Introduction District Base Hospital Theldeniya, Sri Lanka was one of the main Secondary care Setting in Kandy District Sri Lanka.

It was selected as a Level 3 Covid 19 Treatment Centre.

As the Medical Director, I Directed my clinical Team to execute this study.

A Prospective Study To Explore The Impact Of The Vaccination Status On Disease Severity And Mortality In Covid-19

Prathapsinghe I1, Kularatne S.H1, Somachandra B.G.H.M1, Dissanayake D.M.M.S.S.M1, Ariyarathne M.D.S.S1

1 District Base Hospital Theldeniya, Kandy, Sri Lanka

Introduction Vaccination is considered the tipping point that will contribute to curtail the ongoing SARS-CoV-2 outbreak. In this prospective cross sectional study, It was explored the impact of the vaccination status with other factors such as co-morbid conditions on the disease severity and mortality in covid-19 infection.

Objective To assess the impact of vaccination status on disease severity and mortality in Covid-19

Methodology The study was conducted over a 3-month period in District Base Hospital Theldeniya, which is a level III and the third major Covid-19 treatment center in Sri Lanka. A total of 179 Covid-19 positive patients (82 female, 92 male) were purposively selected and data analysis was done by R and ER studio.

Covid Death rates were rising and vaccination process was started. Some Deaths happened even after having both doses of Vaccines. So several Managerial level discussions were held to raise this issue

2. This abstract was selected for publication in last FMLM convention held in year2022 under the no.94141.

Un fortunately I couldn’t attend to present because i met with an accident.

I informed the same to FMLM.

Aims and objectives of the research project or activity Co Authors Were Medical Officers who engaged in patient care in the clinical setting. They used to collect data accordingly.

They were able to collect accurate clinical data at the setting wearing PPE s.

Method or approach It is observed the effect of vaccination particularly the type of the vaccine that is more contributed to disease prevention.

Pfizer, AstraZeneca, and Modena showed better results and outcome comparatively the Chinese cyanopharm vaccine. deaths found even after having both doses of that vaccine.

Study impact reveal to introduce a better vaccine for use and explore the causative and precipitating factors .

Results of the study were very helpful for clinical decision making and take managerial decisional steps to give effective vaccines for needy.

At the same time to address the public about the precipitating and aggravating factors to be alert on viral infection and promote to wear Personnel Protective Equipment ( PPE ).

Reproducibility:

The study reveal the out come of vaccination and type of vaccination. AstraZeneca, and Pfizer showed a better outcome.

Findings Vaccination can Reduce the death rates of Covid 19.

Its depend on the type of the vaccine as well.

Prevention of Non Communicable diseases, helpful to minimize the harmful effects of Covid 19.

Of all participants, 87 patients had taken only a single dose of a vaccine, 47 were fully vaccinated (2 doses) while 45 were not vaccinated at all (69 Sinopharm, 37 Covishield, 15 sputnik, 12 Moderna, 1 Pfizer). Out of all, 10.06% became critically ill requiring ICU care and 7.26% needed ventilator support as well. More than half (59.22%) fully recovered, about a quarter (24.58%) recovered, but required follow up. Unfortunately, 29 patients (16.2%) died of Covid-19. When vaccination status and the disease severity were considered, most of the fully vaccinated (55.4%) were mildly symptomatic and most (33.3%) of the not-vaccinated group were moderately symptomatic. Most, i.e.; 16 of the total 29 mortalities were from the group vaccinated with Sinopharm.

Of all, 61.45% had one or more co-morbidities such as Diabetes mellitus, cardiovascular disease, lung disease, malignancy or immunodeficiency etc.; 75.9% of deaths were from this group, in compared to 24.1% in previously well patient group.

Share the results with other organizations and relevant stakeholders.

Discussion Covid-19 infection has a clinical spectrum of disease from asymptomatic to critically ill, however, the greatest proportion presented with mild infection. Vaccination status i.e.; fully or partially vaccinated or not vaccinated, and the type of the vaccine showed a significant influence on the disease severity and outcome including mortality. Also, the presence of co-morbidities augmented the severity and mortality in Covid-19.

Conclusions and Recommendations Vaccination effectively lowers the disease severity as well as mortality. Howbeit, the vaccine type and the presence of co-morbid conditions can greatly alter the disease outcome. Our findings strengthen the fact that the vaccination is the sustainer in Covid-19 pandemic control, further gives an insight to the future vaccination schedules.

Covid-19 Vaccination, Covid-19 Disease severity, Covid-19 mortality

Key messages Vaccination is the best option to prevent Covid 19.

Its Depend on the type of vaccine, particularly DNA vaccines manufactured in United Kingdom shows better results.

Prevention of Non Communicable diseases, helpful to minimize the harmful effects of Covid 19