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Original article
Available online 24 March 2025
SARS-CoV-2 vaccination reduces the risk of thrombotic complications in severe COVID-19
La vacunación contra el SARS-CoV-2 reduce el riesgo de complicaciones trombóticas en pacientes graves por COVID-19
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M. Ángeles Alonso Fernándeza, Carola Bledigb, Madian Manso Álvareza, Raquel Gómez Guardiolac, Marina Blancas Garcíad, Irene Bartolomée, Manuel Quintana Díazf, Pilar Marcos Neirag, Jose Alberto Silva Obregónh, Ainhoa Serrano Lázaroi, Salvador Campillo Moralesj, Blanca López Matamalaa, Carmen Martín Parraa, Ángela Algaba Calderóna, Rafael Blancas Gómez-Caseroa,
Corresponding author
rafael.blancas@salud.madrid.org

Corresponding author.
, Óscar Martínez Gonzáleza
a Hospital Universitario del Tajo, Critical Care Department, Universidad Alfonso X El Sabio, Spain
b Ospedale Michele e Pietro Ferrero, Servicio de Anestesia e Rianimazione, Italy
c Hospital Universitario de Getafe, Critical Care Department, Spain
d Hospital Universitario Marqués de Valdecilla, Pulmonology Department, Spain
e Universidad CEU San Pablo, Spain
f Hospital Universitario La Paz, Critical Care Department, Universidad Autónoma de Madrid, Spain
g Hospital Germans Trías i Pujol, Critical Care Department, Spain
h Hospital Universitario Guadalajara, Critical Care Department, Spain
i Hospital Clinico Universitario de Valencia, Critical Care Department, Spain
j Instituto de Investigación IdIPaz, Spain
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Received 30 August 2024. Accepted 31 January 2025
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Tables (7)
Table 1. Sample baseline characteristics.
Tables
Table 2. Items related to symptoms, LOS and ICU mortality.
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Table 3. Modalities of oxygen therapy.
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Table 4. Anticoagulant regimens with enoxaparin administered in the ICU.
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Table 5. Multivariate analysis. Variables associated with thrombosis and death.
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Table A1. Variables contrasted with the outcome variable (thrombosis) by logistic regression.
Tables
Table A2. Variables contrasted with the outcome variable (mortality) by logistic regression.
Tables
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Abstract
Objectives

The aim of this study was to evaluate the association between SARS-CoV-2 vaccination and the occurrence of thrombotic complications in patients admitted to intensive care for severe COVID-19 pneumonia.

Design

Observational, descriptive, prospective, multicentre study.

Setting

Intensive care units of five university hospitals.

Patients

A total of 255 patients admitted to the intensive care unit (ICU) with SARS-CoV-2 pneumonia, confirmed by RT-PCR in throat swab or tracheal aspirate, starting the date the first vaccinated patient against SARS-CoV-2 was admitted in one of the participating ICUs, were included in the analysis.

Main variables of interest

Vaccination status against SARS-CoV-2 and thrombotic events.

Results

18.8% of patients had received some form of vaccination. Thrombotic events occurred in 21.2% of patients. Lack of vaccination was associated with thrombotic events (OR 5.024; 95% CI: 1.104−23.123; p = 0.0037) and death (OR 5.161; 95% CI: 1.075–24.787; p = 0.04). ICU mortality was not associated with the occurrence of thrombotic complications.

Conclusions

In this series of patients, vaccination against SARS-CoV-2 reduced the risk of thrombotic events and mortality in patients with severe COVID-19 admitted to the ICU. Thrombotic complications did not alter ICU mortality.

Keywords:
COVID-19
SARS-CoV-2
Vaccination
Thrombosis
Pneumonia
Intensive care unit
Resumen
Objetivos

El objetivo de este estudio fue evaluar la asociación entre la vacunación frente al SARS-CoV-2 y la aparición de complicaciones trombóticas en pacientes ingresados ​​en cuidados intensivos por neumonía grave por COVID-19.

Diseño

Estudio observacional, descriptivo, prospectivo y multicéntrico.

Ámbito

Unidades de cuidados intensivos de cinco hospitales universitarios.

Pacientes

Se incluyeron en el análisis 255 pacientes ingresados ​​en la Unidad de Cuidados Intensivos (UCI) con neumonía por SARS-CoV-2, confirmada mediante la técnica RT-PCR en frotis faríngeo o aspirado traqueal, desde la fecha de ingreso del primer paciente vacunado frente al SARS-CoV-2 en una de las UCI participantes.

Principales variables de interés

Vacunación frente al SARS-CoV-2 y eventos trombóticos.

Resultados

El 18,8% de los pacientes había recibido algún tipo de vacunación. Se produjeron eventos trombóticos en el 21,2% de los pacientes. La falta de vacunación se asoció con eventos trombóticos (OR 5,024; IC 95%: 1,104−23,123; p = 0,0037) y con muerte (OR 5,161; IC 95%:1,075−24,787; p = 0,04). La mortalidad en UCI no se asoció con la aparición de complicaciones trombóticas.

Conclusiones

En esta serie de pacientes, la vacunación frente al SARS-CoV-2 redujo el riesgo de eventos trombóticos y la mortalidad en pacientes con COVID-19 grave ingresados ​​en UCI. Las complicaciones trombóticas no alteraron la mortalidad en UCI.

Palabras clave:
COVID-19
SARS-CoV-2
Vacunación
Trombosis
Neumonía
Unidad de cuidados intensivos

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