A comparison of severity of illness between the SARS-CoV-2 Omicron variant and Delta variant

Abstract Background: The COVID-19 pandemic has disproportionally affected traditionally marginalized groups. Both the Delta and Omicron variants raised concern amongst public health officials due to potentially higher infectivity rates and disease severity than prior variants. This study sought to...

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Main Authors: Laura Peyton Ellis, Olivia Hess, Khoa Le Anh Huynh, Gonzalo Bearman, Le Kang, Christopher D. Doern
Format: Article
Language:English
Published: Cambridge University Press 2023-01-01
Series:Antimicrobial Stewardship & Healthcare Epidemiology
Online Access:https://www.cambridge.org/core/product/identifier/S2732494X23004539/type/journal_article
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author Laura Peyton Ellis
Olivia Hess
Khoa Le Anh Huynh
Gonzalo Bearman
Le Kang
Christopher D. Doern
author_facet Laura Peyton Ellis
Olivia Hess
Khoa Le Anh Huynh
Gonzalo Bearman
Le Kang
Christopher D. Doern
author_sort Laura Peyton Ellis
collection DOAJ
description Abstract Background: The COVID-19 pandemic has disproportionally affected traditionally marginalized groups. Both the Delta and Omicron variants raised concern amongst public health officials due to potentially higher infectivity rates and disease severity than prior variants. This study sought to compare disease severity between adults infected with the Omicron variant and adults infected with the Delta variant who presented to the Emergency Department at an academic, safety-net hospital in Virginia. Methods: This retrospective cohort study used electronic medical record data of patients who presented to the Emergency Department and received a positive SARS-CoV-2 test between September 1, 2021, and January 31, 2022. Positive tests were stratified by genotypic variant through whole genome sequencing. Participants with the Omicron variant were propensity scores matched with individuals with the Delta variant. Results: Among 500 Delta and 500 Omicron participants, 279 propensity score-matched pairs were identified. Participants were predominantly unvaccinated, with medical comorbidities, and self-identified as Black. Individuals infected with the Delta variant had more severe disease compared to those with the Omicron variant, regardless of vaccination status. Patients with kidney, liver, and respiratory disease, as well as cancer, are at higher risk for severe disease. Patients with 2 doses of COVID-19 immunization trended toward less severe disease. Conclusions: Overall, these data further support the literature regarding the disproportionate effects of the COVID-19 pandemic on vulnerable patient populations – such as those with limited access to care, people of color, and those with chronic medical conditions – and can be used to inform public health interventions.
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spelling doaj.art-a46113170f434f39a78e5396c473ba1a2023-10-27T09:04:36ZengCambridge University PressAntimicrobial Stewardship & Healthcare Epidemiology2732-494X2023-01-01310.1017/ash.2023.453A comparison of severity of illness between the SARS-CoV-2 Omicron variant and Delta variantLaura Peyton Ellis0https://orcid.org/0009-0007-0287-400XOlivia Hess1https://orcid.org/0000-0003-2237-9069Khoa Le Anh Huynh2Gonzalo Bearman3Le Kang4Christopher D. Doern5https://orcid.org/0000-0003-2454-4355Obstetrics and Gynecology Residency Program, University of Connecticut, Farmington, CT, USASchool of Medicine, Virginia Commonwealth University, Richmond, VA, USADepartment of Biostatistics, Virginia Commonwealth University, Richmond, VA, USARichard P. Wenzel Professor of Medicine, Chair, Division of Infectious Diseases, Virginia Commonwealth University, Richmond, VA, USA Antimicrobial Stewardship and Healthcare Epidemiology, Cambridge University Press, Cambridge, UKDepartment of Biostatistics, Virginia Commonwealth University, Richmond, VA, USAMicrobiology & Pathology and Pediatrics, Virginia Commonwealth University, Richmond, VA, USA Abstract Background: The COVID-19 pandemic has disproportionally affected traditionally marginalized groups. Both the Delta and Omicron variants raised concern amongst public health officials due to potentially higher infectivity rates and disease severity than prior variants. This study sought to compare disease severity between adults infected with the Omicron variant and adults infected with the Delta variant who presented to the Emergency Department at an academic, safety-net hospital in Virginia. Methods: This retrospective cohort study used electronic medical record data of patients who presented to the Emergency Department and received a positive SARS-CoV-2 test between September 1, 2021, and January 31, 2022. Positive tests were stratified by genotypic variant through whole genome sequencing. Participants with the Omicron variant were propensity scores matched with individuals with the Delta variant. Results: Among 500 Delta and 500 Omicron participants, 279 propensity score-matched pairs were identified. Participants were predominantly unvaccinated, with medical comorbidities, and self-identified as Black. Individuals infected with the Delta variant had more severe disease compared to those with the Omicron variant, regardless of vaccination status. Patients with kidney, liver, and respiratory disease, as well as cancer, are at higher risk for severe disease. Patients with 2 doses of COVID-19 immunization trended toward less severe disease. Conclusions: Overall, these data further support the literature regarding the disproportionate effects of the COVID-19 pandemic on vulnerable patient populations – such as those with limited access to care, people of color, and those with chronic medical conditions – and can be used to inform public health interventions. https://www.cambridge.org/core/product/identifier/S2732494X23004539/type/journal_article
spellingShingle Laura Peyton Ellis
Olivia Hess
Khoa Le Anh Huynh
Gonzalo Bearman
Le Kang
Christopher D. Doern
A comparison of severity of illness between the SARS-CoV-2 Omicron variant and Delta variant
Antimicrobial Stewardship & Healthcare Epidemiology
title A comparison of severity of illness between the SARS-CoV-2 Omicron variant and Delta variant
title_full A comparison of severity of illness between the SARS-CoV-2 Omicron variant and Delta variant
title_fullStr A comparison of severity of illness between the SARS-CoV-2 Omicron variant and Delta variant
title_full_unstemmed A comparison of severity of illness between the SARS-CoV-2 Omicron variant and Delta variant
title_short A comparison of severity of illness between the SARS-CoV-2 Omicron variant and Delta variant
title_sort comparison of severity of illness between the sars cov 2 omicron variant and delta variant
url https://www.cambridge.org/core/product/identifier/S2732494X23004539/type/journal_article
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