Clin Infect Dis
. 2023 May 31;ciad276.
doi: 10.1093/cid/ciad276. Online ahead of print. Changing Severity and Epidemiology of Adults Hospitalized With Coronavirus Disease 2019 (COVID-19) in the United States After Introduction of COVID-19 Vaccines, March 2021-August 2022
Noah Kojima 1 , Katherine Adams 1 , Wesley H Self 2 , Manjusha Gaglani 3 , Tresa McNeal 4 , Shekhar Ghamande 4 , Jay S Steingrub 5 , Nathan I Shapiro 6 , Abhijit Duggal 7 , Laurence W Busse 8 , Matthew E Prekker 9 , Ithan D Peltan 10 , Samuel M Brown 10 , David N Hager 11 , Harith Ali 11 , Michelle N Gong 12 , Amira Mohamed 13 , Matthew C Exline 14 , Akram Khan 15 , Jennifer G Wilson 16 , Nida Qadir 17 , Steven Y Chang 17 , Adit A Ginde 18 , Cori A Withers 18 , Nicholas M Mohr 19 , Christopher Mallow 20 , Emily T Martin 21 , Adam S Lauring 22 23 , Nicholas J Johnson 24 , Jonathan D Casey 25 , William B Stubblefield 26 , Kevin W Gibbs 27 , Jennie H Kwon 28 , Adrienne Baughman 26 , James D Chappell 29 , Kimberly W Hart 30 , Ian D Jones 26 , Jillian P Rhoads 31 , Sydney A Swan 30 , Kelsey N Womack 31 , Yuwei Zhu 30 , Diya Surie 32 , Meredith L McMorrow 32 , Manish M Patel 1 , Mark W Tenforde 1 ; Investigating Respiratory Viruses in the Acutely Ill (IVY) Network
Collaborators, Affiliations
Introduction: Understanding the changing epidemiology of adults hospitalized with coronavirus disease 2019 (COVID-19) informs research priorities and public health policies.
Methods: Among adults (≥18 years) hospitalized with laboratory-confirmed, acute COVID-19 between 11 March 2021, and 31 August 2022 at 21 hospitals in 18 states, those hospitalized during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron-predominant period (BA.1, BA.2, BA.4/BA.5) were compared to those from earlier Alpha- and Delta-predominant periods. Demographic characteristics, biomarkers within 24 hours of admission, and outcomes, including oxygen support and death, were assessed.
Results: Among 9825 patients, median (interquartile range [IQR]) age was 60 years (47-72), 47% were women, and 21% non-Hispanic Black. From the Alpha-predominant period (Mar-Jul 2021; N = 1312) to the Omicron BA.4/BA.5 sublineage-predominant period (Jun-Aug 2022; N = 1307): the percentage of patients who had ≥4 categories of underlying medical conditions increased from 11% to 21%; those vaccinated with at least a primary COVID-19 vaccine series increased from 7% to 67%; those ≥75 years old increased from 11% to 33%; those who did not receive any supplemental oxygen increased from 18% to 42%. Median (IQR) highest C-reactive protein and D-dimer concentration decreased from 42.0 mg/L (9.9-122.0) to 11.5 mg/L (2.7-42.8) and 3.1 mcg/mL (0.8-640.0) to 1.0 mcg/mL (0.5-2.2), respectively. In-hospital death peaked at 12% in the Delta-predominant period and declined to 4% during the BA.4/BA.5-predominant period.
Conclusions: Compared to adults hospitalized during early COVID-19 variant periods, those hospitalized during Omicron-variant COVID-19 were older, had multiple co-morbidities, were more likely to be vaccinated, and less likely to experience severe respiratory disease, systemic inflammation, coagulopathy, and death.
Keywords: COVID-19; SARS-CoV-2; death; hospitalization; severe disease.
. 2023 May 31;ciad276.
doi: 10.1093/cid/ciad276. Online ahead of print. Changing Severity and Epidemiology of Adults Hospitalized With Coronavirus Disease 2019 (COVID-19) in the United States After Introduction of COVID-19 Vaccines, March 2021-August 2022
Noah Kojima 1 , Katherine Adams 1 , Wesley H Self 2 , Manjusha Gaglani 3 , Tresa McNeal 4 , Shekhar Ghamande 4 , Jay S Steingrub 5 , Nathan I Shapiro 6 , Abhijit Duggal 7 , Laurence W Busse 8 , Matthew E Prekker 9 , Ithan D Peltan 10 , Samuel M Brown 10 , David N Hager 11 , Harith Ali 11 , Michelle N Gong 12 , Amira Mohamed 13 , Matthew C Exline 14 , Akram Khan 15 , Jennifer G Wilson 16 , Nida Qadir 17 , Steven Y Chang 17 , Adit A Ginde 18 , Cori A Withers 18 , Nicholas M Mohr 19 , Christopher Mallow 20 , Emily T Martin 21 , Adam S Lauring 22 23 , Nicholas J Johnson 24 , Jonathan D Casey 25 , William B Stubblefield 26 , Kevin W Gibbs 27 , Jennie H Kwon 28 , Adrienne Baughman 26 , James D Chappell 29 , Kimberly W Hart 30 , Ian D Jones 26 , Jillian P Rhoads 31 , Sydney A Swan 30 , Kelsey N Womack 31 , Yuwei Zhu 30 , Diya Surie 32 , Meredith L McMorrow 32 , Manish M Patel 1 , Mark W Tenforde 1 ; Investigating Respiratory Viruses in the Acutely Ill (IVY) Network
Collaborators, Affiliations
- PMID: 37255285
- DOI: 10.1093/cid/ciad276
Introduction: Understanding the changing epidemiology of adults hospitalized with coronavirus disease 2019 (COVID-19) informs research priorities and public health policies.
Methods: Among adults (≥18 years) hospitalized with laboratory-confirmed, acute COVID-19 between 11 March 2021, and 31 August 2022 at 21 hospitals in 18 states, those hospitalized during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron-predominant period (BA.1, BA.2, BA.4/BA.5) were compared to those from earlier Alpha- and Delta-predominant periods. Demographic characteristics, biomarkers within 24 hours of admission, and outcomes, including oxygen support and death, were assessed.
Results: Among 9825 patients, median (interquartile range [IQR]) age was 60 years (47-72), 47% were women, and 21% non-Hispanic Black. From the Alpha-predominant period (Mar-Jul 2021; N = 1312) to the Omicron BA.4/BA.5 sublineage-predominant period (Jun-Aug 2022; N = 1307): the percentage of patients who had ≥4 categories of underlying medical conditions increased from 11% to 21%; those vaccinated with at least a primary COVID-19 vaccine series increased from 7% to 67%; those ≥75 years old increased from 11% to 33%; those who did not receive any supplemental oxygen increased from 18% to 42%. Median (IQR) highest C-reactive protein and D-dimer concentration decreased from 42.0 mg/L (9.9-122.0) to 11.5 mg/L (2.7-42.8) and 3.1 mcg/mL (0.8-640.0) to 1.0 mcg/mL (0.5-2.2), respectively. In-hospital death peaked at 12% in the Delta-predominant period and declined to 4% during the BA.4/BA.5-predominant period.
Conclusions: Compared to adults hospitalized during early COVID-19 variant periods, those hospitalized during Omicron-variant COVID-19 were older, had multiple co-morbidities, were more likely to be vaccinated, and less likely to experience severe respiratory disease, systemic inflammation, coagulopathy, and death.
Keywords: COVID-19; SARS-CoV-2; death; hospitalization; severe disease.