Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Mortality Trend of Severe COVID-19 in Under-Vaccinated Population Admitted to ICU in French Amazonia

Severine Matheus
,
Stéphanie Houcke
,
Guy Roger Lontsingoula
,
Nicolas Higel
,
Abesetou Ba
,
Fabrice Cook
,
Cyrille Gourjault
ORCID logo ,
Flaubert Nkontcho
,
Magalie Demar
ORCID logo ,
Mathieu Nacher
ORCID logo ,
Félix Djossou
,
Didier Hommel
,
Dabor RESIERE
ORCID logo ,
Jean Marc Pujo
,
Hatem Kallel
*
Version 1 : Received: 7 December 2023 / Approved: 7 December 2023 / Online: 8 December 2023 (10:21:21 CET)

A peer-reviewed article of this Preprint also exists.

Matheus, S.; Houcke, S.; Lontsingoula, G.R.; Higel, N.; Ba, A.; Cook, F.; Gourjault, C.; Nkontcho, F.; Demar, M.; Nacher, M.; Djossou, F.; Hommel, D.; Résiere, D.; Pujo, J.M.; Kallel, H. Mortality Trend of Severe COVID-19 in Under-Vaccinated Population Admitted to ICU in French Amazonia. Trop. Med. Infect. Dis. 2024, 9, 15. Matheus, S.; Houcke, S.; Lontsingoula, G.R.; Higel, N.; Ba, A.; Cook, F.; Gourjault, C.; Nkontcho, F.; Demar, M.; Nacher, M.; Djossou, F.; Hommel, D.; Résiere, D.; Pujo, J.M.; Kallel, H. Mortality Trend of Severe COVID-19 in Under-Vaccinated Population Admitted to ICU in French Amazonia. Trop. Med. Infect. Dis. 2024, 9, 15.

Abstract

(1) Background: Until December 2021, French Guiana (FG), located in South America, faced four consecutive COVID-19 epidemic waves. This study sought to analyze the mortality trend of severe COVID-19 patients admitted to the referral ICU of FG. (2) Methods: We conducted a prospective, observational, and non-interventional study in ICU at Cayenne Hospital. We included 383 patients older than 18 admitted with SARS-CoV-2-related pneumonia hospitalized from May 2020 to December 2021. The study covers three periods. Period 1 (Waves 1 and 2, original variant), period 2 (Wave 3, gamma variant), and period 3 (Wave 4, delta variant). (3) Results: The median age was 63 years (52-70). Frailty was diagnosed in 36 patients over 70 (32.4%). Only 4.8% of patients were vaccinated. The median ICU LOS was 10 days (6-19). Hospital mortality was 37.3%. It was 30.9% in period 1, 36.6% in period 2 (p=0.329 vs. period 1), and 47.1% in period 3 (0.015 vs. period 1). In multivariate analysis, independent factors associated with hospital mortality were age more than 40 years (]40-60 years] OR=5.2, 95%CI: 1.4-19.5; (]60-70 years] OR=8.5 95%CI: 2.2-32; (]70+ years] OR=17.9, 95%CI: 4.5-70.9), frailty (OR=5.6, 95%CI: 2.2-17.2), immunosuppression (OR=2.6, 95%CI: 1.05-6.7), and MV use (OR=11, 95%CI: 6.1-19.9). This model had an overall sensitivity of 72%, a specificity of 80.4%, a positive predictive value of 68.7%, and a negative predictive value of 82.8%. (4) Conclusions: The mortality of severe COVID-19 patients in French Amazonia was higher during the delta variant wave. This over-death is explained by the virulence of the responsible SARS-CoV-2 variant and the under-vaccination coverage of the studied population.

Keywords

COVID-19; delta variant; gamma variant; mortality; French Guiana  

Subject

Public Health and Healthcare, Health Policy and Services

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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