato per verificare che le popolazioni seguissero una distribuzione normale; un test non-parametrico, il test di Wilcoxon, è stato applicato per rigettare le ipotesi nulle (p value < 0.05). Il numero di accessi al pronto soccorso è diminuito significativamente da giugno 2021. La mediana dei rapporti P/F della popolazione vaccinata è maggiore rispetto a quella della popolazione non vaccinata (355 vs 298, p value 1.34*10-26). Risultati simili sono stati ottenuti per i tre sottogruppi con patologie specifiche (ipertensione arteriosa: 351 vs 299, p value 2.03*10-7; diabete mellito: 339 vs 282, p value 0.002; BPCO: 324 vs 282, p value 0.193). Lo studio ha quindi confermato il ruolo che la campagna vaccinale sta svolgendo nel contenere gli effetti della pandemia da SARS-CoV-2. Ulteriori ricerche sono necessarie per valutare lo stesso obiettivo ma con una popolazione di pazienti più ampia, l’efficacia a lungo termine delle vaccinazioni, lo studio di nuovi farmaci e l’efficacia dei vaccini sulla “long – COVID-19”.
COVID-19 Pandemic: The Effects of the Vaccination Campaign. Experience of the Emergency Room (ER) of the I.R.C.C.S. Policlinico San Matteo of Pavia
TOMASONI, MICHELANGELO
2021/2022
Abstract
COVID-19 still represents an important challenge for health systems worldwide and for our society. Public health interventions, new drugs and vaccines have all been developed in an attempt to curb the effects of this pandemic. The results of the vaccination campaign have been witnessed from the clinical practice as a reduction in both the number of patients seeking help to the Emergency Room (ER) and the severity of the respiratory insufficiency caused by SARS-CoV-2. The aim of the study is to evaluate these results with a statistical approach. A cohort of 2637 swab – confirmed COVID-19 patients underwent ABG analysis and their P/F ratio was examined to evaluate the overall trend of the severity of SARS-CoV-2 induced respiratory insufficiency. All patients that were admitted to the ER from the 1st of June 2021 were considered vaccinated according to the trend of the vaccination campaign in the province of Pavia. Three subgroups were also identified for people affected by either arterial hypertension, diabetes mellitus or COPD. The Kolmogorov-Smirnov test was used to evaluate whether the two populations were normally distributed; a non-parametric test, i.e. the Wilcoxon signed-rank test, was used to reject null hypothesis (p value < 0.05). The number of patients that accessed the ER was found to be lower from June 2021 onward. The median P/F ratio of the vaccinated population was found to be higher than the one of the non – vaccinated population (355 vs 298, p value 1.34*10-26). Similar results were obtained for the three subgroups of patients with specific pathologies (arterial hypertension: 351 vs 299, p value 2.03*10-7; diabetes mellitus: 339 vs 282, p value 0.002; COPD: 324 vs 282, p value 0.193). This study confirmed how the vaccination campaign is aiding the containment of the COVID-19 pandemic. Further research is needed as to evaluate the same objective with a larger cohort of patients, the long-term efficacy of vaccines, the development of efficacious drugs and the overall effects of vaccines on the “long – COVID-19”.È consentito all'utente scaricare e condividere i documenti disponibili a testo pieno in UNITESI UNIPV nel rispetto della licenza Creative Commons del tipo CC BY NC ND.
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https://hdl.handle.net/20.500.14239/14407