Comparing COVID-19 severity in patients hospitalized for community-associated Delta, BA.1 and BA.4/5 variant infection
BackgroundDespite decreasing COVID-19 disease severity during the Omicron waves, a proportion of patients still require hospitalization and intensive care.ObjectiveTo compare demographic characteristics, comorbidities, vaccination status, and previous infections in patients hospitalized for communit...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-02-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1294261/full |
| _version_ | 1827345915703197696 |
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| author | Maja Sočan Maja Mrzel Katarina Prosenc Miša Korva Tatjana Avšič-Županc Mario Poljak Maja M. Lunar Tina Zupanič |
| author_facet | Maja Sočan Maja Mrzel Katarina Prosenc Miša Korva Tatjana Avšič-Županc Mario Poljak Maja M. Lunar Tina Zupanič |
| author_sort | Maja Sočan |
| collection | DOAJ |
| description | BackgroundDespite decreasing COVID-19 disease severity during the Omicron waves, a proportion of patients still require hospitalization and intensive care.ObjectiveTo compare demographic characteristics, comorbidities, vaccination status, and previous infections in patients hospitalized for community-associated COVID-19 (CAC) in predominantly Delta, Omicron BA.1 and BA.4/5 SARS-CoV-2 waves.MethodsData were extracted from three national databases—the National COVID-19 Database, National Vaccination Registry and National Registry of Hospitalizations.ResultsAmong the hospitalized CAC patients analyzed in this study, 5,512 were infected with Delta, 1,120 with Omicron BA.1, and 1,143 with the Omicron BA.4/5 variant. The age and sex structure changed from Delta to BA.4/5, with the proportion of women (9.5% increase), children and adolescents (10.4% increase), and octa- and nonagenarians increasing significantly (24.5% increase). Significantly more patients had comorbidities (measured by the Charlson Comorbidity Index), 30.3% in Delta and 43% in BA.4/5 period. The need for non-invasive ventilatory support (NiVS), ICU admission, mechanical ventilation (MV), and in-hospital mortality (IHM) decreased from Delta to Omicron BA.4/5 period for 12.6, 13.5, 11.5, and 6.3%, respectively. Multivariate analysis revealed significantly lower odds for ICU admission (OR 0.68, CI 0.54–0.84, p < 0.001) and IHM (OR 0.74, CI 0.58–0.93, p = 0.011) during the Delta period in patients who had been fully vaccinated or boosted with a COVID-19 vaccine within the previous 6 months. In the BA.1 variant period, patients who had less than 6 months elapsed between the last vaccine dose and SARS-CoV-2 positivity had lower odds for MV (OR 0.38, CI 0.18-0.72, p = 0.005) and IHM (OR 0.56, CI 0.37- 0.83, p = 0.005), but not for NIVS or ICU admission.ConclusionThe likelihood of developing severe CAC in hospitalized patients was higher in those with the Delta and Omicron BA.1 variant compared to BA.4/5. |
| first_indexed | 2024-03-07T23:20:40Z |
| format | Article |
| id | doaj.art-2be5dc9757a1467bb272cdd43ec16650 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-03-07T23:20:40Z |
| publishDate | 2024-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-2be5dc9757a1467bb272cdd43ec166502024-02-21T05:36:35ZengFrontiers Media S.A.Frontiers in Public Health2296-25652024-02-011210.3389/fpubh.2024.12942611294261Comparing COVID-19 severity in patients hospitalized for community-associated Delta, BA.1 and BA.4/5 variant infectionMaja Sočan0Maja Mrzel1Katarina Prosenc2Miša Korva3Tatjana Avšič-Županc4Mario Poljak5Maja M. Lunar6Tina Zupanič7National Institute of Public Health, Ljubljana, SloveniaNational Institute of Public Health, Ljubljana, SloveniaNational Institute of Health, Environment and Food, Ljubljana, SloveniaInstitute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, SloveniaInstitute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, SloveniaInstitute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, SloveniaInstitute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, SloveniaNational Institute of Public Health, Ljubljana, SloveniaBackgroundDespite decreasing COVID-19 disease severity during the Omicron waves, a proportion of patients still require hospitalization and intensive care.ObjectiveTo compare demographic characteristics, comorbidities, vaccination status, and previous infections in patients hospitalized for community-associated COVID-19 (CAC) in predominantly Delta, Omicron BA.1 and BA.4/5 SARS-CoV-2 waves.MethodsData were extracted from three national databases—the National COVID-19 Database, National Vaccination Registry and National Registry of Hospitalizations.ResultsAmong the hospitalized CAC patients analyzed in this study, 5,512 were infected with Delta, 1,120 with Omicron BA.1, and 1,143 with the Omicron BA.4/5 variant. The age and sex structure changed from Delta to BA.4/5, with the proportion of women (9.5% increase), children and adolescents (10.4% increase), and octa- and nonagenarians increasing significantly (24.5% increase). Significantly more patients had comorbidities (measured by the Charlson Comorbidity Index), 30.3% in Delta and 43% in BA.4/5 period. The need for non-invasive ventilatory support (NiVS), ICU admission, mechanical ventilation (MV), and in-hospital mortality (IHM) decreased from Delta to Omicron BA.4/5 period for 12.6, 13.5, 11.5, and 6.3%, respectively. Multivariate analysis revealed significantly lower odds for ICU admission (OR 0.68, CI 0.54–0.84, p < 0.001) and IHM (OR 0.74, CI 0.58–0.93, p = 0.011) during the Delta period in patients who had been fully vaccinated or boosted with a COVID-19 vaccine within the previous 6 months. In the BA.1 variant period, patients who had less than 6 months elapsed between the last vaccine dose and SARS-CoV-2 positivity had lower odds for MV (OR 0.38, CI 0.18-0.72, p = 0.005) and IHM (OR 0.56, CI 0.37- 0.83, p = 0.005), but not for NIVS or ICU admission.ConclusionThe likelihood of developing severe CAC in hospitalized patients was higher in those with the Delta and Omicron BA.1 variant compared to BA.4/5.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1294261/fullCOVID-19hospitalizationDeltaOmicronBA.1BA.4 |
| spellingShingle | Maja Sočan Maja Mrzel Katarina Prosenc Miša Korva Tatjana Avšič-Županc Mario Poljak Maja M. Lunar Tina Zupanič Comparing COVID-19 severity in patients hospitalized for community-associated Delta, BA.1 and BA.4/5 variant infection Frontiers in Public Health COVID-19 hospitalization Delta Omicron BA.1 BA.4 |
| title | Comparing COVID-19 severity in patients hospitalized for community-associated Delta, BA.1 and BA.4/5 variant infection |
| title_full | Comparing COVID-19 severity in patients hospitalized for community-associated Delta, BA.1 and BA.4/5 variant infection |
| title_fullStr | Comparing COVID-19 severity in patients hospitalized for community-associated Delta, BA.1 and BA.4/5 variant infection |
| title_full_unstemmed | Comparing COVID-19 severity in patients hospitalized for community-associated Delta, BA.1 and BA.4/5 variant infection |
| title_short | Comparing COVID-19 severity in patients hospitalized for community-associated Delta, BA.1 and BA.4/5 variant infection |
| title_sort | comparing covid 19 severity in patients hospitalized for community associated delta ba 1 and ba 4 5 variant infection |
| topic | COVID-19 hospitalization Delta Omicron BA.1 BA.4 |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1294261/full |
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